Background: In the context of the Irish economic boom we assessed the health, service utilisation and risk behaviour of homeless people in north Dublin city and compared findings with a 1997 study. Methods: A census of homeless adults in north Dublin city was conducted in 2005 using an adapted interviewer-administered questionnaire from the 1997 study. Results: A total of 363 (70) of the target population participated. Compared to 1997 the population was younger (81 versus 70 under 45 years, P < 0.01) with a higher proportion of women (39 versus 29%, P < 0.05) and long-term homeless (66 versus 44, P < 0.001). Drug misuse superseded alcohol as the main addiction with a doubling of the proportion reporting past or current drug use (64 versus 32, P < 0.001). The prevalence of comparable physical chronic conditions was largely unchanged while depression (51 versus 35, P < 0.01) and anxiety (42 versus 32, P < 0.05) had increased. There were high rates of blood-borne infections, such as HIV (6), hepatitis B (5) and hepatitis C (36) in 2005 and dental problems (53) all of which can be associated with drug use. Access to free healthcare had not increased. Similar proportions reported not having medical cards (40 versus 45 NS). Homeless people continued to have higher usage of secondary care services than the general population. Conclusions: This study shows a changing disease profile among the homeless population consistent with a growing drug using population. It confirms that the homeless population in Dublin in terms of health remain excluded from the benefits of an economic boom despite a government policy aimed at redressing social inclusion.
