Sheltered homeless adults use more shelter services, have fewer health risk factors, and report lower stress than unsheltered adults

Abstract Background: In the United States, approximately 568,000 individuals are homeless on a single night. Homelessness can be categorized into three subgroups: sheltered homeless, unsheltered homeless, and unstably housed. Few studies have examined the relations between homelessness subtypes, shelter service utilization, levels of stress experienced, and health risk factors. Methods: Data were collected at multiple homeless shelters in 2016 in the Oklahoma City area (N=575). Multiple linear and logistic regression analyses were conducted to examine relations between homelessness subgroups and outcomes.Results: Results indicated that the sheltered group was younger and more likely to be White than the unsheltered group, and had higher levels of education than the unstably housed group. In addition, unsheltered homeless and unstably housed adults used fewer shelter-based health services, exhibited more health risk factors, experienced greater levels of stress, and had higher levels of food insecurity than sheltered homeless adults.Conclusions: Homeless adults who reside at shelters benefit most from available shelter services. The development of policies and programs targeted toward increasing sheltering options for unsheltered and unstably housed adults is needed.