gms | German Medical Science

Background: Homelessness is recognized as a multifaceted hazard to human health. It is closely associated with premature mortality and an increased prevalence of various pathological conditions. As of 2020, around 1.6 billion people lived in inadequate housing conditions globally. Despite a general rise in global wealth over the recent decades, however, a critical rise in homelessness is observed.

Structural and individual risk-factors are considered determinants for producing and sustaining homelessness. These apply to individuals who are suffering from poverty and low socio-economic status. Meanwhile, wealth inequality is on a constant surge in most countries. A call for political action in conjunction with hands-on initiatives to prevent, redress and alleviate homelessness appears warranted.

The keynote presentation provided insights into health data and structural issues of homeless people from Lahore, Pakistan. Dr. Atif Bilal Aslam is an associate Professor at the University of Engineering & Technology in Lahore Pakistan, where he teaches research methodology, comprehensive urban planning, as well as project planning and management. This international frame of reference was subsequently complemented by the reports of Ms. Pempel and Mr. Doering, two social workers from the cities of Bochum and Dortmund, who shared their practical experience from the field. This was concluded by two real life reports by Ms. Yahiaoui and Ms. Frantzen, two affected individuals from the city of Dortmund who provided first-hand experience and insights on homelessness. Each contribution was followed by a plenary discussion.

Contributions:

• Dr. Atif Bilal Aslam: The Vicious Circle of Homelessness and Urban Health: A Study of Homeless People in Lahore, Pakistan.
• Bianka Pempel, Michael Doering: Reports from the field.
• Ms. Yahiaoui, Ms. Frantzen: Reports of experience as affected individuals.

Plenary discussion & perspective: A need for a more differentiated and consensus-based framework of definitions was initially stated, due to diverse circumstances for people suffering from inadequate housing conditions. This would constitute a necessary basis for communication between stakeholders in science, policy and practice.

It was further emphasized that the lack of availability of legal documents for affected people is a common issue in Pakistan and the Ruhr area of Germany. The main reasons are the absence of acknowledgement in the administration and bureaucratic obstacles. This results in an impediment to recourse to welfare services and an aggravation of the living conditions.

The concept of “billbeds” from Pakistan was newly introduced and raised significant interest. It comprises commercial billboards that can be transformed into sleeping accommodations for homeless individuals at night. This project was successfully implemented in the city of Lahore as a pilot program, financed by an advertising company.

A key take-away was the imperative for participatory research projects to gain a more comprehensive understanding of urban health regarding the needs of the homeless population. The results are expected to provide a basis for the development of extensive health care services.

A first follow-up project was initiated by Leonie Wieners of the Hochschule Bochum with Atif Bilal Aslam from the University of Engineering & Technology of Lahore. The project aims to conceptualize and apply a survey targeted specifically to homeless participants of the Ruhr region and derive indicatory data that may be implemented in urban development programs.