How does one recover from a long life on the street that is so harmful for one’s health? Street Nurses have a simple answer: a home of your own is essential for survival and for long term health. Because homelessness is much more than a social problem – it’s a public health problem.

In 2021, 76 people died on the street as a consequence of having lived there for a long time. The average age of homeless people is 50, whereas the average age of Belgians is around 80. What’s the reason why people living on the street die so young?

clé en main

A glance at the statistics of Street Nurses gives an initial answer to that question: out of the 61 people we followed closely in Brussels at the end of 2021 (both on the street and in their homes), 46 suffered from chronic physical health problems, 47 had mental health problems, 48 admitted being addicted and 80% among them (almost 50 people) simultaneously had two of these three issues. Collectively, they had 114 diseases, 15% of which affected digestion, 13%  breathing and 13% blood circulation


Autopsies are rarely performed

If we then look at the main causes of death, as far as confirmed by diagnoses or autopsies (rarely performed in Belgium), we see many deaths caused by agression and suicide, overdoses and the consequences of chronic alcohol abuse. In addition, deaths can be attributed to weather conditions: hypothermia in winter and dehydration during heat waves. Thanks to the “Winter Plan” there are, however, not more deaths in winter than in summer.

Whatever the causes, the remedy is simple according to Pierre Ryckmans, medical coordinator at Street Nurses: “Housing is part of the treatment – an essential element for survival and long run health protection. Because, in their homes, people find the necessary privacy to take care of themselves, safety, weather protection, better sleeping and feeding conditions, easier physical care and medical follow-up, stronger self-confidence, eventually fewer addicitions, etc. The health advantages are clear and obvious.”

Travailleurs se rendent chez un patient

Housing = less risk

He adds: “We know that much risk is already reduced as soon as we can give people a new home – and the longer they stay there, risk reduces even further. That’s true for risk related to alcohol and drug abuse, as well as mental health problems. Some risk reduces very quickly: aggression, accidents, weather conditions (heat, cold). Extrapolating, you could say that work only starts once the people have found a home, even if some action was already undertaken before on the street.”

At Street Nurses, we also see, however, an increase of health risk during the first months after housing. The main reason is that people, once in their own home, completely change their habits, which can, temporarily, create a bigger health risk.

“Long term, a lot of work must be done. Sometimes,  cancer is diagnosed. Not as a consequence of housing, but because the patient didn’t notice the symptoms before. Simply because there were so many other things to think of in the struggle for survival. As soon as s/he has found safe shelter that becomes less of a pressing problem and other issues surface that went unnoticed before.

Fortunately, we see that these people’s health is in fact less problematic. And that’s good news”, says Pierre Ryckmans.

Even with all these data at our disposal, nobody actually has a good overview of the causes of death in Brussels, neither among people living on the street, nor among those having a home. We think, therefore, that more systematic research is needed into the causes of (premature) death. If we don’t know what we’re fighting, we won’t progress.


Provided health care

In 2021, Street Nurses helped 1047 times, either through treatment and advice or referral: these three services being all provided at each contact.

  • Treatment: bandages, cleaning wipes, ointments, massages, showers, pedicures.
  • Advice: food, hygiene, social affairs, etc.
  • Referral: recommend people to visit a medical institution.

For 12 patients, we established contact with a general practitioner - and for 10 patients with a psychiatrist. And, finally, we helped 8 patients to get a health card.

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