HSO5005 Social Inclusion Essay Sample: Homelessness

For information and reference only – not to be submitted as your own work.

This model-answer extract responds to an HSO5005 Social Inclusion, Empowerment and Health essay of the kind set at Regent College London, where students must explore how social issues shape health and social care and why empowerment and advocacy matter. You can compare the wording of the task with other Regent College London assignment briefs, and the companion HSO5005 essay planning guide explains how the marking criteria translate into a structure. The extract below uses a single topic, homelessness in the UK, and runs to roughly 1,800 words. A full submission would need to reach the 3,000-word limit, so each section here would be expanded with further evidence and critical discussion.

Introduction

Homelessness is among the most visible forms of social exclusion in the United Kingdom, yet it is rarely just a housing problem. It sits where poverty, ill health, discrimination and weak support systems meet. This essay defines homelessness broadly, as rough sleeping, living in temporary or insecure accommodation, and sofa surfing, and then examines how socio-economic factors influence the health and wellbeing of people who experience it. Two sociological theories are applied to explain why the problem persists. The essay then considers powerlessness, empowerment and advocacy, before evaluating social justice and anti-oppressive practice as a basis for health and social care responses.

The argument advanced is that homelessness is best understood as the outcome of structural inequality that is reinforced by stigma, and that practitioners can only reduce its harm when they combine practical help with a deliberate challenge to the power imbalances people face.

LO2: Socio-economic factors influencing health and wellbeing

Scale and health outcomes

The most striking evidence concerns mortality. The Office for National Statistics (2026) estimated that 974 deaths of people experiencing homelessness were registered in England and Wales in 2025, compared with 550 in 2013, a rise of 77.1%. Males accounted for 833 of the 2025 deaths. The mean age at death among identified deaths aged 15 to 74 was 47.3 years for men and 43.2 years for women. The ONS is careful to note that mean age at death is not life expectancy, so these figures should not be compared directly with national life expectancy tables. Even so, they show that death occurs decades earlier than would be expected in the general population. Fazel, Geddes and Kushel (2014) reached a consistent conclusion in an international review of high-income countries, reporting higher premature mortality among homeless people, together with higher rates of infectious disease, mental disorder, substance misuse and non-communicable disease.

Income and poverty

Poverty is the foundation of most routes into homelessness. Bramley and Fitzpatrick (2018) analysed UK data to establish who is most at risk and underlined the centrality of poverty, especially childhood poverty, to the generation of homelessness, while also finding that labour and housing market conditions, personal characteristics and social support matter. Low and unstable income limits access to deposits, secure tenancies and adequate nutrition, and it also restricts the ability to travel to appointments or to keep a phone charged and in credit. These practical barriers matter for health because they delay diagnosis and interrupt treatment, which is why people sleeping rough often present to services only at crisis point.

Marmot et al. (2020) provide the wider context. Their review found that improvements in life expectancy in England had stalled and had declined for women in the most deprived 10% of areas. They also reported that a deprived area in the North East was associated with life expectancy nearly five years lower than a similarly deprived area in London. Place and income therefore shape health before a person ever becomes homeless, which supports the argument that housing loss is often the late stage of a longer process of cumulative disadvantage.

Disability, mental health and ethnicity

Disability and mental ill health can operate in both directions. Poor mental health may make it harder to hold a tenancy or negotiate a benefits system, and homelessness can in turn worsen mental health through insecurity, isolation and stress. Fazel, Geddes and Kushel (2014) conclude that individual factors such as poverty, family problems, mental health and substance misuse interact with structural factors, of which the availability of low-cost housing is considered the most important. Ethnicity and migration status are further dimensions that a full essay should examine with its own sourced evidence, because structural disadvantage does not fall evenly across groups. A Level 5 answer should therefore avoid treating people experiencing homelessness as one homogeneous group, and should instead examine how different factors intersect.

LO1: Applying sociological theory

Marxist and structural perspectives

A Marxist reading argues that housing is a commodity distributed according to ability to pay, so that the labour market and the property market together produce a group who cannot secure shelter. From this perspective homelessness is not an accident or a personal failing but a predictable result of capitalism, in which low-paid and insecure work coexists with high housing costs. The approach explains the strong relationship between poverty and homelessness identified by Bramley and Fitzpatrick (2018), and it connects with the regional inequalities described by Marmot et al. (2020). Its limitation is that it can overlook the agency of individuals and the importance of non-economic oppression, such as gender-based violence or racism, which is why a second theory is needed.

Labelling and interactionism

Becker (1963) argued that deviance is created by social groups when they apply rules and label those who break them as outsiders. Applied to homelessness, labelling helps to explain how a person who sleeps rough is quickly categorised as dangerous, idle or addicted, and how services and members of the public then treat them accordingly. Link and Phelan (2001) extend this insight by defining stigma as the co-occurrence of labelling, stereotyping, separation, status loss and discrimination, and by arguing that stigmatisation depends on the exercise of power. They suggest that stigma shapes life chances in areas such as housing and health. In practice, a person who has been labelled may avoid a GP surgery for fear of being judged, which turns a social attitude into a measurable health risk.

Taken together, the two theories offer complementary explanations. Marxism accounts for why large numbers of people are placed at risk, while interactionism explains how the experience of being labelled deepens exclusion once they are there. A critical answer would also note that neither theory alone captures the gendered nature of homelessness, and that a feminist perspective could be added in a full 3,000-word version.

LO3: Powerlessness, empowerment and advocacy

Power and powerlessness

Lukes (2004) distinguishes three dimensions of power: the visible power to win decisions, the power to keep issues off the agenda, and the shaping of what people believe they want. All three are relevant here. A person without an address may be unable to register with a GP, vote or receive benefits, which is the first dimension. Their concerns may rarely reach policy debate, which is the second. They may also internalise the belief that they deserve little, which is the third. Powerlessness in this sense is produced by systems and attitudes, not by the individual.

Empowerment and advocacy in practice

Empowerment means enabling people to gain control over decisions that affect their lives. In health and social care it begins with listening, offering genuine choice and sharing information in accessible forms. Advocacy supports this by helping people to express their views and secure their rights. Under section 67 of the Care Act 2014, a local authority must arrange an independent advocate where a person would otherwise have substantial difficulty in understanding or retaining information, weighing it up or communicating their views, and where no appropriate person is available to support them (Care Act 2014). For a homeless adult with a mental health condition, an advocate may make the difference between attending a care assessment and being excluded from it.

The NHS 6Cs, namely care, compassion, competence, communication, courage and commitment, provide a values framework for practitioners (NHS England, 2012). Compassion and communication are particularly relevant, because they counter the stigma discussed above. Courage matters when a practitioner must challenge a colleague or an organisation that turns a person away because they lack a fixed address.

LO4: Social justice and anti-oppressive practice

Social justice requires fair distribution of resources, recognition of difference and meaningful participation in decisions. Thompson (2020) frames anti-discriminatory practice around the personal, cultural and structural levels at which discrimination operates, a model often described as PCS. Applied to homelessness, the personal level covers individual prejudice from staff, the cultural level covers shared assumptions that rough sleepers are responsible for their situation, and the structural level covers housing policy and welfare design. Dominelli (2002) adds that anti-oppressive practice must challenge unequal power relations in the helping relationship itself, so practitioners should work with service users as partners instead of positioning themselves as experts who deliver solutions.

The legal framework supports this approach. The Equality Act 2010 prohibits discrimination on the basis of protected characteristics, including disability, race and sex, and it applies to the delivery of services. The Homelessness Reduction Act 2017 strengthened local authority duties to prevent and relieve homelessness. Together, these statutes provide practitioners with grounds to challenge unfair treatment, although a critical answer should acknowledge that legislation alone does not remove the structural pressures described earlier.

Practical anti-oppressive responses might include co-producing support plans with people who have lived experience, ensuring that health services accept registration without proof of address, and training staff to recognise stigma. Government can address affordability and welfare adequacy, practitioners can advocate and coordinate care, and charities can offer outreach and peer support that statutory services struggle to provide.

Conclusion

Homelessness illustrates how socio-economic disadvantage, stigma and powerlessness combine to damage health. The evidence from the ONS (2026), Fazel, Geddes and Kushel (2014) and Marmot et al. (2020) shows large and persistent inequalities, while Marxist and labelling theories explain both the structural origins and the social reinforcement of exclusion. Empowerment, independent advocacy and anti-oppressive practice, supported by the Care Act 2014, the Equality Act 2010 and the Homelessness Reduction Act 2017, offer a credible route to change, provided practitioners also address the wider structures that produce the problem. In the full essay, this conclusion would be followed by a reflective paragraph on the author’s own learning and practice.

If you want to see how a different HSO module is approached, the related HSO5004 health promotion event sample shows the same standards of evidence and structure. Students who need tailored guidance on a similar essay can explore our health and social care assignment help or our sociology assignment help.

About the expert

Cheste Hughes holds a Master’s in Nursing from the University of Pennsylvania and is an expert in health care, public health, nursing research and nursing education. A registered nurse who has worked in the field for the past 5 years, Cheste has also been a nursing tutor at studentsassignmenthelp.co.uk for the past 2 years.

References

• Becker, H.S. (1963) Outsiders: Studies in the Sociology of Deviance. Glencoe: Free Press.
• Bramley, G. and Fitzpatrick, S. (2018) ‘Homelessness in the UK: who is most at risk?’, Housing Studies, 33(1), pp. 96–116. doi:10.1080/02673037.2017.1344957 (Accessed: 25 October 2026).
• Care Act 2014, c. 23, section 67. Available at: https://www.legislation.gov.uk/ukpga/2014/23/section/67 (Accessed: 25 October 2026).
• Dominelli, L. (2002) Anti-Oppressive Social Work Theory and Practice. Basingstoke: Palgrave Macmillan.
• Equality Act 2010, c. 15. Available at: https://www.legislation.gov.uk/ukpga/2010/15/contents (Accessed: 25 October 2026).
• Fazel, S., Geddes, J.R. and Kushel, M. (2014) ‘The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations’, The Lancet, 384(9953), pp. 1529–1540. doi:10.1016/S0140-6736(14)61132-6 (Accessed: 25 October 2026).
• Homelessness Reduction Act 2017, c. 13. Available at: https://www.legislation.gov.uk/ukpga/2017/13/contents (Accessed: 25 October 2026).
• Link, B.G. and Phelan, J.C. (2001) ‘Conceptualizing stigma’, Annual Review of Sociology, 27(1), pp. 363–385. doi:10.1146/annurev.soc.27.1.363 (Accessed: 25 October 2026).
• Lukes, S. (2004) Power: A Radical View. 2nd edn. Basingstoke: Palgrave Macmillan.
• Marmot, M., Allen, J., Boyce, T., Goldblatt, P. and Morrison, J. (2020) Health Equity in England: The Marmot Review 10 Years On. London: The Health Foundation. Available at: https://www.health.org.uk/publications/reports/the-marmot-review-10-years-on (Accessed: 25 October 2026).
• NHS England (2012) Top nurses launch new drive to build culture of compassionate care across the NHS. Available at: https://www.england.nhs.uk/2012/12/compassionate-care/ (Accessed: 25 October 2026).
• Office for National Statistics (2026) Deaths of people experiencing homelessness in England and Wales: 2013 to 2025 registrations. Available at: https://www.ons.gov.uk/peoplepopulationandcommunity/birthsdeathsandmarriages/deaths/bulletins/deathsofhomelesspeopleinenglandandwales/2013to2025registrations (Accessed: 25 October 2026).
• Thompson, N. (2020) Anti-Discriminatory Practice: Equality, Diversity and Social Justice. 7th edn. London: Bloomsbury Academic.