Role of Individual Psychological and Structural Neighborhood Factors in the Health and Well-being of Individuals with Histories of Homelessness: Building an Evidence Base for a Community Health Intervention

Objectives: We investigated the role of psychological and neighborhood factors on physical and mental health, sense of community, and quality of life among individuals with histories of homelessness living in New York City, in order to build a community-based intervention.

Methods: 187 participants completed research interviews. Data on neighborhood conditions was derived from census and local sources. Demographic covariates, individual-level and neighborhood-level factors were the independent variables in a hierarchical regression analyses. Outcomes were: physical health, mental health, quality of life, sense of community.

Results: Age, the only significant demographic variable, was controlled for at the first step. Structural and individual-level variables were entered in the second and third steps, respectively. Structural variables: neighborhood poverty was not a significant predictor; owner-occupancy was related to better physical health and marginally related to better quality of life; housing code violations were related to lower sense of community and marginally related to lower quality of life and poorer mental health. Individual variables: less financial hardship, greater satisfaction with building quality, and greater empowerment predicted better quality of life. Neighborhood participation, satisfaction with building quality, and perceived social capital predicted greater sense of community. Greater satisfaction with building quality, greater empowerment, and perceived social capital predicted better mental health. Finally, greater empowerment predicted better physical health.

Conclusions: Both contextual and individual psychological factors predict health and quality of life outcomes among formerly homeless individuals. These findings point to the role for an advocacy intervention for formerly homeless individuals to improve neighborhood housing conditions.