Abstract: Disconnected and Unwell: The Risk Factors and Health Impacts of Loneliness Among People Experiencing Homelessness (Society for Social Work and Research 30th Annual Conference Anniversary)

Schedule:

Saturday, January 17, 2026

Liberty BR J, ML 4 (Marriott Marquis Washington DC)

* noted as presenting author

Amanda Landrian Gonzalez, PhD, Research Scientist, University of Southern California, Los Angeles, CA

Peichen Liu, MSW, Doctoral student, University of Southern California, Los Angeles, CA

Himal Suthar, PhD student, University of Southern California, Los Angeles, CA

Gisele Corletto, Project Administrator, University of Southern California, Los Angeles, CA

Kevin Adler, Founder in residence, Miracle Messages,, San Francisco, CA

Benjamin Henwood, PhD, Professor, University of Southern California, Los Angeles, CA

Background and Purpose:
People experiencing homelessness (PEH) are disproportionately affected by a range of physical and mental health issues. While numerous factors drive these disparities, the role of social isolation and loneliness is overlooked. This study uses baseline data from a randomized controlled trial of an intervention aimed at reducing social isolation and poverty to assess loneliness among PEH. Specifically, we examine sociodemographic, homelessness experience, and substance use risk factors for loneliness, as well as the association between loneliness and health.

Methods:
This cross-sectional analysis used baseline data from a randomized controlled trial conducted among PEH living in the Los Angeles and San Francisco Bay areas. Of the 760 participants enrolled in the study, 570 had complete information on all variables of interest and were included in multivariable logistic regression analyses. Key independent variables included sociodemographic characteristics, homelessness experience, substance use, social support, and perceived discrimination. Health outcomes included self-rated physical and mental health, substance use disorder diagnosis, and emergency room (ER) visits.

Results:
Identifying as a woman (aOR=0.65; 95% CI: 0.44, 0.94) was significantly associated with a lower odds of loneliness. Poor social support (aOR=3.35; 95% CI: 2.31, 4.86) and greater experiences of perceived daily discrimination (aOR=1.09; 95% CI: 1.05, 1.14) were significantly associated with a higher odds of loneliness. Loneliness was significantly associated with poorer self-rated physical health (aOR=0.43; 95% CI: 0.43, 0.87) and mental health (aOR=0.35; 95% CI: 0.24, 0.50), at least one substance use disorder diagnosis (aOR=1.58; 95% CI: 1.07, 2.31), and greater ER visits (aRRR=1.95; 95% CI: 1.20, 3.17), even after controlling for key sociodemographic characteristics, including age, gender, race/ethnicity, education, marital status, and experience of unsheltered homelessness in the last 30 days.

Conclusions and Implications:
Addressing loneliness may be critical for improving health among PEH and could be accomplished via interventions that target social support and discrimination. Findings underscore the importance of incorporating strategies to reduce social isolation into public health and homelessness services and support systems. Further research is needed to explore longitudinal pathways between loneliness and health among PEH and to evaluate the effectiveness of targeted interventions.