The recent rise in homelessness has its roots in welfare reform and the housing market, almost entirely accounted for by an increase in families losing their privately-rented housing, experts have said.
The number of people officially recorded as sleeping on the streets of England rose from 1,768 in 2010 to 4,751 in 2017, but charities estimate the true figure to be more than double this.
Writing in the BMJ, Mark Fransham and Danny Dorling of the University of Oxford warn of the serious health implications of sleeping rough.
These include respiratory conditions, depression, anxiety, accidents and excess winter mortality.
When last calculated, single homeless people had an average age at death of 47 years, compared with 77 years for the general population.
Sleeping rough can also take its toll on mental health, they said.
They wrote that the rise can be seen alongside an increase in homeless families housed by local authorities in temporary accommodation, rising from 50,000 in 2010 to 78,000 in 2017.
In London alone, there are an estimated 225,000 “hidden homeless” aged 16-25, who move around, being put up by friends or family.
Likely causes for the huge hike in homelessness include upward pressure on housing costs coupled with reduced availability of affordable social housing since the early 1980s, they said.
Reduced funding for supporting vulnerable people with their housing – cut by 59% in real terms since 2010 – and restrictions on housing benefit for lower income families have also contributed, they said.
The pair added that improving services for vulnerable people and creating more affordable housing would help reverse the problem.
They described several initiatives, such as the development of specialist healthcare services for the homeless, and the “housing first” model, which provides a secure tenancy for rough sleepers before associated issues like substance misuse and ill health are addressed.
They said this approach has been given some of the credit for the success seen in Finland, the only European country where homelessness has recently fallen.
It is now being piloted in Liverpool, Manchester and Birmingham, with estimated potential savings of up to £5 million a year.
“What is needed is a comprehensive strategy that improves services for vulnerable people, an increased supply of affordable housing, more security of tenancies, adequate cash benefits to cover the rising cost of housing and more efficient use of our existing housing stock,” they wrote.
Data showing the steep rise in rough sleepers was released by the Ministry of Housing, Communities and Local Government (MHCLG) last week.
It is the highest number since comparable records began in 2010.
Charities condemned the trend as a “catastrophe” and have called on the Government to step up its work to help those in such a predicament.
A Government spokesman said: “Tackling homelessness is a complex issue with no single solution but we are investing £1bn to support those left with nowhere to go, plus more than £9bn to deliver the affordable properties our country needs.
“We are also bringing the most ambitious reform in decades through the Homelessness Reduction Act to ensure people get support they need before they become homeless, as well as helping rough sleepers with the most complex needs off the streets through a new Housing First approach.
“We’re also making sure that the welfare system protects the most vulnerable and restores fairness in our society and we continue to spend £24bn a year helping people with their housing costs.”