Social Isolation and Loneliness, and Health of People with Lived Experience of Homelessness

Background and purpose: Social isolation and loneliness (SIL) pose an increasingly significant challenge for both social work and public health. SIL can be seen as stemming from structural and societal factors, encompassing social exclusion, disaffiliation, digital exclusion, as well as individual and behavioral elements. Some studies also mention structural stigma and alienation as contributing to systematic biases, policies, and practices that reinforce SIL, particularly among vulnerable or underserved communities. Various groups, such as youth, immigrants, or seniors, face a heightened risk of SIL. However, SIL becomes a double burden when these affected groups are also socio-economically marginalized or underserved. Individuals who have experienced homelessness are particularly susceptible to SIL, with limited literature synthesizing their experiences to guide social practices and targeted support programs. This scoping review aims to consolidate evidence on SIL among individuals with a history of homelessness and examine its detrimental effects on their well-being and health, with the goal of informing social interventions effectively.

Methods: We conducted a thorough literature search for peer-reviewed studies spanning from 2000 to January 3rd, 2023, resulting in a total of 5,294 papers after eliminating duplicates. Following screening, we identified 27 qualitative studies, 23 quantitative studies, and two mixed-method studies. Among the selected articles, four centered on women and older women, while five studies focused exclusively on male or older male populations. In total, 10 articles examined the experiences of older women and men, typically defined as individuals aged 50 and above within homeless populations. No studies specifically targeted non-binary groups, although gender-diverse individuals were included in six of the studies.

Results: The prevalence of SIL among people with lived homelessness experience ranged from 25% to 90% across studies. Studies found that self-identities played a critical role in shaping SIL experiences among people with homelessness experience. People had different SIL experiences and faced different related-SIL forms of challenges based on their age, gender, sexual orientation, ethnicity and race. Finally, SIL was significantly associated with social distress, sleeping patterns, physical and risks of mental health, hospitalizations, as well as alcohol and substance use.

Conclusions and Implications: The study findings reveal a significant prevalence of social isolation and loneliness (SIL) among individuals with a history of homelessness, with varied impacts observed among different segments of this population, including youth, women, and gender-diverse groups. Moreover, these studies highlight the correlation between SIL and adverse social, mental, and physical outcomes. As implications for social work practices, integrating SIL assessment into patient care for vulnerable groups or communities is crucial. Furthermore, there is a pressing need for further discussions to generate additional evidence and develop actionable strategies aimed at addressing the issue of SIL effectively.