‘My dog is my life’: One Health approaches to healthcare for people and their companion animals experiencing homelessness in the United Kingdom

Around one in ten people seeking shelter from homelessness in the United Kingdom have a companion animal, most commonly a dog. Dog ownership when homeless can pose a barrier to accessing healthcare and accommodation, and may force individuals to sleep on the streets. People experiencing homelessness with a dog are therefore a stigmatised minority within a minority, often invisible to support services and hard to reach. The bond between human and canine in these situations is usually strong; the dog is often the most significant ‘other’ in that person’s life. Failure to accommodate this relationship as part of a holistic approach has implications for both human and animal healthcare in the homeless community. Bringing these two healthcare disciplines together represents a specific application of One Health that can help us better realise their collaborative transdisciplinary potential. Interpretative phenomenological analysis was used to explore health needs and challenges for people experiencing homelessness with companion dogs in the UK and to investigate the feasibility of joint healthcare provision. Study participants included people experiencing homelessness and service providers working in veterinary or human healthcare and housing services. Human and animal health were considered entangled by both service users and service providers, requiring an approach which accounts for the needs of human and animal together. The idea of joint delivery of human and animal healthcare at the same venue was of interest to both service users and providers but also raised concerns. While sparse examples are available in the literature, a more workable concept may be to aim for a ‘coordinated multi-species healthcare’ which is responsive and empathic to the needs of both people and dogs.