Type of social support among homeless women: Its impact on psychosocial resources, health and health behaviors, and use of health services

Background: Information about whether specific types of support are associa ted with poor psychosocial profiles, health behaviors, and positive use of medical care is critical for identifying homeless women at highest risk for negative outcomes. Objectives: This study aimed to examine the impact that various levels of s upport from substance users and nonusers have on homeless women's psychosoc ial profiles, health and health behaviors, and use of health services. Methods: This cross-sectional survey used a sample of 1,302 sheltered homel ess women. Using controls for potential confounders, outcomes were compared across four mutually exclusive subgroups of women reporting support from s ubstance users only (n = 58), substance nonusers only (n = 439), both users and nonusers (n = 136), and no one (n = 669). Structured and psychometrica lly sound instruments measured social support, substance use, self-esteem, coping, and psychological symptoms. Additional instruments measured sociode mographic characteristics, sexual risk behavior, health status, and use of health services. Results: As compared with those who have little or no support, women whose support included substance nonusers reported better psychosocial profiles a nd somewhat greater use of health services. Support from substance nonusers only was associated with better health behaviors and greater use of health services. Support from substance users only was essentially equivalent to not having support. Conclusion: Modifying the social networks of homeless women appears to be a ssociated with improved mental health outcomes, less risky health behaviors , and greater use of health services.