Health and well-being of the homeless in South African cities and towns

Figures & data

Table 1: Summary of key informants and focus group participants

Description	Key informants	Focus groups (10–16 in each group)
Municipal officials	4
Shelter staff (executive, managers, fieldworkers)	12
Homeless support groups (feeding, training)	8
Adults living in shelters (male and female separately)		3
Adults living on the street (male and female separately)		3
Children/youth living in shelters (boys and girls separately)		3
Children/youth living on the street (boys and girls separately)		3

Figure 1: Age distribution of the Cape Town shelter population

Table 2: Summary of types of injury and assault (in the past six months)

Causes of injury	Child (<18 years)	Adult (≥18 years)
Beaten up	34 (51.5%)	100 (47.4%)
Stabbed	16 (24.2%)	46 (21.8%)
Hit by vehicle while a pedestrian	5 (7.6%)	23 (10.9%)
Vehicle accident while passenger or driver	0	12 (5.7%)
Sexually assaulted	5 (7.6%)	11 (5.2%)
Injured at work	0	12 (5.7%)
Shot	1 (1.5%)	8 (3.8%)
Other (including undefined injuries and falls)	6 (9.1%)	13 (6.2%)
Total	66	211
Percentage of overall sample injured or assaulted	22.0%	22.5%

Table 3: Disability reported by children under 18 years old

Description of disability	No difficulty	Yes, some difficulty	Yes, a lot of difficulty	Cannot do at all
Difficulty seeing, even if wearing glasses?	267 (87.5%)	29 (9.5%)	9 (3.0%)	0
Difficulty hearing, even if using a hearing aid?	278 (91.1%)	18 (5.9%)	9 (3.0%)	0
Difficulty walking or climbing stairs?	290 (95.1%)	13 (4.3%)	2 (0.7%)	0
Difficulty remembering or concentrating?	287 (94.1%)	17 (5.6%)	0	0
Difficulty with self-care such as washing all over or dressing?	291 (95.4%)	11 (3.6%)	3 (1.0%)	0
Difficulty communicating because of a physical, mental or emotional health condition (e.g. understanding others or others understanding you)?	290 (95.1%)	15 (4.9%)	0	0

Table 4: Disability reported by adults aged 18 and over

Description of disability	No difficulty	Yes, some difficulty	Yes, a lot of difficulty	Cannot do at all
Difficulty seeing, even if wearing glasses?	759 (80.7%)	141 (15.0%)	40 (4.3%)	0
Difficulty hearing, even if using a hearing aid?	835 (88.6%)	90 (9.6%)	16 (1.7%)	1 (0.1%)
Difficulty walking or climbing stairs?	804 (85.4%)	98 (10.4%)	38 (4.0%)	1 (0.1%)
Difficulty remembering or concentrating?	847 (90.7%)	78 (8.4%)	9 (1.0%)	0
Difficulty with self-care such as washing all over or dressing?	807 (85.9%)	97 (10.3%)	33 (3.5%)	3 (0.3%)
Difficulty communicating because of a physical, mental or emotional health condition (for example, understanding others or others understanding you)?	869 (92.3%)	61 (6.5%)	11 (1.2%)	0

Table 5: Self-reported symptoms of mental illness

Respondents reporting symptoms of depression (‘At any time in the last 30 days have you felt sad, empty or depressed for a period lasting several days?’)	Child (<18 years)	Adult (≥18 years)
Never	169 (55.4%)	393 (41.7%)
Some of the time	84 (27.5%)	279 (29.6%)
A lot of the time	37 (12.1%)	133 (14.1%)
Most of the time	10 (3.3%)	92 (9.8%)
All the time	5 (1.6%)	45 (4.8%)
Total	305	942

Table 6: Self-reported drug use

	Child (<18 years)	Adult (≥18 years)
Those who had ever used recreational drugs	121 (37.0%)	217 (23.1%)
Current drug use; that is, during the past three months (multiple responses possible)	121 (37.0%)	206 (21.9%)
Dagga (marijuana)	71 (23.3%)	174 (18.5%)
Glue, thinners, petrol	79 (25.9%)	33 (3.5%)
Mandrax	15 (4.9%)	14 (1.5%)
Heroin	8 (2.6%)	8 (0.8%)
Tik	8 (2.6%)	11 (1.2%)
Ecstasy	6 (2.0%)	9 (1.0%)
Other	14 (4.6%)	14 (1.5%)

Table 7: Self-reported alcohol use

	Child (<18 years)	Adult (≥18 years)
Drinking alcohol two to three times per week or more	11 (3.7%)	201 (21.4%)
Number of drinks consumed when drinking
1 or 2	20 (36.4%)	119 (27.1%)
3 or 4	19 (34.5%)	163 (37.1%)
5 or 6	12 (21.8%)	78 (17.8%)
7, 8 or 9	0	38 (8.7%)
10 or more	1 (1.8%)	27 (6.2%)
Don't know	3 (1.0%)	14 (3.2%)
Frequency of drinking six or more drinks on one occasion for those who drink
Never	17 (30.9%)	133 (30.3%)
Less than monthly	8 (14.5%)	84 (19.1%)
Monthly	13 (23.6%)	88 (20%)
Weekly	13 (23.6%)	88 (20.0%)
Daily or almost daily	1 (1.8%)	50 (11.4%)
Don't know	3 (3.5%)	9 (2.1%)

Table 8: Assessment of potentially hazardous drinking among adults

	Male	Female
Hazardous drinkers (AUDIT≥10)	203 (25.0%)	25 (19.8%)
Non hazardous drinkers (AUDIT<10)	610 (75.0%)	101 (80.2%)
Total	813	126
AUDIT, Alcohol Use Disorders Identification Test (WHO, 1992).

Table 9: Reported use of and satisfaction with health services during the past three months

Health services	Children making use of service (<18 years)	Of those children using service, proportion dissatisfied (<18 years)	Adults making use of service (≥18 years)	Of those adults using service, proportion dissatisfied (≥18 years)
Government hospital/government clinic	45 (14.8%)	3 (6.8%)	238 (25.3%)	25 (11.2%)
Day hospital	10 (3.3%)	2 (20%)	87 (9.3%)	14 (16.3%)
Retail pharmacy	6 (2.0%)	1 (16.7%)	55 (5.8%)	4 (7.4%)
Faith healer	–	–	21 (2.2%)	0
Traditional healer or herbalist	–	–	27 (2.9%)	1 (3.7%)
Home-based care services/house visit/treatment at a shelter	–	–	10 (1.1%)	1 (10.0%)
Dentist/oral hygienist/oral therapist	–	–	12 (1.3%)	0
Private doctor	–	–	13 (1.4%)	0

Figure 2: Prevalence of tuberculosis in homeless males compared with the general population

Table 10: Self-reported chronic illness by age group (percentage of persons reporting they had been told by a doctor or nurse that they had the condition)

Age group (years)	High blood pressure		Heart attack/angina		Stroke		High blood cholesterol		Diabetes or blood sugar		Emphysema or bronchitis		Asthma		Tuberculosis		Cancer
	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS
Male
15–24	2.1	1.7	1.4	1.2		0.1	0.7	0.2	1.4	1.3	2.1	0.8	0.7	1.9	2.8	1.8	0.7	0.5
25–34	2.3	2.9	2.3	2.0	1.5	0.7	2.3	0.6	1.1	0.4	1.9	1.1	3.1	2.7	5.7	3.4	1.9	0.1
35–44	8.2	10.6	2.1	2.4	0.5	0.5	2.1	3.5	3.1	1.8	2.1	1.7	3.1	2.4	8.8	3.0	1.0	0.2
45–54	10.9	18.2	3.9	4.4	2.3	1.0	1.6	6.3	3.9	5.9	3.9	4.3	3.1	4.1	8.5	6.1		1.1
55–64	20.6	17.9	1.6	5.1		4.8	1.6	1.7	1.6	7.0	6.3	5.2	7.9	5.5	11.1	3.9		1.0
65+	14.3	26.2	4.8	7.0		1.5		2.9	9.5	5.2		2.3		5.4	9.5	6.7		1.8
Female
15–24	3.0	3.1		0.9	6.1	0.0		0.8		0.4		1.0	3.0	2.7		1.9		0.4
25–34	7.9	8.8	2.6	2.5		0.1	5.3	0.9	2.6	1.1	2.6	1.6	7.9	3.5	5.3	1.2		0.9
35–44	23.5	19.2	8.8	2.9		1.0	8.8	2.3	2.9	2.9	5.9	2.2	2.9	5.1	14.7	2.6	5.9	0.6
45–54	46.7	33.5	13.3	7.8	6.7	1.6	13.3	3.7	13.3	6.7		4.1		5.8		3.2		1.1
55–64	50.0	40.1	16.7	8.2	16.7	3.6	16.7	4.8		12.5	16.7	4.8	16.7	6.7		1.9		2.0
65+		41.4		7.6		2.3		3.3		8.6		5.4		5.5		3.5		0.9
Comparison of the homeless population (Human Sciences Research Council Survey) with a nationally representative sample (South Africa Demographic and Health Survey 2003; Department of Health et al., 2004). H = HSRC homelessness survey; DHS = South Africa Demographic and Health Survey 2003. Boxed and bolded cells indicate excess morbidity in the homeless population relative to the general population (South Africa Demographic and Health Survey 2003). Excess morbidity in females aged 55–64 should be interpreted with caution owing to the small sample size (n = 6).

Table 11: Self-reported chronic illness by population group (percentage of persons reporting that they had been told by a doctor or nurse that they had the condition)

Population group	High blood pressure		Heart attack/angina		Stroke		High blood cholesterol		Diabetes or blood sugar		Emphysema or bronchitis		Asthma		Tuberculosis		Cancer
	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS	H	DHS
Male
African	6.7	6.9	2.4	2.8	1.0	0.9	1.7	1.0	2.2	1.8	2.6	1.7	3.1	2.5	6.9	3.6	1.0	0.3
Coloured	5.9	15.3	0.0	2.1	0.0	1.5	5.9	3.8	11.8	3.1	5.9	3.2	0.0	3.9	11.8	4.4	0.0	0.8
White	15.4	23.3	0.0	0.9	0.0	0.3	0.0	9.8	0.0	8.6	0.0	3.7	0.0	8.0	0.0	1.2	0.0	4.6
Female
African	16.2	18.9	6.0	4.1	3.4	0.9	6.8	1.5	3.4	3.6	3.4	1.9	4.3	3.8	5.1	2.1	1.7	0.7
Coloured	33.3	24.0	0.0	2.8	0.0	1.0	0.0	2.9	0.0	5.5	0.0	5.1	11.1	8.5	11.1	5.1	0.0	1.4
Comparison of the homeless population (Human Sciences Research Council Survey) with a nationally representative sample (South Africa Demographic and Health Survey 2003; Department of Health et al., 2004). H = HSRC homelessness survey; DHS = South Africa Demographic and Health Survey 2003. Boxed and bolded cells indicate excess morbidity in the homeless population relative to the general population (South Africa Demographic and Health Survey 2003).