Addressing Hidden Homelessness: The Cost of Unseen Needs

In the heart of Swansea city centre, John Williams has been selling the Big Issue for over a decade. His work relies on a simple but crucial tool: a pair of glasses. Without them, he experiences debilitating headaches and struggles to perform basic tasks like reading or using a card reader. “Without them I’d get really bad headaches, near enough migraines,” he explains. His story highlights the often-overlooked challenges faced by those experiencing hidden homelessness, which affects a significant portion of the population.

John’s difficulties intensified when his benefits ceased, making access to essential eye care a daunting task. “Sometimes I could get glasses free on benefits, but when that ended it became difficult,” he recounts. Recently homeless and without a fixed address, John found himself excluded from vital services. For many living in temporary accommodations or “sofa surfing,” the lack of stability can make basic healthcare seem unattainable.

According to a study by Crisis, a staggering 95% of people experiencing homelessness are classified as “hidden,” with only 5% sleeping rough. This hidden aspect of homelessness often results in limited access to crucial health services, such as eye and hearing care. The implications are profound, particularly for those on the fringes of society, where even minor obstacles can hinder employment opportunities.

Statistics reveal the extent of the problem. Vision Care reports that one in three individuals experiencing homelessness requires glasses, yet nearly 65% avoid visiting an optician, not out of indifference but due to systemic barriers. John notes, “If you’re moving around, trying to get letters or register anywhere it’s very hard.” His experience reflects that of countless others whose health needs remain unmet due to the hidden nature of their homelessness.

The economic impact of untreated sensory issues is also significant. The British Academy of Audiology estimates that hearing loss costs the UK economy £25 billion annually in lost productivity, disproportionately affecting those in precarious employment situations. For individuals on zero-hours contracts or informal jobs, untreated health issues can lead to immediate dismissal, further entrenching them in poverty.

Compounding these challenges, poverty exacerbates vision and hearing problems. In 2023, Vision Care found that 90% of the 216 people they supported, who were ineligible for NHS treatment, needed glasses, while 14.2% had diagnosable eye conditions—ten times the rate in the general population. A study from Canada indicated that nearly 40% of homeless adults suffered from speech-frequency hearing loss, double the prevalence in the general population.

These statistics illustrate a harsh reality: each represents an individual unable to read a job application, hear an interview question, or perceive an offered hand of assistance. As poverty perpetuates impairment, the cycle continues, making these issues remain invisible until they escalate into a full-blown crisis.

Fortunately, initiatives are being implemented to address these challenges. In the 2024/25 period, Specsavers reported supporting 729 patients through their homelessness programme, a fourfold increase from the previous year. They provided 472 pairs of glasses and ear care to 147 individuals, effectively removing barriers rather than adding to them.

Since November 2022, all Big Issue vendors have been eligible for vouchers covering free eye tests, glasses, and ear wax removal at Specsavers. Mobile units have been deployed to community centres, and out-of-hours clinics operate in over 150 stores. In Yorkshire, a programme across 16 temporary accommodation sites delivered 271 eye tests and 231 pairs of glasses, with 88% of recipients stating they would have otherwise gone without.

As of June 2023, 131,140 households were living in temporary accommodation, highlighting that the crisis is not an impending threat but a current reality. Each person denied access to glasses is another individual unable to complete a job application. Each untreated infection represents another barrier to employment, perpetuating a cycle of preventable poverty.

John Williams understands the gravity of these issues all too well. “Big Issue were a huge help,” he acknowledges. “If they hadn’t stepped in, I honestly don’t know what I would have done.” His journey underscores the potential for invisible problems to spiral without support, and the transformative power of removing barriers to essential care.

Every pair of glasses dispensed and every hearing test offered represents more than just healthcare; it serves as a lifeline for those frequently overlooked by the system. Addressing hidden homelessness and its associated health challenges is crucial in breaking the cycle of poverty and providing individuals with the support they need to thrive.