Health social inequality of the homeless in the city of Sao Paulo

To describe the sociodemographic characteristics, health status and access to services of the population living on the streets in a sample obtained from three homeless shelters in the downtown area of Sao Paulo. The sample included 251 subjects: 171 males, 78 females and 2 people who reported themselves as transgender. A structured questionnaire was applied about: sociodemographic characteristics, time on the street, physical activity, discrimination, social network and support, health status, alcohol or drug use, violence and access to health services. The subjects were adults, non-white, low education level, and with a monthly income lower than half the minimum wage. A third of the respondents had already been in this situation for more than 5 years. The health status for 45% of the respondents was considered good or very good health. The majority preferred to use primary care centers when needed and the precarious financial conditions and lack of family added to physical violence situations. Discrimination, poor hygiene and physical or mental disabilities are common in their lives. The challenge of formulating health policy is to incorporate the representations and care practices of these individuals, but also the services, as a starting point for organizing care.