Homeless children twice as likely to need emergency hospitalisation

Homeless children are twice as likely to require emergency hospitalisation and have a higher risk of scabies, obesity, scalds, abuse and sexually transmitted infections, a consultant paediatrician has said.

Dr Ellen Crushell, clinical lead of the Health Service Executive's national clinical programme for paediatrics, said an increasing number of homeless children were presenting at Temple Street Children's University Hospital in Dublin and that some families were using its emergency department as a primary care service.

"Parents in overcrowded homes are less responsive to their children's needs compared to families in non-crowded but similar-income housing," she told a housing conference hosted by Maynooth University on Thursday.

These children had been the most disadvantaged by the Covid-19 pandemic, with the removal of school supports and “less access to supportive adults outside the immediate family”, she said.

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Pandemic conditions

“It has been well-publicised how alcohol intake and child-reported domestic violence increased during the pandemic.”

She said babies born into homelessness were disadvantaged before birth as they were less likely to be breast-fed and more likely to face exposure to alcohol and tobacco in utero and infections like HIV or hepatitis.

Homeless toddlers were also particularly prone to burns and scalds, often from pulling over kettles in hotel rooms, and obesity was the most common “nutritional problem” due to their diets, she said.

“Homeless children get more colds and ear infections, they are more prone to skin infestations. Homeless adolescents are at increased risk of sexually transmitted infections,” Dr Crushell said.

Temple Street

A new service, staffed by Temple Street doctors and nurses, was established in October to address the health needs of marginalised children, and to reduce attendance at the emergency department.

Taxis are provided to bring families to appointments and “multiple phone calls” are made to encourage attendance.

“If the child fails to attend they are given a slot in the very next clinic and only 5 per cent fail to attend that,” she said.

Of those attending the clinic, 75 per cent are in homeless accommodation, more than 60 per cent have incomplete or no vaccinations, and 42 per cent had been using the children’s emergency department as their main source of primary care.