Well-Being without a Roof: Examining Well-Being among Unhoused Individuals Using Mixed Methods and Propensity Score Matching

• Published in: International journal of environmental research and public health Vol. 17; no. 19; p. 7228
• Main Authors: Ahuja, Naina J, Nguyen, Allison, Winter, Sandra J, Freeman, Mark, Shi, Robert, Rodriguez Espinosa, Patricia, Heaney, Catherine A
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 02.10.2020; MDPI
• Subjects: Adaptation, Psychological; Data collection; Domains; Female; Focus groups; Health care expenditures; Homeless people; Homeless Persons; Humans; Life expectancy; Male; Mixed methods research; Morbidity; Propensity Score; Religion; Religiosity; Religious beliefs; Research methodology; Resilience; Spirituality; Surveys and Questionnaires; Well being; United States > US; California; well-being; mixed methodology; propensity matching; unhoused
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17197228

The morbidity and mortality experiences of people who are unhoused have been well-described, but much less is known about the overall well-being of these individuals. In this mixed methods study, housed and unhoused participants completed a multi-faceted 10 domain measure of well-being (the Stanford WELL Survey), and a subset of unhoused participants shared their experiences during qualitative interviews. Using propensity score matching, unhoused participants ( = 51) were matched at a ratio of 1:5 with housed participants ( = 255). The mean overall well-being score of the unhoused participants was significantly lower than that of the matched housed participants (B = -5.022, = 0.013). Additionally, the two groups differed on some of the constituent domains of well-being, with unhoused participants reporting statistically significantly lower mean scores on social connectedness (B = -1.086, = 0.000), lifestyle and daily practices (B = -1.219, = 0.000), stress and resilience (B = -0.493, = 0.023), experience of emotions (B = -0.632, = 0.009), physical health (B = -0.944, = 0.0001), and finances (B = -3.099, = 0.000). The unhoused participants had a statistically significantly higher mean score for spirituality and religiosity (B = 2.401, = 0.000) than their matched housed counterparts. The qualitative interviews further highlighted spirituality and religion as a coping mechanism for the unhoused. The results of this study highlight both unexpected strengths exhibited by the unhoused individuals and areas of challenge.