Social Support Among Homeless Individuals

Background and Purpose: Homeless persons often lack social support which has been shown to be associated to poor health. This study focuses on the specific types of social support provided from specific network members in personal networks of homeless individuals.  We examine what types of support are associated with physical and mental health outcomes and what relational factors contribute to the provision of that support.

Methods: The sample in this study is of chronically homeless individuals (n=421) entering permanent supportive housing in the Los Angeles area between the August 2014 and October 2015. Social support networks were defined by the following criteria: (1) provide tangible support, (2) give information or advice, (3) someone respondents could confide in or (4) borrow money from. Additionally, respondents were asked about network members they felt emotionally close to and those whom they had conflict with. Types of relationship (i.e. partner, family member, case manager, health professional) with network members were also assessed. Outcomes were chronic physical and mental health conditions based on self-reported responses.

Results: The sample was predominantly African American (55.82%) males (71.84%).  The average age was 54.44 years old (range 38-81) and time homeless was 6.02 years (range 0-44). On average respondent reported at least two chronic physical health and mental health conditions. Overall, the mean network size consisted of eight network members. Most respondents reported four network members who provided some type of social support. Multiple linear regression models were analyzed for physical and mental health conditions. For physical health, the lack of persons who participants felt they could confide in (β= -0.162, t= - 2.26, p= 0.025) suggested a higher number of chronic health problems. The model account for 13.15% of the variance in the number physical health issues. However, there were no significant findings for types of alters that participants could confide in. For mental health, lack of persons who provided any type of support (β= -0.468, t= -1.94 0.179, p= 0.053) was significantly associated with a higher number of mental health problems. Interestingly, persons who participants had conflict with (β= -0.216, t= -2.25, p= 0.025) had a significant negative association with number of mental health issues. Among alter types that provided any of the types of social support, partners (β= 0.039, t= 2.08, p= 0.038) and health professionals (β= 0.023, t= 2.17, p= 0.030) were significant.

Conclusions and Implications: Few studies have comprehensively examined the impact of social support on mental and physical health outcomes among homeless. Overall, the findings from this research are consistent with evidence that different types of support are associated with different health outcomes and different types of relationships provide different types of social support. It is important to understand the associations between social support and health for persons experiencing homelessness because there is evidence to suggest that supportive social networks may have a protective effect “beyond the effects of housing.” Interventions for persons transitioning into housing should consider facilitating social support to subsequently improve health.