総説

Common Conceptions and Acceptance of Homeless People:
A Questionnaire Study of the Citizens of Sapporo, Japan
Kaori Ohta, 1,2 Gen Kobashi, 1 Hideto Yamada, 2 Hisanori Minakami, 2 and Yasuma Fukuchi, 3
1 Department of Health for Senior Citizens, Hokkaido University
2 Department of Obstetrics and Gynecology, Graduate School of Medicine, Hokkaido University
3 Division of Health and Sports Science, Graduate School of Education, Hokkaido University
Correspondence to: Gen Kobashi, MD, PhD.

Email: genkoba@med.hokudai.ac.jp

Objective:

To study public awareness and conceptions about homeless people.

Methods:

A questionnaire was sent to citizens of Sapporo by mail.

Four hundred seventy-two of 1,450 residents

randomly selected (response rate, 32.1%) replied a self-administered questionnaire.
Results:

One of the survey questions asked respondents to list common ailments that they assumed would afflict

homeless people to a greater degree than the general public. There responses were as follows: diarrhea (331, 70.1%),
common cold (312, 66.1%), dysentery (281, 59.5%), and alcoholism (235, 49.8%).

In contrast, respondents wereasked to note diseases that they assumed would be less likely to affect the homeless, and their responses were as
follows: hypercholesteremia (216, 45.8%), diabetes mellitus (210, 44.5%), and drug addiction (157, 33.3%).
Respondents tended to agree with the following statements: "Homeless people destroy the scenery of the city" (328,
69.5%); "Homeless people stink" (325, 68.9%); and "Homeless people should improve their present situation bythemselves" (321, 68.0%). They tended to disagree with the following statements: "People become homeless primarily
because of health problems" (370, 78.4%); "Homeless people are involved in the trafficking of narcotic drugs andstimulants" (337, 71.4%); and "Homeless people are frightening" (287, 60.8%).
Conclusion:

The present results suggest that there are significant differences between the citizens’ conceptions about

the homeless and the reality of the homeless in Sapporo.

Follow-up studies in other cities and actions to educate thegeneral public would be necessary to establish measures for dealing with the problem of the homeless in Japan.

Key words: homeless people， conception， acceptance， questionnaire

Introduction

HIV 6) in homeless people in Japan as well as in the

In Japan, the number of homeless people has been

United States.

increasing since 1998 because of the poor economy andwith the two primary problems regarding the homeless.

accompanying high unemployment.

One problem deals with the general support of homeless

The Japanese

government passed a special law to support thehomeless in August 2002.

1)

peopleonCompromises will be required to deal

such

issuesas

housing,

health,and

The Japanese government

employment, all of which will prevent high-risk groups

reported that there were 25,296 homeless people infrom becoming homeless. These preventive programs

Japan in 2003,

2)

which was an increase of about 1,200

implemented

by

the
19)

government

and/or

The other challengeonposed by the homeless involves the appearance ordysentery (reported by a Japanese local

cosmetic aspect of a city and the idea that the homelessPrevious
tuberculosis,benon-governmental organizations.

from the number reported in 2001.
3-6)

may

studieshave

paper), lifestyle-related diseases,

7-12)

focusedalcoholism,

13,14)

psychiatric disorders, 15,16) drug dependence, 17,18) andare potential sources of infectious diseases. 20)
However, in Japan, little research has been

undertaken to determine the general conceptions held

66.1%), dysentery (281, 59.5%), and alcoholism (235,

about homeless people.

49.8%).

Therefore, for the present

In contrast, they believed that the homelessstudy, a general survey was used among the residents ofwere less likely to be afflicted with hypercholesteremia

Sapporo.

(216, 45.8%), diabetes mellitus (210, 44.5%), and drug
addiction (157, 33.3%) than the general public (Table
1).

Subjects and methods
A group of 1,472 residents from 20-69 years of age was
randomly selected from every electoral district. The

3. Thoughts and images about the homelesselectoral list (total of 151,573 registrants) was from a

Respondents

specific ward of Sapporo, in which many homelessstatements: "Homeless people destroy the scenery of thepeople gather in a central park and downtown area. The

city" (328, 69.5%); "Homeless people stink" (325,residents received the self-administered questionnaire

68.9%); and "Homeless people should improve theirby mail.

The survey included questions about (1)present situation by themselves" (321, 68.0%). They

status (sex, age, number of household members,

tended to disagree with the following statements:

occupation, length of time as Sapporo residents), (2)"People become homeless primarily because of healthconceptions regarding the health of homeless people,

problems" (370, 78.4%); "Homeless people are involvedand (3) thoughts and images about homeless people.

in the trafficking of narcotic drugs and stimulants" (337,

The health conceptions were determined by answers to

71.4%); and "Homeless people are frightening" (287,the following question: “Do you think homeless people

60.8%) (Table 2).

tended

to

agree

with

the

following

are more susceptible to specific diseases than the
Discussion

general public?

The government reported that 88 people were homeless
Results

in Sapporo in 2003, 2) which was an increase of 20 over

1. Status of respondents

the number reported in 2001.

Answers were obtained from 472 of 1,472 residents

Hokkaido, the northern-most prefecture, which receives(response rate, 32.1%), consisting of 188 males (39.8%),

a large annual snowfall. The mean temperature is less279 females (59.1%), and 5 who did not respond to thethan zero degrees centigrade from December to March

item about sex (1.1%). The mean age was 46.7 ± 14.1

(according to reports in local newspapers). As a result,

years old (Mean ± SD).

The most frequent number ofthe number of homeless in Sapporo is much lower thanhousehold members living together was 2 among boththat reported in other metropolitan areas, such as Tokyo

males (56, 11.9%) and females (86, 18.2%); 3 was theand Osaka, even though Sapporo has a population of

second most frequent number for males (44, 9.3%) andapproximately 1.8 million and is the fifth-largest city infemales (62, 13.1%).

Japan.

Occupations were distributed as

Sapporo is located in

Because of the unique circumstances infollows: for males, "employee of a company" (88,

Sapporo, less has been done than in other cities to solve

18.6%); "public employee" (22, 4.7%); "unemployed"

the problems related to homelessness.

(17, 3.6%); "construction" (11, 2.3%); for females,

assist the homeless and to learn more about their"housewife" (127, 26.9%); "employee of a company"

circumstances, health exams, consultation, and boiled(56, 11.9%); "unemployed" (19, 4.0%); and "public

rice have been made available periodically since

employee" (12, 2.5%).

December 1999 to the homeless in a park near Sapporo

A total of 329 respondents(69.3%) had lived in Sapporo for more than 10 years.

In an effort tostation. 7)
In December 2000, 49 homeless people who

2. Conceptions regarding the health of homeless people

attended the event were interviewed so that more could

Afflictions that the respondents believed the homelessbe learned about their lives. 21)

were more susceptible to than the general public

examinations were provided as a part of a tuberculosis

included diarrhea (331, 70.1%), the common cold (312,

detection program being conducted by the Sapporo City

Furthermore, medical

regarding lifestyle-related diseases such as diabetes

Health Center and private regional hospitals.
Throughout the world, few studies have been

mellitus.

There are two possible reasons for this: one

conducted to learn about the conceptions and reality ofpossibility is that the residents were not aware of thehomeless people.

In one such study 240, people fromreal situation of homeless people concerning, for

22)example, unsatisfactory diet, insufficient sleep, andErie County, PA, were interviewed by telephone.

The present study is not only the first to examine thesevere mental stress. 7)

attitudes of residents about homeless people in Japan,

residents did not know that the lifestyle of homelessbut also one of the very few such studies in the world.

peopleFortunately, the study was completed before the new

diseases, which are sometimes mistakenly thought to be

Japanese law in support of the homeless took effect.

1)

involves

The other possibility is that theriskfactorsforlifestyle-relateddiseases of the wealthy.
On

The problem of infectious diseases among

the

other

hand,

the

present

resultshomeless people is very serious, particularly in big

suggested that the residents did not sympathize withcities in the main island in Japan, where 5,000-9,000

homeless people on the whole, although the Japanese

homeless people live.

government classifies homeless people as being (1)For example, some cases of3)4)

and one case ofpeople who have become unemployed against their will,

dysentery in Osaka (reported by a Japanese local(2) people who need medical treatment or welfare

newspaper) have been documented.

support, and (3) people who refuse to become integrated

tuberculosis in Tokyoand in Nagoya

Likewise, it wasalso reported in San Francisco in 1994 that the

into the society.19)

prevalence of tuberculosis among the homeless wasof the residents disagreed the statement that "homeless

32%

.6)

Furthermore, the fact that 71.4%

people are involved in the traffic king of narcotic drugs
theand stimulants" suggests that the residents in Sapporo

prevalence of hypertension and diabetes mellitus among

do not believe that the homeless problem is as critical as

homeless people was reported to be 15% and 4%,

residents in other cities in Japan do.

Regardinglifestyle-relateddiseases,

23)

Actually, there

and 13% andhave been few reports of the use of narcotic drugs and

10%, respectively, in our previous study in Sapporo instimulants by homeless people in Japan, although there

respectively, in Shibuya, Tokyo in 1997,

The health check-up for homeless people inhave been many reports of drug dependence 17,18) andSapporo conducted in the course of our study also

HIV infection by drug injection 6) among homelessrevealed that the number of homeless people who

people in countries other than Japan.

2000.

7)

sufferedfromdiabetesandneededurgentConsidering that drug abuse by young peopleIn

has recently become a problem in Japan, 26) it seems

the United States, the prevalence of hypertension inpossible that drug problems among the Japanese

8-11)

homeless people will also become significant in the near

hospitalization was higher than we had expected.

homeless people has been reported to be 14-25%.

It has been noted that homeless people usually eat meals
that are insufficient in nutrition and high in salt,
24)

future.
In conclusion, the present results suggest that

Furthermore,

there were some significant differences between thehomeless people suffering from diabetes mellitus areresidents' conceptions and the real situation of homelessparticularly

theirpeople in Sapporo, although the results did not25)necessarily reflect the whole population, since thetheresponse rate was not very high.

saturated fatty acids, and cholesterol.

susceptible

toaworseningof

condition due to their inability to have a healthy diet.
The

present

results

showedthat

Follow-up studies inconceptions of residents were fairly consistent with theother cities and campaigns to enlighten the generalreal situation of Japanese homeless people regarding

population will be necessary in the future in order toinfectious diseases such as tuberculosis and dysentery

establish appropriate countermeasures to address thebut not consistent with the real situation of the homelessproblem of homelessness in Japan.

(in Japanese)

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