JMIR Publications

ABSTRACT

Background:

In the last years, especially since the outbreak of the pandemic, there has been an expansion in using digital technology for personal health and wellbeing. Previous research revealed that these technologies might provide vulnerable populations, including those who are homeless, better access to health services, thus a greater chance of more personalised care. However, less is known about the relations between technology and health among homeless people in Central and Eastern Europe.

Objective:

As part of a series of studies by the Digital Health Research Group at Semmelweis University (Budapest, Hungary) in cooperation with the Hungarian Charity Service of the Order of Malta, this study assessed existing technological resources available for and health-related Internet usage characteristics of homeless groups to set the ground for potential health policy interventions with the aim to enable better access to health services via strengthening digital components of the existing healthcare system.

Methods:

Between 19 April and 11 August 2021, 662 people from 28 institutions providing social services for homeless people in Budapest, Hungary, were surveyed about their access to digital tools, as well as Internet usage patterns. For selected questions, responses of a representative sample of the Hungarian population were used for comparison. Chi-squared test and logistic regression analyses were completed to identify variables affecting Internet use for health-related reasons.

Results:

The results demonstrated a considerable level of Internet usage in the homeless population: 52.9 percent use the Internet frequently, while that is 81.3 percent in the reference group. 69.6 percent of the homeless group reported mobile phone ownership, 39.9 percent added it had a smartphone function. 10.8 percent had already used a health mobile application, and 34.6 percent used the Internet for medical purposes. Based on such characteristics, we were able to identify a broadly defined, digitally engaged group among people experiencing homelessness (n=129, 19.5%). This subpopulation possessed their own resources and was inclined to benefit from digitalization related to their personal health as well. The multivariate analysis demonstrated that Internet use for health reasons was more significant for younger respondents, for women, for those who had higher levels of education, and no chronic conditions.

Conclusions:

Although compared to the general population, health-related Internet usage statistics are lower, our results show that the idea of involving homeless populations in the digital health ecosystem is viable, especially if barriers to access are systematically reduced. The results show that for keeping homeless populations well-ingrained in the social infrastructure, as well as for health prevention purposes for younger generations, digital health services have great promise as another tool in the hands of community shelters.