From disparity to empowerment
Transforming cancer care for people experiencing homelessness
Lee Smith is Professor of Public Health at ARU. He carries out work to improve wellbeing in the workplace and in education, and the health of under-represented groups such as the homeless.
The Cancerless project, featured here, focused on health inequalities and addressing the cancer-related mortality rate among those experiencing homelessness.
Background and motivation
Cancer-related mortality among people experiencing homelessness is twice as high as that of the general population. The Cancerless project was initiated to address this alarming disparity through health navigation and patient empowerment. The project aimed to support people experiencing homelessness in accessing healthcare, participating in cancer screening, and tackling behaviours that increase cancer risk.
The project developed a novel solution to help those experiencing homelessness navigate healthcare systems and empower them to take control of their health. This research is part of a broader effort to address health inequalities and reduce the health disparity gap at regional, national, and international levels.
"Cancerless... aimed to support people experiencing homelessness in accessing healthcare, participating in cancer screening, and tackling behaviours that increase cancer risk."
Research process
The project employed a health navigator and patient empowerment model, developed through a series of studies that embedded patient and public involvement techniques. This model was piloted and evaluated across four European countries: England, Spain, Greece, and Austria.
One of the biggest challenges was recruiting those experiencing homelessness into the study. This population is often reluctant to engage with healthcare professionals due to negative past experiences. To overcome this, the project team spent several months building trust with the clients.
Findings
The project observed an increase in cancer screening uptake among those experiencing homelessness. The study produced a novel intervention that supports this population in navigating healthcare pathways and empowers them to take care of their own health. This model is now being rolled out across several sites in the East of England, moving from research to implementation.
"The project employed a health navigator and patient empowerment model... and observed an increase in cancer screening uptake."
Collaboration
The Cancerless project was a €2.2 million Horizon 2020 funded initiative, involving collaboration between multiple academic institutions and hostels across four European countries.
Future directions
The project has now transitioned to implementation across several sites in the East of England, with funding for two years. The team will continue to monitor and evaluate its impact, with hopes of extending the funding and rolling out the intervention in other UK localities. Additionally, the model has the potential to be used for other underrepresented populations and various clinical physical or mental health conditions.
The long-term vision for the Cancerless project is to continue its implementation beyond the current two-year period and expand the model to other areas of the UK. The team also hopes to test the model in different settings to address various health inequalities.
