College of Social Work, The Ohio State University, 1947 College Rd, Columbus, OH, 43210, USA.
MAP Centre for Urban Health Solutions, Unity Health Toronto, Toronto, ON, Canada.
BMC Public Health. 2024 Sep 16;24(1):2515. doi: 10.1186/s12889-024-19850-7.
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.
社会隔离和孤独（SIL）是影响那些经历结构性和社会经济排斥的个人的公共卫生挑战。无家可归者的 SIL 对他们的社会和健康结果的影响在很大程度上仍未得到探索。然而，针对无家可归者的 SIL 文献综述很少，无法为政策和有针对性的社会干预提供适当信息。本研究旨在对无家可归者的 SIL 证据进行综合，并探讨其如何对他们的幸福感产生负面影响。我们从 Medline、Embase、Cochrane 图书馆、PsycINFO、CINAHL、社会学摘要和 Web of Science 的社会科学引文索引和科学引文索引中进行了全面的文献检索，以获取 2000 年 1 月 1 日至 2023 年 1 月 3 日期间发表的同行评审研究。研究经过至少两名评审员进行的标题、摘要和全文筛选。然后对纳入的研究进行分析和综合，以确定 SIL 的概念化、测量工具和方法、流行率特征以及与社会和健康结果的关系。文献检索在去除重复记录后得到了 5294 篇论文。经过筛选，我们保留了 27 篇定性研究、23 篇定量研究和 2 篇混合方法研究。大多数纳入的文章并不是 SIL 的主要研究目的。无家可归者的 SIL 患病率在不同研究中从 25%到 90%不等。研究中使用了一系列不同的测量工具来测量 SIL，使得难以在研究之间进行结果比较。尽管这些研究报告了 SIL、健康、幸福感和物质使用之间的关联，但我们发现文献中存在很大的差距。大多数定量研究都是横断面研究，只有一项研究使用健康管理数据来确定健康结果。需要更多的研究来更好地了解这一人群中的 SIL，并为解决其社会和健康影响的可行战略和政策提供证据。
