Disability, Health, and Quality of Life Among Homeless Women: A Follow-up Study

The objectives of this study were: (a) to assess the prevalence of disability among homeless women; (b) to compare homeless women with and without a disability in key variables (e.g., sociodemographic, homelessness history, physical and mental health, etc.); (c) to examine paths between disability, perceived discrimination, mental health, and quality of life. The methodology was a longitudinal study of homeless women in Madrid, who were followed for a 12-month period. There were 136 interviewees at baseline and 85 interviewees at follow-up. Prevalence of self-reported disability was 36.6% at baseline and 58.8% at follow-up. Approximately, in three out of four cases, disability existed prior to becoming homeless. Participants with a disability had been homeless for a longer time at baseline compared to participants without a disability. Moreover, they presented worse mental health, worse overall health status, and lower health-related quality of life at follow-up. Mediation analyses showed that disability at baseline had direct effects on health-related quality of life, but also indirect effects mediated by perceived discrimination and mental health. This study shows the prominent prevalence rates of disability among homeless women in comparison with the general population, and the links to discrimination and negative health outcomes. These findings have significant implications for planning community services for homeless women. Public Policy Relevance Statements Little is known about disability and health among homeless women. This longitudinal study showed a poor health status and a remarkable prevalence of disability and functional impairment among homeless women, significantly greater than women in the Spanish general population. A key policy priority should be to plan for the long-term care of homeless women with disabilities.