Homelessness, inclusion health, and gender

The subject of ‘inclusion health’ has gained increasing prominence in both homelessness and health policy discourses across the United Kingdom in recent years. This Housing Futures essay reflects on the drivers underpinning and key debates associated with its rapid ascendance in policy. Against that backdrop, the essay then draws upon a UK-wide qualitative study examining the experiences of one particular inclusion health cohort, this being women affected by ‘severe and multiple disadvantage’ (SMD). It argues that their experiences of each of the main SMD domains (homelessness, substance use, and involvement with the criminal justice system) are highly gendered. It also casts light on the horrifying extent to which violence has featured throughout these women’s lives, usually since childhood. The essay disentangles the reasons why women affected by SMD often downplay and/or conceal the severity of their circumstances, and documents how most services fail to respond in a sufficiently trauma- and gender-informed way. It concludes with a call for greater cross-sectoral sharing of both responsibility and risk in addressing unmet needs, arguing that until this is achieved many vulnerable women will remain caught in a pernicious cycle of exclusion and exploitation.