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Access to healthcare for people experiencing homelessness in the post-conflict society of Northern Ireland

Northern Ireland is a society that is still emerging from the clutches of violent conflict. The ‘Troubles’ as the conflict is colloquially referred to, spanned the years from 1969 to 1998. Although over 20 years have passed since the ceasefire and Good Friday Agreement (a key moment in the peace process), the societal emergence has been slow in evolution and at times has been hindered by lingering political conflict and paramilitary intimidation. As the control of communities by paramilitary groups has receded, the underlying cost of conflict has become more apparent. It is well documented that social factors impact health disproportionately, creating a social gradient of health and health inequalities within populations (Aldridge et al. 2018; Fagrell Trygg, Gustafsson, and Månsdotter 2019). These inequalities present themselves in local areas of deprivation and social vulnerability while the more advantaged in society flourish in both health and wealth (Marmot 2010). The gap between need and access to healthcare was described in the ‘Inverse Care Law’ which highlighted the paradoxical issue that healthcare availability is inversely related to need (Haggerty et al. 2020; Tudor Hart 1971). This correlation between social vulnerability and access emphasizes the importance of exploring access when aiming to reduce health gaps and inequity. People experiencing homelessness (PEH) are among the most excluded in society, facing multiple factors that lead to extreme deprivation. The health of homeless populations is notably worse than the general population, with high risks of premature death and both physical and mental illness (RogansWatson et al. 2020). Access is often highlighted as a key area for improvement in research for vulnerable groups, including PEH (Jagpal et al. 2020). Access