conclusion of homelessness essay

5 Essays About Homelessness

Around the world, people experience homelessness. According to a 2005 survey by the United Nations, 1.6 billion people lack adequate housing. The causes vary depending on the place and person. Common reasons include a lack of affordable housing, poverty, a lack of mental health services, and more. Homelessness is rooted in systemic failures that fail to protect those who are most vulnerable. Here are five essays that shine a light on the issue of homelessness:

What Would ‘Housing as a Human Right’ Look Like in California? (2020) – Molly Solomon

For some time, activists and organizations have proclaimed that housing is a human right. This essay explores what that means and that it isn’t a new idea. Housing as a human right was part of federal policy following the Great Depression. In a 1944 speech introducing what he called the “Second Bill of Rights,” President Roosevelt attempted to address poverty and income equality. The right to have a “decent home” was included in his proposals. Article 25 of the Universal Declaration also recognizes housing as a human right. It describes the right to an “adequate standard of living.” Other countries such as France and Scotland include the right to housing in their constitutions. In the US, small local governments have adopted resolutions on housing. How would it work in California?

At KQED, Molly Solomon covers housing affordability. Her stories have aired on NPR’s All Things Considered, Morning Edition, and other places. She’s won three national Edward R. Murrow awards.

“What People Get Wrong When They Try To End Homelessness” – James Abro

In his essay, James Abro explains what led up to six weeks of homelessness and his experiences helping people through social services. Following the death of his mother and eviction, Abro found himself unhoused. He describes himself as “fortunate” and feeling motivated to teach people how social services worked. However, he learned that his experience was somewhat unique. The system is complicated and those involved don’t understand homelessness. Abro believes investing in affordable housing is critical to truly ending homelessness.

James Abro is the founder of Advocate for Economic Fairness and 32 Beach Productions. He works as an advocate for homeless rights locally and nationally. Besides TalkPoverty, he contributes to Rebelle Society and is an active member of the New Jersey Coalition to End Homelessness.

“No Shelter For Some: Street-Sleepers” (2019)

This piece (by an unknown author) introduces the reader to homelessness in urban China. In the past decades, a person wouldn’t see many homeless people. This was because of strict rules on internal migration and government-supplied housing. Now, the rules have changed. People from rural areas can travel more and most urban housing is privatized. People who are homeless – known as “street-sleepers” are more visible. This essay is a good summary of the system (which includes a shift from police management of homelessness to the Ministry of Civil Affairs) and how street-sleepers are treated.

“A Window Onto An American Nightmare” (2020) – Nathan Heller

This essay from the New Yorker focuses on San Francisco’s history with homelessness, the issue’s complexities, and various efforts to address it. It also touches on how the pandemic has affected homelessness. One of the most intriguing parts of this essay is Heller’s description of becoming homeless. He says people “slide” into it, as opposed to plunging. As an example, someone could be staying with friends while looking for a job, but then the friends decide to stop helping. Maybe someone is jumping in and out of Airbnbs, looking for an apartment. Heller’s point is that the line between only needing a place to stay for a night or two and true “homelessness” is very thin.

Nathan Heller joined the New Yorker’s writing staff in 2013. He writes about technology, higher education, the Bay Area, socioeconomics, and more. He’s also a contributing editor at Vogue, a former columnist for Slate, and contributor to other publications.

“Homelessness in Ireland is at crisis point, and the vitriol shown towards homeless people is just as shocking” (2020)#- Megan Nolan

In Ireland, the housing crisis has been a big issue for years. Recently, it’s come to a head in part due to a few high-profile incidents, such as the death of a young woman in emergency accommodation. The number of children experiencing homelessness (around 4,000) has also shone a light on the severity of the issue. In this essay, Megan Nolan explores homelessness in Ireland as well as the contempt that society has for those who are unhoused.

Megan Nolan writes a column for the New Statesman. She also writes essays, criticism, and fiction. She’s from Ireland but based in London.

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About the author, emmaline soken-huberty.

Emmaline Soken-Huberty is a freelance writer based in Portland, Oregon. She started to become interested in human rights while attending college, eventually getting a concentration in human rights and humanitarianism. LGBTQ+ rights, women’s rights, and climate change are of special concern to her. In her spare time, she can be found reading or enjoying Oregon’s natural beauty with her husband and dog.

Permanent Supportive Housing: Evaluating the Evidence for Improving Health Outcomes Among People Experiencing Chronic Homelessness (2018)

Chapter: 9 conclusions and recommendations, 9 conclusions and recommendations.

Homelessness, and especially chronic homelessness, is a highly complex problem that communities across the country are struggling to address. Despite the diligent efforts of federal agencies and nonprofit and philanthropic organizations to develop and implement programs to address the challenges of homelessness, the large number of Americans who continue to experience homelessness makes clear that much remains to be done to solve this pressing societal problem.

Permanent supportive housing (PSH) is a housing model designed to primarily serve individuals and families experiencing chronic homelessness, a population having different needs from those individuals and families who experience acute episodic or temporary homelessness. This committee was charged to examine the connection between PSH and improved health outcomes, addressing the primary question, “To what extent have permanent supportive housing programs improved health outcomes and affected health care costs in people experiencing chronic homelessness?” This chapter offers the committee’s overall conclusions about the evidence on the effect of PSH on health outcomes, as well as research and policy recommendations.

CONCLUSIONS

Evaluating the impact of psh on health: assessment and limitations of the evidence.

During the course of the study, the committee examined the published and unpublished literature and conducted a variety of other data-gathering efforts, including site visits. The committee found that interpreting the research relevant to PSH and health outcomes was challenging because, as discussed in the report, common terms have different meanings within and between homelessness lexicons used by various agencies, nongovernmental organizations, researchers, and advocates ( USICH, 2011 ). The lack of precise definitions of the housing models

reported upon and the paucity of detail about the exact nature and extent of supportive services provided in different housing models and in control or comparison groups further complicated the interpretation of reported findings.

In addition, data about PSH programs are generally siloed, uncoordinated, and fragmented. There are multiple barriers to collecting and sharing these data across agencies or programs, and there is a need for much greater interoperability of the data. The paucity of comparable data available across agencies makes it difficult to assess a variety of outcomes, and complicates efforts to provide the array of housing and social services that may be needed by individuals experiencing homelessness ( Culhane, 2016 ). See Chapter 8 for an in-depth discussion of related research gaps.

On the basis of currently available studies, the committee found no substantial evidence that PSH contributes to improved health outcomes, notwithstanding the intuitive logic that it should do so and limited data showing that it does do so for persons with HIV/AIDS. There are significant limitations in the current research and evidentiary base on this topic. Most studies did not explicitly include people with serious health problems, who are the most likely to benefit from housing. Of the studies that were more rigorous, the committee found that, in general, housing increases the well-being of persons experiencing homelessness.

The committee found no substantial published evidence that PSH improves health; however, PSH increases an individual’s ability to remain housed and plausibly alleviates a number of conditions that negatively impact health. However, few randomized controlled trials or other methodologically rigorous studies have evaluated the role of PSH in producing improved health outcomes. Consistent data in this regard are presently lacking. While the committee recognizes that there are moral and ethical reasons that make it problematic to carry out randomized controlled trials with this population, an overarching finding of this study is that more rigorous research is needed to determine how health outcomes per se are influenced by PSH. Different types of studies might pose fewer ethical concerns, such as stepped-wedge study designs, which are increasingly being used in the evaluation of health care research ( Simmons et al., 2017 ).

Housing has long been acknowledged as a key social determinant of health, and extensive literature has accumulated over the past two centuries showing that housing is foundational for good health. The United Nations adopted the Universal Declaration of Human Rights in Paris in 1948 in response to the devastation of World War II, declaring that the right to housing was among the rights to which all humans should be entitled. The United States was among the 48 signatories of this declaration. More recently, safe housing was noted as fundamental to the health of populations by the World Health Organization’s Commission on Social Determinants of Health ( CSDH, 2008 ).

While safe, secure, and stable housing contributes to good health, there is extensive literature also showing it is not sufficient. The quality and location of housing make a difference. Robust public health studies have shown the untoward health consequences of inadequate housing, including asthma, the spread of communicable diseases, exposure to toxins such as lead and radon, injuries, childhood

malnutrition, mental health conditions, violence, and the harmful effects of air pollution. Population studies have also shown that a person’s neighborhood matters a great deal with regard to health outcomes, with safe streets, safe schools, and economic opportunity essential for good health and well-being.

The committee acknowledges the importance of housing in improving health in general, but it also believes that some persons experiencing homelessness have health conditions for which failure to provide housing would result in a significant worsening of their health. Said differently, notwithstanding that housing is good for health in general, the committee believes that stable housing has an especially important impact on the course and ability to care for certain specific conditions and, therefore, the health outcomes of persons with those conditions. The committee refers to these conditions as “housing-sensitive” conditions and recommends that high priority be given to conducting research to further explore whether there are health conditions that fall into this category and, if so, what those specific conditions are. The evidence of the impact of housing on HIV/AIDS in individuals experiencing chronic homelessness may serve as a basis for more fully examining this concept. Chapter 3 describes the current research and the concept of housing-sensitive conditions in more detail.

Scaling Up PSH: Policy and Program Barriers

As part of its charge, the committee was asked to identify the “key policy barriers and research gaps associated with developing programs to address the housing and health needs of homeless populations.” While the committee found no substantial published evidence that PSH improves health, the intervention increases an individual’s ability to remain housed and that plausibly alleviates a number of conditions that negatively impact health. Based on its position that PSH holds potential for reducing the number of persons experiencing chronic homelessness and for improving their health outcomes, the committee describes the key policy and program barriers to bringing PSH and other housing models to scale to meet the needs of those experiencing chronic homelessness (discussed in greater detail in Chapter 7 ).

There are many barriers to bringing PSH to scale to meet the current level of need. As is often the case with housing and social service providers generally, PSH programs operate in an environment of scarcity with often inadequate and unreliable funding. The siloed nature of the programs and funding streams for PSH is an important barrier to scaling up. PSH providers working at the ground level to fulfill an already challenging mission are further challenged by the need to pool or braid together funding from multiple agencies and levels of government, each with its own requirements.

Multiple barriers also exist at the local level in meeting the need for PSH. As highlighted in the committee’s site visits in Denver and San Jose (see Appendix D ), operationalizing PSH programs is a very complicated and lengthy process, often taking many years to complete single-site projects. The high capital costs

and long development process are a substantive barrier to the replicability of successful programs. In the case of single-site PSH developments, myriad local land-use, permitting, and other regulatory barriers, which may be undergirded by prejudicial stereotypes and neighborhood opposition, makes land unavailable, leads to protracted delays, drives up development costs by as much as 20-35 percent, and generally impairs the efficiency of government assistance programs (see, e.g., van den Berk-Clark, 2016 ). Experts and government officials across the political spectrum have long recognized these barriers, but few of the many recommendations over the years for eliminating unnecessary regulatory barriers, streamlining processes, and more vigorously enforcing anti-discrimination laws have been implemented. Until such recommendations are effectively implemented, single-site PSH will not be a sufficient answer to address the need.

Scattered-site approaches, which generally make use of Housing Choice Vouchers (HCV) to lease existing housing stock, avoid some of the barriers relevant to single-site PSH and appear to offer promise for scaling up PSH in a shorter time. But scattered-site programs also face challenges when operating in high-priced housing markets and markets where state and local laws allow property owners to refuse to accept vouchers. It also can be more difficult for residents to access supportive services when not directly available on-site. Moreover, federal funding for the HCV program has been at best stable and at worse declining, forcing PSH providers and clients to compete with others on long waiting lists for vouchers.

RECOMMENDATIONS

The committee developed the following recommendations based on its assessment of the evidence that it hopes will guide research and federal action on this issue. The recommendations flow from the specific questions posed to the committee in the statement of task, including research needs related to assessing PSH and health outcomes, the cost-effectiveness of PSH, and key policy and program barriers to bringing PSH and other housing models to scale to meet the needs of those experiencing chronic homelessness.

Recommendation 3-1: Research should be conducted to assess whether there are health conditions whose course and medical management are more significantly influenced than others by having safe and stable housing (i.e., housing-sensitive conditions ). This research should include prospective longitudinal studies, beyond 2 years in duration, to examine health and housing data that could inform which health conditions, or combinations of conditions, should be considered especially housing sensitive. Studies also should be undertaken to clarify linkages between the provision of both permanent housing and supportive services and specific health outcomes. (See Chapter 3 .)

Recommendation 3-2 : The Department of Health and Human Services, in collaboration with the Department of Housing and Urban Development, should call

for and support a convening of subject matter experts to assess how research and policy could be used to facilitate access to permanent supportive housing and ensure the availability of needed support services, as well as facilitate access to health care services. (See Chapter 3 .)

Recommendation 4-1: Incorporating current recommendations on cost-effectiveness analysis in health and medicine ( Sanders et al., 2016 ), standardized approaches should be developed to conduct financial analyses of the cost-effectiveness of permanent supportive housing in improving health outcomes. Such analyses should account for the broad range of societal benefits achieved for the costs, as is customarily done when evaluating other health interventions. (See Chapter 4 .)

Recommendation 4-2: Additional research should be undertaken to address current research gaps in cost-effectiveness analysis and the health benefits of permanent supportive housing. (See Chapter 4 .)

Recommendation 5-1: Agencies, organizations, and researchers who conduct research and evaluation on permanent supportive housing should clearly specify and delineate: (1) the characteristics of supportive services, (2) what exactly constitutes “usual services” (when “usual services” is the comparator), (3) which range of services is provided for which groups of individuals experiencing homelessness, and (4) the costs associated with those supportive services. Whenever possible, studies should include an examination of different models of permanent supportive housing, which could be used to elucidate important elements of the intervention. (See Chapter 5 .)

Recommendation 5-2: Based on what is currently known about services and housing approaches in permanent supportive housing (PSH), federal agencies, in particular the Department of Housing and Urban Development, should develop and adopt standards related to best practices in implementing PSH. These standards can be used to improve practice at the program level and guide funding decisions. (See Chapter 5 .)

Recommendation 7-1: The Department of Housing and Urban Development and the Department of Health and Human Services should undertake a review of their programs and policies for funding permanent supportive housing with the goal of maximizing flexibility and the coordinated use of funding streams for supportive services, health-related care, housing-related services, the capital costs of housing, and operating funds such as Housing Choice Vouchers. (See Chapter 7 .)

Recommendation 7-2: The Centers for Medicare & Medicaid Services should clarify the policies and procedures for states to use to request reimbursement for allowable housing-related services, and states should pursue opportunities to ex-

pand the use of Medicaid reimbursement for housing-related services to beneficiaries whose medical care cannot be well provided without safe, secure, and stable housing. (See Chapter 7 .)

Recommendation 7-3: The Department of Health and Human Services and the Department of Housing and Urban Development, working with other concerned entities (e.g., nonprofit and philanthropic organizations and state and local governments) should make concerted efforts to increase the supply of PSH for the purpose of addressing both chronic homelessness and the complex health needs of this population. These efforts should include an assessment of the need for new resources for the components of PSH, such as health care, supportive services, housing-related services, vouchers, and capital for construction. (See Chapter 7 .)

Chronic homelessness and related health conditions are problems that require an appropriate multidimensional strategy and an ample menu of targeted interventions that are premised on a resolute commitment of resources. More precisely defined and focused research to refine the menu of needed interventions, and a materially increased supply of PSH are part of the multidimensional strategy. The committee hopes that this report will help to stimulate research and federal action to move the field forward and further efforts to address chronic homelessness and improved health in this country.

Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed.

Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.

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• Arts & Humanities

Homelessness: Conclusion Study

15 Jan 2023

• Arts & Humanities

Format: MLA

Academic level: High School

Paper type: Essay (Any Type)

Downloads: 0

• Homelessness Essays

Homelessness is a social problem that requires a national approach for it to have a lasting solution. Although many societal and public policy approaches have been enacted to address the problem, it remains a major social issue that the United States is struggling to address. Despite the efforts by government agencies and non-profit organizations working hard towards the eradication of the problem with notable results, the problem remains strong. However, homelessness has been effectively managed among veterans, and the same can be replicated in other groups that are dealing with homelessness. Every society has its unique reasons or issues that result in people becoming homeless, although some of them are common. One of the standard solutions to the problem of homelessness needs to be the provision of housing for those who are genuine. 

Homelessness cannot be defined based on only one factor. There is a complex mixture of societal and individual factors that contribute to homelessness. Some of the individual factors associated with homelessness have an impact on a substantial percentage of the population. Some of these factors are related to mental illness, substance abuse, and addition. Any attempt to deal with the problem of homelessness has to first deal with individual factors. The analysis shows that there are people who are not genuinely homeless, as they have attained the status because of individual choices that reduce their productivity in society. In regards to societal causes, some of the ways that society has affected homelessness revolves around the increase in house prices and a decrease in funding. Another problem that escalates the problem and affects any attempt to eradicate the problem is public opinion. When public opinion shifts, polices and media follows reading to the varying response from the stakeholders. The shifting of public opinion may lead to resistance or acceptance of the proposed solutions. Solutions to homelessness do not have to be worth many funds as they can be community-based before expansion to cover larger audiences. Starting with a community gives room for evaluation and effective alteration to increase the chances of success. 

Delegate your assignment to our experts and they will do the rest.

There needs to be a multi-sector approach to attaining long-term solutions for homelessness. The first step is to prevent homeless by reducing the risk of housing crises in the first place. Families living in shelters or in makeshift places face barriers to functioning as families. Strategies to reduce the risk of homelessness should be done to ensure adequate and secure housing in order for families to function as a family. These strategies should mainly focus on the strengths as well as the participation of the families. Federal housing programs for homeless individuals have been proven to be one of the most effective methods in managing homelessness. The strategy’s focus ranges from landlord engagement, affordable housing, rapid re-housing, and supportive housing. The provision of health care is another solution that helps in reducing the risk of homelessness. People with chronic health usually affect the ability of individuals to remain housed. Having comprehensive health care deals with the risk of homelessness for those with chronic health issues. The government and other organizations need to focus on building career pathways as people are assisted in moving from homelessness to permanent housings. Job training and employment ensures that individuals make a living that reduces the chances of them returning to homelessness. Children of homeless individuals are more prone to facing challenges such as lagging behind in education, and fostering education should be an integral part of the strategy. 

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Why Homelessness Still Exists and How We Can End It

The Official Blog of the National Alliance to End Homelessness

By Jeff Olivet, Executive Director, U.S. Interagency Council on Homelessness

When one person—even one—dies on the street, we as a society have failed them. When one family seeking safe housing and a stable school for their children is discriminated against by a landlord, we have failed them. When one young queer person of color ages out of foster care with no place to go, or when one person completes a sentence and leaves prison only to end up in a shelter, we have failed. When one Veteran returns from serving this country and ends up homeless, we have failed.

I believe we can do better.

Over the last several decades, our public policies have allowed homelessness to persist. We have created homelessness on a systemic level—a societal level—and on a scale we have not witnessed since the Great Depression. Yet we try to solve it at the individual level. And we have gotten very good at that part of the picture. Effective housing and service interventions like Housing First, Critical Time Intervention, and others have helped hundreds of thousands of people exit homelessness over the past decade.

So why does homelessness still exist? Is it because what we are doing isn’t working? Absolutely not.

We have developed systems that are increasingly efficient in helping people move from homelessness to the stability and connection of a permanent home. We see these success stories every day. It is what inspires us to continue in this challenging work.

So what are we not doing right?

One problem is that we haven’t scaled effective solutions to meet the demand. Another is that we haven’t held ourselves and our communities accountable to the goal of ending homelessness. We too often measure ourselves by outputs rather than outcomes. We haven’t gone upstream to stem the tide of people becoming newly homeless. And we haven’t yet figured out how to address the underlying root causes of homelessness, including the dual crises of housing affordability and eviction, and the persistent structural racism that drives disproportionately high rates of homelessness for people of color.

The result is that even as we see individual successes all the time—tens of thousands of people every year exiting homelessness, holding down jobs, reconnecting with family and friends, stepping strongly into courageous journeys of recovery from mental health and substance use issues— we have not solved homelessness systemically . It is time that we do just that.

A systemic end to homelessness will require:

• Leading with equity , so that even as we work for an end to all homelessness for all people, we use strategies specifically designed to eliminate racial disparities.
• Grounding our policy decisions in accurate, real-time data, and sound evidence , so that we are making the best use of the resources we have. Until we have a clearer picture of the scope of the problem, it is impossible to understand the scope of resources needed to solve it.
• Going upstream to stem inflow and prevent homelessness from ever happening in the first place. This will require focused, cross-sector collaboration at the federal, state, and local levels in a way that we have not done before.
• Strengthening our crisis response system to address unsheltered homelessness, encampments, and barriers to shelter, so that people stay alive long enough to get back into housing and supports.
• Scaling effective housing solutions , with the recognition that housing is the stable foundation from which individuals, families, young people, seniors, and Veterans can achieve health, wellness, and connection.
• Providing a broad range of supportive services —from mental health and substance use treatment to employment and educational supports to childcare and transportation to direct cash transfers—so that people can sustain themselves in permanent housing.

In the coming months, the team from the U.S. Interagency Council on Homelessness (USICH) will release our federal strategic plan to guide the work of preventing and ending homelessness in the U.S. The plan will reflect what we heard from many of you through nearly 100 listening sessions that included many individuals who themselves have experienced the horrors of homelessness.

As we finalize the plan and roll it out, we will need your help putting it into action.

The work ahead will be difficult, but it will not be impossible. If we can imagine a better, more humane society , a society in which no one is left behind and no one is without a home, then we can build toward that vision. We must come together—housed and unhoused, Republicans and Democrats, government agencies and nonprofits, faith communities and corporations, people of all racial/ethnic backgrounds and all gender expressions and sexual orientations. We must come together to find common ground around the shared goal of ending homelessness once and for all.

We have a long road ahead. Remember to take care of yourselves and take care of each other. Find joy in the daily victories. Stay focused, stay strong, and stay engaged until homelessness is a relic of the past, a faded memory.

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Homelessness - Free Essay Samples And Topic Ideas

Homelessness is a social issue characterized by individuals lacking stable, safe, and adequate housing. Essays on homelessness could explore the causes, such as economic instability, mental health issues, or systemic problems, and the societal impacts of homelessness. Discussions may also cover various solutions and strategies being employed by different regions to address homelessness and support the affected populations. A substantial compilation of free essay instances related to Homelessness you can find at Papersowl. You can use our samples for inspiration to write your own essay, research paper, or just to explore a new topic for yourself.

Effects of Homelessness and Student Academic Achievement

Supporting and understanding the differing at-risk students, especially students experiencing homelessness, in the classroom is an important aspect of being an educator. Teachers are often seen as important referents in a community. The ways that teachers interact with homeless children and families convey important messages to children and families. Teacher views about children and families can indeed foster feelings of worthiness or the lack thereof (Powers-Costell & Swick, 2011 p.208). For teachers to teach these at-risk students, they must fully […]

Substance Abuse and Homelessness

Homelessness is becoming a more and more prevalent issue in America as years progress. Drive through any city's downtown area and you're bound to see at least one, if not many more, homeless individuals or families residing along the streets or in homeless camps. In many cases, these people have been suffering from homelessness for years and this has simply become their norm; this is known as chronic homelessness. Although this has become a way of life for many, homelessness […]

Veterans: Fight for Freedom and Rights

Veterans have sacrificed so much for our country by fighting to maintain our freedom and rights. For this reason, the government should do something about the veterans poverty rate. Veterans have resources that they could use but the resources do not always reach out to the veterans in need. The rate of homeless veterans is very high compared to non-veterans in the United States because they were usually not ever taught how to write a resume and many have had […]

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My Opinion about Homelessness

My opinion is based on what I see and encounter and also from research. Homelessness. Homeless people did not choose the lifestyle on purpose, misfortune made the choice for them consequently they should be generously assisted kind heartedly without social isolation, pity, job insecurities, humiliation, pitiful wages e.t.c. Learning by choice or pain, which would you rather settle with? Unique story. Every person who has become homeless has a unique story about what happened to them. I can fill these […]

Homelessness and Mental Illness

Research problem: Homelessness Research question: Why is the mental health population and people with disabilities more susceptible to becoming homeless? Mental health policies that underserve vulnerable people are a major cause of homelessness. The deinstitutionalization of mental hospitals, including the failure of aftercare and community support programs are linked to homelessness. Also, restrictive admission policies that keep all but the most disturbed people out of psychiatric hospitals have an effect on the rising number of homeless people. The New York […]

Homeless Veterans

From bullet shells, to bomb blasts, and potentially amputated limbs, U.S. soldiers face on the scariest and life threatening situations no man or woman could ever imagine. America's military is one of the strongest forces in the world and consists of the toughest and strongest men and women in the US. These soldiers have risked their lives, lost limbs, their friends, their family, and their lives. The bravery and honor that any soldier musters up to go into battle can […]

Homelessness Problem in LA

Homelessness in LA is not an isolated case in U.S but rather public issue from 1980s since represents a huge problem for several cities as well as for largely populated states. People are facing this problem in daily basis; every time we are waiting by the traffic lights on the street, homeless people approaches to us and ask us either for a food or a change. Homeless people are people who are without a home and therefore living on the […]

The Causes of Homelessness

Homelessness has been a problem in American society for many generations. There are countless amounts of people who live without a permanent home and lack the basic essentials of life, such as food,wds `1ater, and clothes. It is likely when you walk or drive in your city that you will encounter a homeless person. Often when you are passing by a homeless individual or group, the thought comes to your mind, how did the end up here? Or why or […]

How Poverty Affects a Child’s Brain and Education

Although children are some of the most resilient creatures on earth. Living in poverty has risks that can cause children all types of issues. That makes you wonder, does poverty have an effect on a child's brain development? The million dollar question. How does poverty affect children's brain development? Poverty can cause health and behavioral issues. There is suggestive evidence that living in poverty may alter the way a child's brain develops and grows, which can, in turn, alter the […]

Unemployment a Major Cause of Homelessness

Homelessness or known as extreme poverty can be interpreted as a circumstance when people have no place to stay with the result that they end up live in the street, under the bridge even at the side of the river. There are 3.5 million Americans are homeless each year. Of these, more than 1 million are children and on any given night, more than 300,000 children are homeless. They who do not have an occupation are the one that is […]

Homelessness is not a Choice

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Youth Homelessness in the United States

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Homelessness Policy in the United States

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How To Write an Essay About Homelessness

Understanding the complexity of homelessness.

Before beginning an essay on homelessness, it's essential to understand its complexity. Homelessness is not just the absence of physical housing but is often intertwined with issues like poverty, mental health, substance abuse, and social exclusion. Start your essay by defining homelessness, which may vary from sleeping rough on the streets to living in temporary shelters or inadequate housing. It's also important to acknowledge the different demographics affected by homelessness, such as veterans, families, the youth, and the chronically homeless. This foundational understanding sets the stage for a nuanced discussion in your essay.

Researching and Gathering Data

An essay on homelessness should be grounded in factual, up-to-date data. Research statistics from reliable sources such as government reports, reputable NGOs, and academic studies. This research might include figures on the number of homeless individuals in a specific region, the primary causes of homelessness, and the effectiveness of various intervention programs. By presenting well-researched information, your essay will not only be more credible but will also provide a factual basis for your arguments.

Selecting a Specific Angle

Homelessness is a broad topic, so it's crucial to select a specific angle for your essay. You might choose to focus on the causes of homelessness, the challenges faced by homeless individuals, or the societal impact of homelessness. Alternatively, you could discuss policy solutions and interventions that have been successful or have failed. This focus will provide your essay with a clear direction and allow you to explore a particular aspect of homelessness in depth.

Analyzing Causes and Effects

A key part of your essay should be dedicated to analyzing the causes and effects of homelessness. Discuss various factors that lead to homelessness, such as economic downturns, lack of affordable housing, family breakdown, and mental health issues. Similarly, explore the impact of homelessness on individuals and society, like health problems, social isolation, and economic costs. This analysis will help readers understand the multifaceted nature of the problem.

Discussing Solutions and Conclusions

Towards the end of your essay, discuss potential solutions to homelessness. This could include government policies, community-based initiatives, or innovative approaches like housing-first models. Highlight the importance of a multi-faceted approach, addressing not just the lack of housing but also underlying issues like health care, education, and employment support. Conclude your essay by summarizing the key points discussed, restating the importance of addressing homelessness, and suggesting areas for future research or action.

Finalizing Your Essay

After writing your essay, take the time to review and refine it. Ensure that your arguments are coherent and supported by evidence. Check for grammatical errors and ensure that your writing is clear and concise. It might also be beneficial to get feedback from peers or instructors. A well-written essay on homelessness will not only inform but also potentially inspire action or further discussion on this critical social issue.

• Open access
• Published: 16 September 2024

Social isolation and loneliness among people living with experience of homelessness: a scoping review

• James Lachaud 1 , 2 ,
• Ayan A. Yusuf 2 ,
• Faith Maelzer 2 , 3 ,
• Melissa Perri 2 , 4 ,
• Evie Gogosis 2 ,
• Carolyn Ziegler 5 ,
• Cilia Mejia-Lancheros 2 , 6 &
• Stephen W. Hwang 2 , 4 , 7  

BMC Public Health volume  24 , Article number:  2515 ( 2024 ) Cite this article

Metrics details

Social isolation and loneliness (SIL) are public health challenges that disproportionally affect individuals who experience structural and socio-economic exclusion. The social and health outcomes of SIL for people with experiences of being unhoused have largely remained unexplored. Yet, there is limited synthesis of literature focused on SIL to appropriately inform policy and targeted social interventions for people with homelessness experience. The aim of this scoping review is to synthesize evidence on SIL among people with lived experience of homelessness and explore how it negatively impacts their wellbeing. We carried out a comprehensive literature search from Medline, Embase, Cochrane Library, PsycINFO, CINAHL, Sociological Abstracts, and Web of Science's Social Sciences Citation Index and Science Citation Index for peer-reviewed studies published between January 1st, 2000 to January 3rd, 2023. Studies went through title, abstract and full-text screening conducted independently by at least two reviewers. Included studies were then analyzed and synthesized to identify the conceptualizations of SIL, measurement tools and approaches, prevalence characterization, and relationship with social and health outcomes. The literature search yielded 5,294 papers after removing duplicate records. Following screening, we retained 27 qualitative studies, 23 quantitative studies and two mixed method studies. SIL was not the primary objective of most of the included articles. The prevalence of SIL among people with homelessness experience varied from 25 to 90% across studies. A range of measurement tools were used to measure SIL making it difficult to compare results across studies. Though the studies reported associations between SIL, health, wellbeing, and substance use, we found substantial gaps in the literature. Most of the quantitative studies were cross-sectional, and only one study used health administrative data to ascertain health outcomes. More studies are needed to better understand SIL among this population and to build evidence for actionable strategies and policies to address its social and health impacts.

Peer Review reports

Introduction

Social isolation and loneliness (SIL) are major social and health issues representing a growing global public health challenge, particularly for socio-economically excluded and underserved populations [ 1 , 2 ]. Social isolation is defined as a lack of close or meaningful relationships and results from multidimensional experiences associated with exclusion from mainstream society, hopelessness, abandonment, social marginalization, lack of community networks and dissatisfaction with relationships [ 3 , 4 ]. Loneliness is a more personal and subjective multifaceted experience consisting of different types of self-perceived social deficits, including social loneliness, defined as a self-perceived lack of friendships in either quality or quantity and emotional loneliness, experienced as a deficit of intimate attachments such as familial or romantic relationships or feeling alone and isolated [ 3 , 4 , 5 ].

SIL has been linked to putting people at increased risk for adverse health outcomes, social distress and premature death [ 6 ]. Lack of adequate social support has been reported to increase the odds of premature death by 50% [ 6 ]. Previous studies have also found an association between SIL and increased risk of developing dementia, coronary heart disease and stroke, poorer mental and cognitive health outcomes, and consumption of a low-quality diet [ 7 , 8 ]. While SIL affects many populations, individuals with experiences of being unhoused are among those with the highest risk of being socially isolated and lonely. First, experiences of homelessness are visible and extreme forms of social exclusion. Unhoused people are more socially disconnected, can feel rejected or abandoned, and may not have appropriate informal (family, relatives, friends) and formal support networks [ 9 , 10 ]. Second, even after being housed, structural forms of oppression (i.e., racism) and discrimination associated with previous experiences of being unhoused continue to impact individuals’ lives and deprive people of meaningful recovery and social integration, connection and relationships [ 11 , 12 , 13 ]. Individuals who have experienced homelessness often face persistent stigma and discrimination that can affect their social interactions and access to essential services [ 12 ]. People with experiences of being unhoused have self-reported higher odds of poor mental and physical health and loneliness than their housed counterparts [ 14 ]. Moreover, people with experiences of being unhoused have lower life expectancy and experience impairments associated with aging earlier compared with people without experiences of being unhoused [ 15 , 16 , 17 ]. These factors can make individuals more vulnerable to social and economic abuse, which may affect their ability to build meaningful social connections.

Recent years have seen increased initiatives to address SIL among formerly homeless populations. There is some consensus in social work to consider SIL in needs assessments for health and social care for some specific population groups, such as seniors and youth [ 18 , 19 ]. More resources are being allocated to address SIL in supportive housing programs and intervention design [ 20 ]. Social prescribing, which involves primary care physicians prescribing social activities to patients as a strategy to strengthen social engagement and lower loneliness, is becoming a growing practice [ 21 , 22 ]. Nonetheless, SIL remains complex to conceptualize, and it has been difficult to measure its prevalence and association with social and health outcomes and other indicators of wellbeing. Without a clear conceptualization and measurement approach, it is uncertain how to design adequate interventions and policies to address SIL.

The aim of this scoping review was to identify, map, and synthesize the findings of qualitative and quantitative studies that measure SIL among people over the age of 18 with lived or living experience of homelessness including those living in supportive or social housing, or staying in emergency or transitional accommodation in order to highlight the gaps in the existing literature and inform the development of future interventions. This scoping review will aim to answer the following questions:

How are SIL conceptualized across studies involving people with experience of homelessness?

What scales and tools are used to measure SIL across these studies?

What is the prevalence of SIL and the relationship between SIL and social and health outcomes in people with experience of homelessness?

Data sources and searches

The scoping review protocol followed the methodology outlined by Arksey and O’Malley, Levac et al. [ 18 ] and is guided by Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA ScR) [ 23 ]. Initially, a preliminary search was performed in Medline and Embase to identify any existing scoping reviews related to the topic, and to refine the search strategies by pinpointing key concepts and determining an appropriate timeframe to include relevant studies [ 24 ]. Then, comprehensive literature searches were carried out by an information specialist (CZ) in Medline (Ovid platform), Embase (Ovid), Cochrane Central Register of Controlled Trials & Cochrane Database of Systematic Reviews (Ovid), PsycINFO (Ovid), CINAHL (EBSCOhost), Sociological Abstracts (ProQuest), and Web of Science's Social Sciences Citation Index and Science Citation Index. The search strategies had a broad range of subject headings and keywords, adapted for each database, for the two core concepts of SIL and homelessness or social housing, combined with the Boolean operator AND. The searches were limited to articles in English, French, and Spanish published between January 1st, 2000 to October 27, 2021, followed by an updated search to January 3rd, 2023. The publication languages were chosen for feasibility purpose, considering the linguistic capacity of the research team. Comments, editorials, and letters were excluded from the search. There were a total of 8,398 results from these two rounds of searches prior to de-duplication (7,356 at search one and 1,042 at search two) and the records were compiled in EndNote. The complete search strategies as run are included in the Supplementary material .

Definition and screening process

To refine our screening process, we defined individuals experiencing homelessness as those lacking stable, safe, permanent, and appropriate housing, or the immediate means and ability to acquire such housing [ 25 ]. This definition encompasses individuals who are marginally housed or at high risk of eviction, including individuals who are "doubled up," couch surfing, or living in overcrowded conditions [ 26 ].

To be considered eligible for inclusion, we established the following inclusion criteria for the scoping review:

studies had to include participants that were people with homelessness experience or marginally/vulnerably housed populations (people living in supportive housing or shelters). While our screening process did not establish an age criterion, we excluded studies that focused exclusively on minors (under 18 years old) experiencing homelessness. This decision was made as a recent study showed that minors experiencing homelessness might need specific considerations and theoretical framework [ 27 ];

studies had to be peer-reviewed qualitative and quantitative original research papers published in English, French, or Spanish;

studies had to be published between 2000-and January 3, 2023;

studies had to examine or include in the analyses: loneliness, social isolation, social disconnection, solitude, social withdrawal, abandonment, lack of contact, social exclusion or rejection.

We excluded papers that were systematic or scoping reviews, and papers where the studied populations was exclusively minors; where the field activities and data were collected from caregivers or other workers, and not people with homelessness experience or marginally/vulnerably housed; studies that only focused on networking, social or community integration and did not refer to social isolation or loneliness. No exclusion was made based on geographic region or countries, however we excluded studies that focused on people residing in camps due to displacement from war, insecurity, or major natural disasters, as these situations are typically addressed by different theoretical and humanitarian frameworks [ 28 ].

The results from all searches were imported to Covidence systematic review software, where duplicates were removed. The searches yielded 5,294 papers for screening after the deletion of duplicates. Four researchers (AY, EG, FM, and MP) screened the article titles and abstracts independently and in duplicate in Covidence using the predetermined inclusion and exclusion criteria. The full-text of the articles that met our eligibility criteria were then assessed by two independent reviewers. At both stages, differences in voting were discussed and resolved as a group, and included the Principal Investigator (JL). In total, 52 articles met the criteria for data extraction and analyses. The PRISMA diagram in Fig.  1 shows the flow of information through the different stages of the review.

PRISMA flow diagram

Data extraction

The main characteristics, research questions, targeted populations, measurement and findings of the selected studies were extracted in an Excel database file by the four researchers (AY, EG, FM, and MP) and reviewed by the Principal Investigator (JL). A summary of each selected paper can be found in Tables 1 and Table  2 .

Data synthesis

The studies reviewed exhibited considerable variability in their methodological approaches, participant demographics (including young adults, adults, and seniors) or sex and gender-based groups, measures of SIL, definitions of homelessness experience, and countries where they were conducted. To provide a thorough overview, we examined both quantitative and qualitative research. Initially, we assessed the theoretical frameworks used in these studies to better grasp the conceptualization and ongoing discussions about SIL within the target population. In our analysis of quantitative studies, we identified key similarities and differences in SIL measurements, demographic characteristics, discussions of the prevalence and patterns of SIL and its relationship with health status. To deepen our understanding, we used a crosswalk approach [ 29 ] using both quantitative and qualitative studies to examine how participants described, contextualized, and nuanced their experiences of SIL, and how SIL related to demographic factors, gender, and homelessness experience.

Overview of included studies

The main characteristics of the 52 articles included in this review are outlined in Tables 1 and Table  2 . Most articles (n = 42) were published from 2010 and later and were conducted in the US (n = 16) and Canada (n = 16). Study methodology was almost evenly split between quantitative (n = 23) and qualitative (n = 27) methods, and a very small number (n = 2) used a mixed methods approach. Among quantitative studies, 18 had a cross-sectional or one-point-in-time design, and 5 used a longitudinal design. Most of the qualitative studies (15) used a thematic analysis approach.

Characteristics of the populations covered in included studies

Among included articles, 4 focused on women [ 30 , 31 , 32 , 33 ] and older women [ 34 ]; 5 studies examined male [ 35 , 36 , 37 , 38 ] or older male populations [ 39 ]. In total, 10 articles focused on older adults, which usually included early aging starting from 50 years [ 40 ] or 55 years [ 41 ] of age and above for populations with experience of homelessness. We found no studies that focused on non-binary groups, though gender-diverse self-identified individuals were included in 6 of the studies [ 33 , 42 , 43 , 44 , 45 , 46 ]. Moreover, there were a small number of studies (n = 6) focused on youth. Three of these were quantitative studies [ 47 , 48 , 49 ] comparing homeless youth and young adults to youth in the general population. The other 3 were qualitative studies [ 50 , 51 , 52 ]; 2 described how youth experience loneliness [ 51 , 52 ]; one study identified strategies for dealing with feelings of loneliness among homeless adolescents [ 50 ]. Three studies [ 53 , 54 , 55 ] focused on a population of veterans who were currently experiencing homelessness or were formerly homeless and living in either subsidized or supportive housing. Participants’ ethnicity was reported in most of the studies (n = 32).

Social isolation and loneliness as the primary objective

Only 18 of the 52 studies focused on SIL as their primary objective or included SIL in the main research questions. Of these 18 studies, 13 were quantitative and 5 were qualitative as summarized in Tables 1 and  2 . In the remaining 34 articles, SIL neither was the main objective nor clearly stated in the objectives or research questions. In those studies, SIL was usually considered as one of the potential explicative or control factors [ 30 , 56 , 57 ], and eventually emerged or co-created from participants’ narratives.

Conceptualization of social isolation and loneliness

Different theoretical frameworks were used to contextualize SIL in relation to unhoused or homelessness experiences. For some studies, SIL was embedded in the homelessness experience, since homelessness is in itself a form of social exclusion, which limits people’s participation in society [ 36 , 58 ]. Lafuente et al. [ 36 ] explained the experience of unhoused men through the lens of social disaffiliation theory. They explained that situational changes (i.e., loss of employment) or intrinsic factors (voluntary withdrawal) caused participants to become socially disaffiliated. Narratives on isolation from this study revealed feelings of alienation, powerlessness, self-rejection, depression, loneliness and unworthiness. Similarly, the study by Burns et al. [ 39 ] explained how the transient nature of being unhoused creates interrelated dimensions of social exclusion, generating a sense of invisibility, identity exclusion, racism, exclusion of social ties and meaningful interactions with the community, thus leading to social isolation.

Bell and Walsh [ 37 ] conceptualized SIL among individuals experiencing homelessness as being driven by mainstream normative conceptions of homelessness and the stigma of homelessness. The authors suggest that conceptions of homelessness conflate between notions of “rooflessness” and “rootlessness” which “denotes the absence of support and inclusion in one’s community driving experiences of isolation and loneliness.” [ 37 ].

In the study by Baker et al., [ 58 ] SIL is discussed as part of a new landscape of a network society and digital exclusion. The rapid development of information and communication technologies (ICT) has drastically changed human communication and interactions leaving many behind and out of communication flows . The authors explained that aging combined with many social disadvantages like histories of homelessness, multiple complex needs, rural areas of residence, and economically restricted mobility can contribute to creating or keeping affected older adults disconnected and socially isolated.

Meaning and experiences of social exclusion and, in particular SIL were further voiced through semi-structured qualitative interviews or focus groups in different studies. Often, participants reflected on how broader structural stigmatization and alienation associated with housing insecurity contributed to their perceived SIL. Jurewicz et al. [ 59 ] highlighted how systemic policies and practices affecting individuals experiencing homelessness who used substances generate and contribute to ongoing experiences of housing precarity, loneliness and isolation. Participants further discussed the complex interrelationship between substance use and homelessness including the strain on social relationships as a result of substance use [ 59 ]. Similarly, Martínez et al., [ 60 ] described how experiences of loneliness are driven by a lack of meaningful relationships, conflicts with families, a lack of social inclusion, and marginalization faced by individuals residing in a residential center in Gipuzkoa, Spain. In the study by Johnstone et al., [ 61 ] social isolation was defined as being associated with not having perceived opportunities to develop multiple group memberships.

Experiences and conceptualizations of loneliness were not strictly dependent upon one’s lack of access to housing. Two studies discussed how the transition into supportive or transitional housing further exacerbated experiences of loneliness and isolation [ 53 , 62 ]. Polvere, Macnaughton and Piat [ 62 ] and Winer et al. [ 53 ] highlighted that the transition to living within congregate-supported settings or independent apartments can be linked to experiences of SIL even when people are offered social engagement activities. Some participants reported feeling voluntarily isolated as they did not want to engage with others and some participants anticipated social isolation due to transitioning into a new environment.

Measurement tools to assess social isolation and loneliness

There were multiple approaches to measuring SIL across all studies, including widely used and validated multi-item scales and single-item measures. There were three main scales that were developed, revised, tested or used to measure SIL among people experiencing homelessness: The Rokach Loneliness questionnaire, the UCLA Loneliness Scale and its revised versions, and the De Jong Gierveld Loneliness Scale. 

The rokach loneliness questionnaire

Five studies used the Rokach Loneliness Questionnaire [ 47 , 48 , 49 , 63 , 64 ]. The Rokach Loneliness Questionnaire [ 47 , 48 ] measures causes of loneliness and coping strategies and has been used in studies with young people aged 15–30 in Toronto, Canada. The questionnaire measures the experience of loneliness across five factors, with yes/no items on five subscales: emotional distress such as pain or feelings of hopelessness; social inadequacy and alienation including a sense of detachment; growth and discovery such as feelings of inner strength and self-reliance; interpersonal isolation including alienation or rejection; and self-alienation such as feelings of numbness or denial. The items on the interpersonal isolation subscale relate to an overall lack of close or romantic relationships.

The UCLA loneliness scale

Six of the studies in this review used the UCLA Loneliness Scale or a revised version. Novacek et al. [ 54 ] assessed subjective feelings of SIL among Black and White identifying veterans with psychosis and recent homelessness compared with a control group at the onset of the COVID-19 pandemic. The 20-item scale was used to measure subjective feelings of SIL over the past month. Participants rated their experience ranging from “never” to “often,” with higher scores indicating higher subjective feelings of loneliness. Lehmann et al. [ 38 ] used a revised version of the UCLA Loneliness Scale to examine individual factors including loneliness relevant in people experiencing homelessness to report their victimization to police. The researcher recruited 60 self-identified adult males aged 19 to 67 currently experiencing homelessness in Germany and used a revised and shorter German UCLA Loneliness Scale developed by Bilsky and Hosser [ 65 ], to measure loneliness. The scale is composed of 12 items with a 5-point Likert scale ranging from 0 (“not at all”) to 5 (“very much”) and positively formulated items were recorded to reflect a higher level of loneliness. The load factors for the scale are experiences of general loneliness, emotional loneliness, and inner distance. Drum and Medvene [ 66 ] used the UCLA-R Loneliness Scale, which has been adapted for an older adult population to measure loneliness among older adults living in affordable seniors housing in Wichita, Kansas. This version is composed of 23 items, with a four-point Likert scale-type of response options. Participants’ total score ranged from 20 to 80, with a higher score representing greater loneliness.

Tsai et al. [ 67 ], Dost et al. [ 68 ] and Ferrari et al. [ 69 ] used a shortened revised version of the UCLA Loneliness Scale Version 3, which consists of three items: “how often they feel they lack companionship, how often they feel left out, and how often they feel isolated from others.” Participants self-reported their responses using a 3-point Likert scale (“hardly ever,” “some of the time,” and “often”) to answer questions. A summed score of 3 to 5 is defined as not lonely and a summed score of 6 or more is defined as lonely. The 3-item scale is used widely in research and clinical settings as a short assessment of loneliness.

De Jong Gierveld loneliness scale

Valerio-Urena, Herrara-Murillo and Rodriguez-Martinez [ 70 ] examined the association between perceived loneliness and internet use among 129 currently homeless single adults aged 35–60 staying in a public shelter in Monterrey, Mexico. The authors used questions from the De Jong Gierveld Loneliness Scale, which includes 11 items with three response options (1 = no, 2 = more or less, 3 = yes) asking about having friends or people to talk with or contact, feeling empty or missing other people’s company, and having people or friends you can trust. The subscales measure emotional loneliness (due to the lack of a close relationship) and social loneliness (due to the lack of a general social network) with scores ranging between 0 (no solitude) and 11 (extreme solitude).

Other social isolation and loneliness scales

Some of the quantitative studies used subscales or single questions from measurement tools that were not primarily designed to measure SIL. For example, Cruwys et al. [ 71 ] used the short form of the Young Schema Questionnaire, which included 75 items with five items assessing each of the 15 schemas. This study focused on the social isolation schema, which was described as a “feeling that one is isolated from the rest of the world, different from others, and or/ not part of a group.” Statements included “I don’t fit in; I don’t belong; I’m a loner; I feel outside the groups.” Respondents answered on a 6-point scale from 1 if “completely untrue to me” to 6 if “describes me perfectly.” In this study, participants who responded with 5 or 6 (“Mostly true of me” or “describes me perfectly”) on the scale were assigned 1 point, otherwise they were assigned 0 points.

Wrucke et al. [ 72 ] investigated factors associated with cigarette use among people with experiences of homelessness. Social isolation was one of the variables hypothesized to be associated with smoking among this population. The authors used the short form of the social isolation questionnaire developed using the Patient-Reported Outcomes Measurement Information System (PROMIS). PROMIS defines social isolation as the “perceptions of being avoided, excluded, detached, and disconnected from, or unknown by others.” It uses a 4-item social isolation questionnaire to capture each of these dimensions, for which the option of responses range from never to always.

In their study, Drum and Medvene [ 66 ] used the Lubben Social Network Scale (LSNS) to measure social isolation in addition to the UCLA-R Loneliness Scale mentioned above. LSNS was used as a measure of risk of isolation and included 10 items; three (3) items referred to family networks, three items (3) to friend networks, and four items (4) to confident relationships. Each of the items had a five-point Likert scale-type response, with the total adding up to a score between 0 and 50. A higher score on the LSNS represents greater risk of social isolation. Participants were categorized based on their LSNS score as low risk (0–20), moderate risk (21–25), high risk (26–30), or isolated (31–50).

Ferreiro et al. [ 73 ] used one question from the 22-item Camberwell Assessment of Need (CAN) to measure loneliness among Housing First program participants in Spain. One item asks, “Does the person need help with social contact?” and the answer is classified as a serious problem if a respondent answered, “Frequently feels lonely and isolated.” Rodriguez-Moreno [ 31 ] used the General Health Questionnaire (GHQ-28) which includes a subscale of somatic symptoms, anxiety and insomnia, social dysfunction and depression to study the mental health risk of women with homelessness experience. The GHQ has one question related to “feeling lonely or abandoned.” Similarly, Vazquez et al. [ 30 ] reported one question on the extent participants feel lonely or abandoned using a 4-point Likert scale ranging from “not at all” to “a lot.” Pedersen, Gronbaek and Curtis [ 74 ], Bige et al. [ 56 ] and Muir et al. [ 57 ] also measured loneliness using one question. Another study by Rivera-Rivera et al. [ 55 ] examined factors associated with readmission to a housing program for veterans with a number of measurement tools and administrative data to create a profile of participants. In their study, social isolation was measured using the relationships section of the significant psychosocial problem areas of the Social Work Behavioral Health Psychosocial Assessment Tool where isolation/withdrawal can be measured using “yes” or “no” responses [ 55 ]. Finally, Bower [ 75 ] piloted the short version of the Social and Emotional Loneliness Scale for Adults (SELSA-S) with a group of 129 Australian adults with homelessness experience. However, this paper was excluded from our review as the authors concluded that the SELSA-S seems to be inappropriate to measure loneliness among people with homelessness experience.

Prevalence and scores of social isolation and loneliness: quantitative evidence

The prevalence of SIL varied from 25% to more than 90% across studies included in this review. Based on LSNS risk categorizations, Drum and Medvene [ 66 ] found over one-quarter (25.8%) of participants were categorized as being socially isolated and nearly one in five (19.4%) as being at high risk for social isolation. Cruwys et al. [ 71 ], using the Young Schema Questionnaire-2 found more than one-quarter (28%) of participants reported elevated social isolation at time T1 (day 1) of the study, with no change in social isolation reported at time T2 (2 weeks after leaving temporary accommodations). An examination by Rivera et al. [ 55 ] of 620 patient records of veterans who requested services at the Homeless Program of the VA Caribbean Healthcare System from 2005 to 2014 found that over one-third (34.7%) reported experiencing social isolation. In a study with 1,306 socially marginalized people recruited at shelters and drop-in centres in Denmark, more than one-quarter (28.4%) reported often unwillingly being alone [ 74 ]. Bige et al. [ 56 ] found that more than 90% of 421 people experiencing homelessness were socially isolated.

Using the De Jong Gierveld Loneliness Scale, Herrara-Murillo and Rodriguez-Martinez [ 70 ] estimated an average score of 7.12 for loneliness among surveyed participants, which is between moderate and severe loneliness (score = 8). Ferrari et al. [ 69 ] also found a high mean score among homeless adults (score = 6) at baseline, based on the revised 3-item UCLA scale. Rokach [ 64 ] reported homeless adults had significantly higher mean subscale scores than non-homeless adults on four of five subscales measuring loneliness: interpersonal isolation (3.44 vs 2.82), self-alienation (1.92 vs 1.27), emotional distress (2.97 vs 2.73), and social inadequacy and alienation (2.92 vs 2.70).

Social isolation and loneliness evidence in qualitative studies

Twenty-nine studies reported qualitative evidence with the majority (n = 15) using thematic analysis to convey experiences of SIL among participants with histories of being unhoused or experiences of housing precarity. In most qualitative studies, participants referred to a lack of social connectedness, weak relationships with community members, family, or friends, feelings of abandonment, or a desire to withdraw. In a study by Bower, Conroy and Perz [ 10 ], researchers explored experiences of social connectedness, isolation and loneliness among 16 homeless or previously homeless adults ages 22–70 in Sydney, Australia. Participants described feelings of rejection through marginalization and stigma, rejection from family, lack of companionship, and shallow and precarious relationships with others, which made them feel alone [ 10 ].

Similarly Burns et al., [ 39 ] reported social isolation among older adults with histories of chronic homelessness living at a single-site permanent supportive housing program in Montreal, Canada. Participants revealed that they were socially excluded based on their ethnicity and sexual orientation, which made them feel isolated. Participants in the study by Lafuente [ 36 ] attributed their feelings of isolation to experiences of being unhoused and narratives from 10 male-identifying participants centered on discussions of isolation, including feelings of alienation, depression, loneliness, resignation, unworthiness and withdrawal. Participants shared their feelings of being “frightened, sad, lonely, and frustrated” and wanting to “withdraw from society” [ 36 ]. Studies by Kaplan et al. [ 76 ] and Grenier et al. [ 41 ] also reported concerns of social isolation due to lack of strong familial ties among participants, which impacted their engagement with services and contributed to feeling isolated and ostracized.

In a study of 46 adults using shelters and drop-in centres in Denmark, participants reported challenges with developing lasting and meaningful social relationships with others [ 77 ]. With data from the 30 participants included in the analysis, the authors categorized SIL into 5 groups: socially related and content (n = 9) characterized by satisfying relations with social and professional groups; satisfied loners (n = 5) centered on social isolation bringing rewards of peace and quiet; socially related but lonely (n = 4) focused on superficial social relations; socially isolated (n = 9) comprised of sporadic social connections; and in-between (n = 3) characterized by broad networks, however feeling unsatisfied with social networks [ 77 ].

Other studies focused on experiences of SIL in relation to the negative consequences of being unhoused and experiencing associated stigma. Bell et al. [ 24 ] revealed participants’ feelings of worthlessness as a result of the social stigma of being unhoused. Participants described homelessness as: “ walking around with a big sign on your head that says , “ I’m worthless” … the way you are looked on by society, like you feel like an alien…you always have to leave because you’re not welcome, you’re not welcome, you’re not welcome anywhere. In a town of a million people you are made to feel like you’re by yourself and you’re alone because there is nowhere to go.”  Another study aimed to understand the experiences of SIL among 11 adults ages 22–60 (5 self-identified females; 6 self-identified males) staying in residential centers in Spain [ 60 ]. Participants reported feelings of loneliness as a chronic and persistent experience. One participant described it as follows: “I’ve always felt lonely, everywhere I’ve been, even having people around me…It’s not about being physically alone…it’s a loneliness inside.” [ 60 ].

Nonetheless, transitioning from homelessness to housing does not imply a reduction in SIL, at least in the short term. Several qualitative studies [ 53 , 62 , 78 , 79 , 80 ] were conducted with participants of the At Home / Chez Soi study, a pragmatic randomized controlled trial in Canada that used a Housing First approach to provide housing and supports to individuals experiencing homelessness and mental health problems [ 11 ]. Some participants who received housing experienced loneliness [ 80 ] whereas others expressed concerns about not being able to cope with social isolation following a transition to independent housing [ 62 ]. Moving into housing can contribute to SIL with a shift from being surrounded by people in congregate settings such as shelters or jail, to living alone [ 78 , 33 ]. One participant said: “ It’s [the transition] hard because I’m used to having people around me all the time.” [ 62 ] In a study by Winer et al. [ 53 ], some participants who received housing chose not to socialize or build relationships: “ But I don’t socialize here at all. I didn’t think, I didn’t realize that I would be so isolated. You know, I could go knocking on doors and try to be friends with people. But I just don’t bother to do that. I’m not interested in reaching out .”

Other studies examining individuals accessing transitional accommodation reported that participants’ positive comments illustrated connections with peers and program staff and these connections resulted in them no longer feeling lonely or isolated [ 61 ]. Over one-third (34%) of participants reported positive experiences with respect to their accommodations, interactions with caseworkers and with their peers/other residents, which made them not feel lonely or isolated. Another study [ 81 ] found access to supportive housing was also associated with a reduction in drug use; while some participants were spending time alone, they did not report feeling lonely. Some reported having pets and others did volunteer work to help them overcome feelings of social isolation.

Other studies reported SIL among young populations with homelessness experience. A study by Rew [ 50 ] conducted interviews and focus groups with 32 homeless youth ages 16–23 participating in a community outreach project in central Texas. Participants discussed reasons for loneliness including personal loss, traveling and being away from family and friends, and at certain times, for example at night, during winter, or specific occasions such as holidays and birthdays: “ I just get lonely at night…more at night .” [ 50 ] Another study by Johari et al [ 52 ] conducted interviews and focus groups with 13 individuals ages 18–29 in Iran about their experiences of homelessness. Participants described feeling lonely, harassed and abandoned by society. Themes that emerged from the interviews included “ avoidance of/ by society, comprehensive harassment, and lack of comprehensive support. ” [ 52 ] Participants reported feeling isolated due to a loss of self-confidence and social trust. One participant shared, “ I have nothing to do with anyone, and I am alone .”

Some qualitative studies reported on SIL among people with experiences of homelessness in the context of COVID-19 [ 51 , 79 , 82 , 83 ]. These studies explained how social distancing and other public health restrictions disrupted social relationships with housing staff, other residents, family members and communities and reduced access to services. Participants discussed how an increased fear and a lack of social networks exacerbated feelings of social isolation during lockdown periods: “ Aside from not being allowed to go out the f… door aye. I’m not allowed out. Everybody else can go for a walk, I am imprisoned in the square .” [ 83 ] Another study by Noble et al. [ 51 ] analyzed the impact of COVID-19 on 45 youth ages 16–24 living in emergency shelters in Toronto, Canada. Youth stressed that the pandemic and associated public health restrictions (e.g., closed common spaces, canceled in-person activities, social distancing and single-occupancy sleeping arrangements) led to reduced access to important social networks, and an associated increase in feelings of SIL: “ Like, right now, because of everyone’s at home, because of the lockdown and you can’t really like meet people […] it’s a very challenging moment, it’s testing me, another limit of me.” [ 51 ].

Intersectionality in homelessness, social isolation and loneliness

Using an intersectionality framework, defined as an approach that explores how various forms of discrimination and privilege overlap and interact to influence an individual’s experiences and challenges [ 84 ],we analyzed how studies explored the critical role of multiple identities in shaping SIL experiences among people with homelessness experience. People reported different SIL experiences and faced different SIL-related challenges based on their gender [ 69 ], ethnicity and sexual orientation [ 39 ], and age [ 48 ]. For example, Ferrari et al. [ 69 ], using the revised 3-item UCLA scale, found women had statistically significant and higher mean loneliness scores (6.29) compared with men (5.57). Using the same scale, Dost et al. [ 68 ] reported an average loneliness score of 5.2 (SD = 1.9); among self-identified men it was 5.1 (SD = 1.9) and among self-identified women, it was 5.4 (SD = 2.0) (n = 265 reported frequency of loneliness). Using the De Jong Gierveld Loneliness Scale, Herrara-Murillo and Rodriguez-Martinez [ 70 ] found younger participants ( < 35 years of age) reported slightly higher levels of loneliness (mean score = 7.88) compared with older adult participants (between 35–60 years of age) (mean score = 7.4). Rokach [ 47 , 48 ] found homeless youth, compared to young adults, had higher mean subscale scores on interpersonal isolation (3.43 vs. 2.84) and self-alienation (1.91 vs. 1.48).

Other studies among younger populations also described how young people with experiences of being unhoused and coping with SIL are significantly different than their housed counterparts and older adults. Histories of addiction, rejection, trauma, and violence were intertwined with loneliness for young people with experience of homelessness [ 48 , 50 , 51 , 52 ]. A study by Rokach [ 48 ] focusing on the experiences of loneliness among homeless youth in a Canadian urban city found that causes of loneliness included feelings of personal inadequacy, developmental deficits, unfulfilling intimate relationships, relocation, and social marginality, which are unique to these groups of individuals when compared with older adults.

Toolis et al. [ 33 ] examined how multi-faceted forms of structural inequities faced by self-identified women experiencing homelessness (i.e., stigmatization, violence, and child apprehension) drive social exclusion experiences from services, peers, and broader society. This study illustrated how organizational settings with a culture of acceptance, support and mutuality can help women develop positive affirming relationships with one another that can alleviate feelings of social isolation. In this analysis, participants highlighted how their transgender identity contributed to experiences of isolation and loneliness and how their experiences were driven by forms of oppression prevalent across social service spaces such as co-ed shelters [ 33 ].

Association between SIL and health status or outcomes

Among the quantitative studies, only 8 reported direct associations between SIL and health status or outcomes (See Table  3 ). All of these studies utilized cross-sectional analyses and only one [ 56 ] used health administrative data to ascertain health outcomes. The health status and outcomes examined in these studies varied and included self-rated health [ 74 ], subjective health status [ 66 ], current cigarette use [ 72 ], ICU and hospital mortality [ 56 ], physical health burden [ 40 ], and risk of mental ill-health [ 31 ]. Additionally, some studies also examined social distress indicators such as sleep patterns [ 85 ], and experiences with eviction [ 67 ] or readmission to housing programs [ 55 ].

SIL was significantly associated with physical and mental health outcomes for people with experiences of homelessness. Drum and Medvene [ 66 ] found a negative correlation between subjective health and SIL (r = -0.39, p > 0.03). SIL was associated with higher odds of reporting poor health and mental health among men (OR: 1.98, 95% CI 1.36–2.88), but not statistically significant for women (OR: 1.71, 95% CI 0.96–3.05) [ 74 ]. Another study found participants who reported being sick had a higher level of SIL than those who reported being healthy (OR: Sick 1.228(0.524) p < 0.05) [ 70 ].

Moreover, a study by Patanwala et al. [ 40 ] reported that participants in the moderate-high physical symptom burden category had a significantly higher SIL score than participants in the minimal-low physical symptom burden category (AOR 2.32, 95% CI 1.26–4.28)). In addition, homeless veteran participants who reported SIL were 1.36 more likely (95% CI: 1.04–1.78) to report readmission to the Homeless Program of the VA Caribbean Healthcare System when compared to those who did not report social isolation [ 55 ].

Furthermore, people with severe mental health problems are generally at higher risk of being socially isolated or feeling alone. For example, Rodriguez-Moreno [ 31 ] compared homeless adult women at high risk of mental-ill health (HW-MI) and homeless women not at high risk of mental-ill health (HW-NMI) and found that HW-MI participants reported feeling significantly lonelier than homeless women without this risk (OR: 0.24, 95% CI 0.09–0.64).

Association between SIL, substance use, and social distress

None of the quantitative studies investigated the association between SIL and substance use, despite the fact that substance use is a prevalent issue among people with homelessness experience. However, some of the qualitative studies discussed how SIL and substance use are interconnected among people with experiences of homelessness [ 86 ]. Lafuente [ 36 ] reported participants relapsed to alcohol and other risk behaviors due to SIL: “I 've started drinking and at this particular time. They offered to put me back into treatment and at this time I was not homeless…and I refuse it…the alcohol has really taken over me. " Another study discussed how substance use contributed to SIL for participants who identified as male [ 59 ]. Participants discussed how the use of substances affected their social relationships in different ways including added strain, limited availability of resources from social relationships, and the interplay between substance use and feelings of social isolation at earlier and later stages in life [ 59 ].

Regarding social distress, Cruwys et al. [ 71 ] found that the social isolation schema predicted lower social identification with homelessness services. Individuals with negative experiences with homelessness services were less likely to become socially engaged with new groups, and this relationship remained over time. SIL was also associated with poor or restless sleeping patterns, particularly among women with restless sleep compared to men as reported by Davis et al. [ 85 ] Moreover, Tsai et al. [ 67 ] found that measures of loneliness (percentage relative importance = 17.12) as measured by the shortened revised version 3 of the UCLA Loneliness Scale and severity of substance use (percentage relative importance = 16.93) were the most important variables associated with any lifetime eviction and lifetime homelessness. Participants also depicted signs of social distress due to SIL, including fear of dying alone. Studies by Bazari et al. [ 87 ] and Finlay, Gaugler and Kane [ 88 ] highlighted the unique challenges of older adults with homelessness experience, including concerns of dying alone. Van Dongen et al. [ 89 ] examined medical and nursing records from 61 adults receiving end-of-life care in shelter-based nursing care settings in the Netherlands and found that one quarter (n = 15) of patients died alone.

In this scoping review, we explored social isolation and loneliness (SIL) as an under-researched social determinant of health among individuals with experiences of homelessness or those who are marginally or vulnerably housed. We summarized findings from 52 studies published between 2000 and 2023. Our review detailed how these studies conceptualized SIL, including the scales and tools used for its measurement. We also reported on the prevalence of SIL and examined its associations with well-being, health and social outcomes, and substance use among people with experiences of homelessness.

Most studies included in this review were published in 2010 or later, which shows a growing interest in this area. However, studies that have a specific focus on SIL and associated health and social outcomes continue to be scarce. Only one-third of the studies included in this review identify SIL as their primary goal or one of their main research questions. Most of the quantitative studies used a cross-sectional methodology, and we did not find any intervention studies that addressed SIL among people with histories of homelessness as the primary or secondary outcome. Despite these limitations, the studies summarized in this review provide an important overview of SIL among people with histories of homelessness.

Three main theoretical corpuses were used to conceptualize SIL in the context of housing and homelessness experience across the studies: theory of social exclusion [ 36 , 39 , 58 ], theory of social disaffiliation [ 36 ], and theory of digital exclusion (also called digital divide) [ 90 ]. Some studies mentioned structural stigma and alienation to explain systematic biases, policies and practices resulting in reinforcing SIL among people with histories of homelessness, particularly among people who use alcohol and other substances [ 37 ]. This suggests that SIL is a complex issue, embedded in a larger societal problem of socio-economic exclusion, which makes people who are marginalized by structural systems feel invisible, powerless and detached from society. Moreover, the shift to a more digital world, which requires some digital literacy and access to information and communication technologies, may lead to increased feelings of SIL and barriers to services for people with homelessness experience.

We found that the proportion of studied populations who reported SIL varies largely ranging from 25 to 90% across studies. However, the range of measurement scales used to measure SIL across studies limits consistency and comparability between studies. In addition, there are questions around the suitability and fitness of certain tools for measuring SIL among individuals who have experienced homelessness. For instance, the UCLA Loneliness Scale has been found to be challenging for Australians with cognitive disabilities [ 91 ], which is a common issue among some individuals experiencing homelessness [ 92 ]. Likewise, some tools focus on a single dimension [ 93 ] or use a single question [ 94 ], which limits their ability to capture the complex and multifaceted nature of SIL. A study conducted by Bower [ 75 ] identified several factors affecting the effectiveness and validity of SIL measures in marginalized groups while using the Social and Emotional Loneliness Scale for Adults (SELSA-S) with 128 homeless adults in Sydney, Australia. These factors included variations in loneliness dimensions (such as social, family, and romantic loneliness), the cognitive abilities of participants to understand and answer questions, and the necessity for cultural adaptation, as meanings can differ across countries and cultures.

Studies included in this review also showed how personal identities play a role in an individual’s perception of their experiences of SIL and how it affects them as they navigate health, social and housing services. In one study [ 33 ], a participant described how they were rejected from a shelter agency because they identified as transgender. This raises important questions about the inclusivity and equity of service provision and suggests that personal identity can significantly affect one's ability to access essential support. Other studies showed relationships between SIL, age and self-identifying as a woman. These findings are not only consistent with broader research [ 95 , 96 ] but also underscore deeper, often systemic issues within social service frameworks [ 97 ]. The intersection of SIL with identity-related factors indicates that care and social services may be insufficiently trained and equipped to address the unique challenges faced by different demographic groups [ 98 , 99 ].

Findings from studies included in this review show a relationship between SIL, health and social distress among people with homelessness experience. SIL was associated with poor sleeping patterns [ 85 ], and with lower social identification with homelessness services [ 71 ], with any lifetime eviction and lifetime homelessness [ 67 ]. Related to health, SIL is negatively associated with subjective health [ 66 ], self-reported illness [ 70 ], health and mental health among both men and women [ 74 ], severe mental health problems [ 31 ] and substance use [ 59 ]. These findings are in line with what has been reported in studies carried out in other population groups, where an association has been found between SIL and health behavior and physical heath [ 1 , 100 , 101 ] including risk of heart disease, stroke, hospitalization, death and mental health [ 3 , 102 , 103 , 110 , 111 ].

There are several potential reasons for the relationship between SIL, negative health [ 6 ] and desire to participate in social and physical activities [ 101 , 104 ] or use healthcare services, thereby exacerbating pre-existing conditions or contributing to the emergence of new health problems [ 105 , 106 , 109 ]. For instance, some studies indicate that SIL can lead to reduced participation in social and physical activities, as well as lower utilization of social and healthcare services [ 43 , 107 ]. This diminished engagement can subsequently heighten the likelihood of developing or worsening mental health issues, such as depression and anxiety [ 108 ].

Additionally, individuals with SIL combined with homelessness experience often suffer from a significant loss of self-esteem, self-worth, and self-confidence [ 36 , 52 ].This situation can be worsened when individuals perceive that their SIL is related to ageism, racial or ethnic background or discrimination based on gender identity or sexual orientation [ 39 ]. The interplay of these factors can result in increased social withdrawal, decreased physical activity, and diminished engagement with healthcare services, all of which further elevate the risks for a range of physical and mental health problems [ 59 , 103 ], including obesity and associated health issues, depression, food and sleeping issues, suicidal ideation and premature deaths [ 82 , 83 , 84 ].

Gaps in the existing literature and recommendations

We identified several gaps in the studies included in this review. First, SIL was not the primary objective of the majority of the included studies. Thus, there was limited interest to provide a clear definition of SIL or a detailed description of its measurement. Second, the quantitative studies used different measurement tools, with some of them not primarily conceived to measure SIL, thus making comparisons across studies difficult. Additionally, many of these studies used cross-sectional design and covered very small and not generally representative samples. Thus, the estimation of the prevalence of SIL among people with homelessness experience and living in supportive or social housing remained exploratory, and the studies cannot establish causality between SIL and physical or mental health conditions or with social wellbeing. Studies that are mainly focused on SIL, and more longitudinal and targeted interventions are required to better understand the potential links between SIL and these outcomes. Future studies must also include more specific and objective health outcomes like depression or anxiety disorder, drug and alcohol disorder, service use, suicidal ideation and attempts or premature aging, which are prevalent among people with homelessness experience [ 86 ]. Third, the existing literature is very limited in analyzing how SIL impacts some populations differently, in particular women [ 112 , 113 ] and non-binary or gender-diverse groups [ 114 , 115 ]. Mayock and Bretherton [ 116 ] discussed how gender shapes the trajectories of women experiencing homelessness. Research has demonstrated that women are often affected by and respond to homelessness in different ways than males, and thus have different experiences of homelessness [ 112 ]. Self-identified queer people/people who are sexually diverse and/or trans- and gender-diverse and are experiencing homelessness similarly have a distinct experience [ 114 ]. Hail-Jares et al. [ 115 ] discussed how queer youth experience higher rates of homelessness and greater housing instability compared to their cisgender and heterosexual counterparts. Gender diverse youth who must choose between staying in the family home, maintaining their LGBTQ2S identity, and continuing to be physically and mentally safe, often consider homelessness as the perceived safer option [ 117 ]. In addition, future homelessness-related studies examining SIL should seek to make methodological distinctions that reflect differences based on gender identity and not consider queer/gender-diverse people as a homogenous group.

Finally, we found no studies that specifically explored SIL among people with homelessness experience from a particular ethnicity. Given the significant impact of ethnicity on experiences of homelessness, it is likely that ethnicity plays an important role or has a multiplier effect in the way SIL is experienced [ 118 , 119 ]. There is also a lack of geographic and regional representation across the studies, since most of them were conducted in the US and Canada. Further, research that includes diverse population and geographic regions would help inform broader policy change and programming for people from different cultural and ethnic groups.

Limitations

This study has some limitations. First, to ensure feasibility, the review exclusively included peer-reviewed articles published in English, French, and Spanish from the year 2000 onwards. This restriction could introduce publication bias and potentially omit relevant studies published in other languages or formats. Second, the review utilized a broad definition of both homelessness experience and health outcomes. This inclusive approach allowed the incorporation of a diverse range of studies from various countries and methodological approaches. However, this broad scope might have introduced heterogeneity that complicates the synthesis of findings. This lack of standardized definitions and measurements makes it challenging to compare and aggregate results across different studies.

Conclusions

Despite these limitations, our scoping review is the first in the literature to provide a deep and nuanced understanding of SIL that accounts for the theoretical conceptualizations, the measurement and complex interplay of identity and systemic barriers among people with homelessness experience. Our review points to the critical need for more research to better understand SIL among different populations experiencing marginalization and to assess the relationship between SIL and health and social outcomes. Testing and validating SIL measurement tools would help to improve the quality of evidence. Additional research with diverse populations and countries is urgently needed, along with interventional studies to build evidence to inform the development of actionable strategies to address SIL among people with homelessness experience. As implications for public policies, these studies highlight that SIL is a prevalent and significant issue in the lives of people with homelessness experience. There is a lack of awareness and training of healthcare providers to recognize and understand SIL as a health risk factor in addition to other challenges for marginalized groups and in particular people with homeliness experience. It is crucial to develop and implement policies to create awareness and best practices that are sensitive to SIL as a growing public health issue and to advocate for systemic changes that address the root causes of discrimination and exclusion, in particular among people with homelessness experience or housing precarity.

Availability of data and materials

All data generated or analysed during this study are included in supplementary information files.

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Olivet J, Wilkey C, Richard M, et al. Racial Inequity and Homelessness: Findings from the SPARC Study. Ann Am Acad Pol Soc Sci. 2021;693(1):82–100. https://doi.org/10.1177/0002716221991040 .

Jones MM. Does Race Matter in Addressing Homelessness? A Review of the Literature. World Med Heal Policy. 2016;8(2):139–56. https://doi.org/10.1002/wmh3.189 .

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Acknowledgements

The authors thank the members of MAP Centre for Urban Health Solutions Community Expert Group for participating in reviewing the scoping review protocol and manuscript. We also thank Parvin Merchant the Director of Support Services Department at Houselink and Mainstay Community Housing for her input and support of this project. Lastly, we are grateful for the review by Jesse I.R. Jenkinson at MAP Centre for Urban Health Solutions.

This research was supported by a Canadian Institutes of Health Research (CIHR) Foundation Grant (FDN-167263) awarded to Stephen Wesley Hwang, and a Canadian Institutes of Health Research (CIHR)- Fellowship Award (RAT-171348) in partnership with Canada Mortgage and Housing Corporation awarded to James Lachaud. Stephen Wesley Hwang is supported by funding from the Canada Research Chairs Program. The funding institutions had no role in the collection, analysis, and interpretation of the data, nor in the preparation, revision, or approval of the present manuscript. The views expressed in this publication are solely those of the authors.

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JL had full access to all of the data and takes responsibility for the integrity of the data and the accuracy of the results. JL, AY, and SH conceptualized and designed the review. JL, AY, MF, MP, EG, CZ, CM-L, and SW performed data acquisition, analysis, or interpretation. JL, AY, MF, MP, and EG drafted the manuscript. JL, AY, MF, MP, EG, CZ, CM-L, and SW performed critical revision of the manuscript for important intellectual content. JL, AY, EG, and SH were responsible for administrative, technical, or material support. JL and SH obtained funding.

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Lachaud, J., Yusuf, A.A., Maelzer, F. et al. Social isolation and loneliness among people living with experience of homelessness: a scoping review. BMC Public Health 24 , 2515 (2024). https://doi.org/10.1186/s12889-024-19850-7

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Home — Essay Samples — Social Issues — Homelessness — Causes and Solutions to Homelessness

The Problems Caused by Homelessness and Ways to Solve Them

• Categories: Homelessness Poverty in America

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Published: Jan 28, 2021

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Introduction, problems related to homelessness, homelessness solutions.

This essay delves into the escalating issue of homelessness, highlighting the historical context and current challenges faced by individuals without homes. It examines the root causes, including job loss, unaffordable housing, and health crises. Offering comprehensive solutions such as health insurance access, affordable housing, and employment opportunities, it presents a problem solution short essay example aimed at mitigating homelessness. Through detailed analysis, it advocates for systemic changes to support those affected, emphasizing the need for actionable policies and community involvement.

Homelessness,Health care,Poverty,Homelessness in the United States,Health insurance,Healthcare reform

Works Cited

• Caton, C. L. M., Wilkins, C., & Anderson, J. (2007). People who experience long-term homelessness: Characteristics and interventions. In D. Levinson (Ed.), Encyclopedia of Homelessness (Vol. 2, pp. 609-617). Sage Publications.
• Culhane, D. P., Metraux, S., Byrne, T., Stino, M., & Bainbridge, J. (2013). The age structure of contemporary homelessness: Evidence and implications for public policy. Analyses of Social Issues and Public Policy, 13(1), 228-244.
• D’Amore, J., Hung, O., Chiang, W., Goldfrank, L., & Adams, J. G. (2016). The epidemiology of the homeless population and its impact on an urban emergency department. Academic Emergency Medicine, 23(6), 655-657.
• Fazel, S., Geddes, J. R., & Kushel, M. (2014). The health of homeless people in high-income countries: Descriptive epidemiology, health consequences, and clinical and policy recommendations. The Lancet, 384(9953), 1529-1540.
• Hwang, S. W., & Burns, T. (2014). Health interventions for people who are homeless. The Lancet, 384(9953), 1541-1547.
• Kertesz, S. G., Baggett, T. P., O’Connell, J. J., & Buck, D. S. (2017). Permanent supportive housing for homeless people—Refining the concept. Journal of General Internal Medicine, 32(9), 1016-1017.
• National Alliance to End Homelessness. (n.d.). Health care and homelessness. Retrieved from https://endhomelessness.org/homelessness-in-america/what-causes-homelessness/health-care/
• National Coalition for the Homeless. (2021). Factsheet: Healthcare and homelessness. Retrieved from https://nationalhomeless.org/issues/healthcare/
• O’Connell, J. J., & Sledge, W. H. (2005). Substance abuse among the homeless: Epidemiology and treatment. Psychiatric Clinics, 28(4), 1023-1034.
• Tsemberis, S., & Eisenberg, R. F. (2000). Pathways to housing: Supported housing for street-dwelling homeless individuals with psychiatric disabilities. Psychiatric Services, 51(4), 487-493.

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On How to Eradicate Homelessness Essay (Speech)

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Introduction

Causes of homelessness, homelessness associated with hunger, how to eradicate homelessness, works cited.

The ugly state of homelessness is present and clearly visible in every street in most parts of the United States. It is devastating to see the homeless people trying to survive the hard life surviving the harsh weather conditions. Many people who have never had a firsthand experience would assume that only the alcoholics, drug addicts and the poor are the homeless. This is unlike what is reality. Anyone can be homeless despite a person’s class, level of education and sanity. Homelessness is a national catastrophe that should be well addressed to help in eradicating in society.

Many times homelessness has been misinterpreted to be an experience that happens to wicked and evil people. The notion that society has adopted is that homelessness happens to people who have no vision and dreams in life. The truth of the matter is that majority of the homeless are people with dreams, ambitions and desire to succeed. The barriers are the constraints that surround them making it impossible for them to rise up go beyond their limits. Society has played a big role in neglecting and despising the homeless. Society fails to understand that the homeless need care, support, and nurturing.

Understanding homelessness is very important when working to eradicate it in our society. This enables a person who has not been in this situation to understand how it feels to lack a place to call home. The general understanding is that homelessness is brought by negligence and through events that could have been prevented (Urban Institute). This is not true as there are people who have jobs, are educated, and with stable families but still are homeless. Hence, the biggest reason to understand homelessness and the best way possible to eradicate if not minimize the rate it’s in the country.

There are many causes of homelessness. According to the National Law Center on Homelessness and Poverty, paucity has been the key issue that has rendered many families to the street. There are many families that have succumbed to life on the street due to lack. With the shortage of job opportunities and resources, many families cannot afford housing facilities (Maide). Domestic violence has been a factor that leads to homelessness. The violence that erupts in a home can result in the destruction of properties and separations. There are many broken families who are on the run with no place to call home. Eviction from homes to pave way for the construction of other facilities has been a factor that has contributed to homelessness. Often, families have been evicted from houses without a proper settlement plan. These families are left stranded with nowhere to go.

Teenage homelessness is widespread. Young girls run from their homes the minute they realize they are pregnant. They lack a place to live and they resolve to live on the street. Teenagers are also at risk of being homeless when they fall victim to vices like drug addictions and immorality. They tend to move out of their homestead to live in the street where they could easily access their hobbies. The other major factors that have contributed to homeliness are family disputes, expenses incurred in a divorce procedure, and the death of a loved one (Brendan).

Another aspect that has contributed to homelessness is the natural disaster. These disasters are beyond humanity and cannot be prevented yet they have rendered many homeless. The devastating hurricane Katrina is a good example where many families were left with no place to call home. The destruction of housing was rampant. The sight of young children, mothers and elderly people with no shelter was heartbreaking. These natural calamities cannot be prevented, unlike the other factors that lead to homelessness (Sommer).

Homelessness is closely associated with hunger, crime, child mortality and death (Bredan). When people are living in the street it is very hard for them to acquire other basic needs such as food and clothing. Young mothers on the street cannot be able to shield their young children from the harsh weather conditions. As a result, child mortality is at a high rate for the homeless. Diseases are easily spread among the homeless people in the street. Some become sick due to the unfavorable weather conditions cause deaths to the individuals in the street. A homeless person in the street has the highest chance of getting involved in an accident more than a person safely tacked in the house. Crime is rampant as the homeless opt to do anything to survive.

There is a need for society, government, and well-wishers to team up to help stamp out homelessness in the United States. This can be achieved by the provision of shelter homes for those hit by natural disasters like hurricanes, tornados and floods. The poor people in society should be given an opportunity to own a home (Burt, Carpenter and Hall). This can be attained by the provision of cheap houses that they can afford. It is very hard to get a house that is not expensive that suits an average person. The government should help in the construction of cheap but comfortable homes and place a fee that the poor in society can afford.

The lack of education which plays a bigger role in homelessness should be well tackled. More should be done to end ignorance on youths and adults by working with the cooperation that helps to end poverty. Such organizations include the National Law Center on Homelessness and Poverty. This one educates and provides homes for the poor in society. Another organization is the National Alliance to End Homelessness. This organization works hand in hand with other Nongovernmental organizations to eliminate homelessness in the country.

It is evident that some churches are working very hard to eradicate homelessness. These churches include the Salvation Army and Catholics. The churches help in building shelters for the homeless while providing them with basic needs. The churches although working all round the clock cannot be able to manage the overwhelming number of the homeless in society. There is a need therefore for every individual to work together and give aid to this organization (Bredan). It is wise to give the organization any aid possible than offering money to a homeless person who in turn uses the money to buy drugs.

In conclusion, homelessness is a national disaster that should be tackled quickly possible before it goes out of hand. It is wiser to understand that homelessness is not reserved for a particular group of people. Anyone can be homeless and therefore measures to end homelessness need to be taken care of by all people. Giving the homeless people on the street money and food are not enough. Efforts are needed to ensure that every human being has a roof on top of their head. By understanding the effects of homelessness the society would understand that what the homeless need is care, education and nurturing. A little help can go a long way to help the homeless.

Bredan, Coyne. New Report Shows Increase in Urban Hunger, Homelessness. 2005. Web.

Burt, Martha, R., Jenneth, Carpenter, and Sam Hall. Strategies for improving Homeless People’s Access to Mainstream Benefits and Services. 2010. Web.

Maide, Jeff. Top Causes of Homelessness in America. EzineArticles. 2010. Web.

Sommer, Heidi. Homelessness in Urban America: A Review of the Literature . 2001. Web.

Urban Institute . A New Look at Homelessness in America. 2000. Web.

• The Poverty Rates in the USA
• The Effects of Poverty Within Criminal Justice
• Homelessness in the US
• Mumbai Great Problem: Homelessness Problem in Cities
• Homelessness as a Global Social Issue
• Poverty in America: A Paradox
• Economic Crisis: Social & Psychological Impact
• War and Poverty Connection in Developing Countries
• Social Security Strategies Reform Plan
• Poverty in the World
• Chicago (A-D)
• Chicago (N-B)

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Pedro Almodóvar’s first book, like his movies, blends reality and fiction: ‘A fragmentary autobiography’

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The Last Dream

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When Pedro Almodóvar was a young boy, his mother would read and translate letters for their illiterate neighbors. One day, Almodóvar discovered that his mother was embellishing, even fabricating, what was in them.

With the irate purity of an 8-year-old, he confronted her and asked why she told one neighbor that the author of the letter had written movingly about her grandmother, a person not even mentioned in the communication.

“Did you see how happy she was?” his mother responded.

With ‘Parallel Mothers,’ Pedro Almodóvar ties in personal and historical emotions

Writer-director Pedro Almodóvar’s latest film was passed over by Spain; he hopes the Oscars see it differently.

Jan. 11, 2022

“That was a very good lesson for me even if I didn’t know it at that moment,” the Spanish filmmaker recalled in a recent video interview. Resplendent in a deep blue shirt, he was promoting his first book, a mix of short stories and personal essays called “The Last Dream.” The title piece is an essay about his mother that was written after her death.

“I soon realized reality needs fiction to make life easier and more livable,” he says, adding that it informed his stories and later his screenwriting. He always blended reality and fiction, telling personal stories without being beholden to a documentary-style reciting of the facts. (His mother also got Almodóvar a job teaching young men to read and write, which became a scene in “Pain and Glory.”)

Those stories have fueled a career that includes an original screenplay Oscar for “Talk to Her,” plus noms for his films “Women on the Verge of a Nervous Breakdown,” “All About My Mother” and “Pain and Glory.” Along the way, Almodóvar, whose movies are renowned for their vibrant color palettes and dynamic soundtracks, became an icon in the LGBTQ+ community for capturing the love — and the complex nuances — of queer characters and helped make Antonio Banderas and Penélope Cruz into stars.

Almodóvar’s book — out Sept. 24 — came about accidentally. He has always been a storyteller and started writing as a teen. “But then, as I grew older, I started experimenting with Super 8 films and discovered I had more talent for expressing my stories with images. I was better at writing for the movies than as a fiction writer.”

But he always wrote, even if he stuck the short stories and essays in a drawer. “I wrote because I wanted to,” he says. “I didn’t think about the stories being published or made into movies; I just felt the necessity of writing it.”

Eventually, his assistant, Lola García, pulled out some of the old folders and suggested that Almodóvar consider publishing them. As he notes in the introduction, he has never written a memoir, allowed for an authorized biography or even formally kept a diary. But Almodóvar found, on reading the pieces he has collected, that they amount to “a fragmentary autobiography, incomplete and a little cryptic.”

Of course, most of his films are so personal that they fill in many of those gaps. “My stories and movies are all mixed together in a kind of indivisible manner,” he says.

Review: ‘Pain and Glory’ is Pedro Almodóvar at his best

Antonio Banderas’ performance is the key to a soulful, personal exploration of life and film.

Oct. 2, 2019

You might expect a director publishing his first book to stick to the writing but Almodóvar continually returns to the world of film in our conversation. He talks about having “always dreamed of writing a great novel” but finally accepting that he wouldn’t be able to while still hoping to at least write a “good and entertaining one,” then veers off into the difference between writing novels and scripts. He points to Cormac McCarthy’s screenplay for Ridley Scott’s “The Counselor,” starring Cruz, Michael Fassbender, Cameron Diaz, Javier Bardem and Brad Pitt.

“I love McCarthy’s novels, and they’re so full of dialogue so you immediately think they’d be a good script, but the rules for one are very different from the other, and it doesn’t mean the novelist can be a good screenwriter,” he says, then goes on to discuss Joseph and Herman Mankiewicz, Raymond Chandler and the ways writers do or do not adapt to Hollywood.

He also answers one question about his stories with a long explanation about how a car accident in “All About My Mother” is both an homage to John Cassavetes’ “Opening Night” and also deeply personal for him. “The movies I see, the things I read, they all become part of my own experience,” he says, “so there are many scenes in my movies that reference other movies.”

He also notes that the first story in his book, “The Visit,” later became the inspiration for his 2004 movie “Bad Education.” But it’s far from a straightforward adaptation. While the story opens with a classic Almodóvar flourish — a young woman flamboyantly dressed like Marlene Dietrich saunters through a small town before stopping at a Catholic school where she forces a showdown with the headmaster — and finishes with a dramatic plot twist, the film, with its multilayered meta examination of storytelling, is far more ambitious.

It’s hard not to read a book on Bruce Willis’ legacy as a valediction of sorts, though it’s also a celebration

There’s something very sad about referring to Bruce Willis in the past tense, or the arrival of a book that serves as a career retrospective.

June 11, 2024

While “Bad Education” still condemns the church and the priests who sexually molested young boys and got away with it, that’s not the focal point. and the priests are even somewhat humanized.

“I wrote the story in the ’70s, and I can see my anger,” he says. “I was still furious in 2000, and I wanted to talk about the abuse but I was less interested in making an anticlerical movie than in talking about the origin of creativity and creation and how far people are willing to take a lie or a fiction. I was much more interested in sort of mixing all the different realities, including my own reality of being a filmmaker, as part of the story.”

Other stories, like “Too Many Gender Swaps,” aren’t directly connected to a specific movie, but he says they share thematic interests with his films. “You can see the origins of ‘Women on the Verge of a Nervous Breakdown’ and ‘All About My Mother’ in there,” he says.

Almodóvar notes that while he is very much still the same person who wrote all these stories across the decades, he is also very different. “Back then, I could spend the whole night in a disco, drinking and dancing and then in the morning go straight to work,” he says. “But there’s a moment [when] you have to choose between excitement and health. I decided to be healthy, to work more than party.”

While he gave up partying, his health has remained an issue — his spine and heart conditions are central to “Pain and Glory.” (He‘s had to have spinal fusion, which immobilized part of his spine.)

“Now, I just write and make movies,” he says. This year, he’ll release his first English-language feature, “The Room Next Door,” starring Julianne Moore and Tilda Swinton. “My excitement now comes from my work. This means that I’m condemned to keep on making movies. The only thing now is whether they are good or not.”

More to Read

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These films changed queer representation forever. We spoke with their earliest champion

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How people of color carry the burden of untold stories

April 3, 2024

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