Homeless women in Chile: Examining daily life capabilities

Abstract

Homeless women in Chile live in high-risk situations; however, little research exists about how they face their homelessness. This article helps address this information gap through the identification of factors associated with the level of capabilities that homeless women face in their daily lives. Data were obtained from the Chilean government (December 2017) and included a final analytic sample of 1580 homeless women. Findings indicated that capability level was strongly associated with the individual characteristics of women linked to their life trajectories.

Keywords

Functioning health conditions homelessness social work trajectories

Introduction

The general objective of this article is to identify the factors that explain capability level that homeless women have in their daily lives as homeless people in Chile. The specific aims are to (1) describe the relationship of individual characteristics of homeless women (age, time being homeless, and health condition) and their ability to complete daily activities; (2) identify the relationship between basic services and social resources that homeless women use, with their ability to complete daily activities; and (3) compare relationships by geographic zones where homeless women live in Chile.

To meet these aims, I (Ignacio Eissmann) used data drawn from the Annex Questionnaire for People in Street Situation of the Social Registry of Households, Chilean government. The objective of the registry is to identify, characterize, monitor, and analyze the trajectory of people in street situations. The registry has been carried out continuously since 2016 in all regions of Chile. The database contains updated information as of 31 December 2017.

To understand these daily life capabilities, I based on the International Classification of the Functioning of Disability and Health (OMS, 2001), where what is observed is the situation of a person within the set of domains of health or health related (OMS, 2001 in Ministerio de Desarrollo Social [MDS], 2016). Also, this provides a description of situations related to human functioning and their restrictions. In this sense, the concept of ‘capability’ indicates ‘the maximum possible level of functioning that a person can reach at any given time, in any of the domains included in the activity and participation’ (OMS, 2001: 232).

Homelessness is a global phenomenon that affects a large number of people regardless of a country’s stage of economic development (Eissmann and Cuadra, 2018; Johnson et al., 2018). Although there is no agreement on a single definition of homeless people, due to the high diversity of situations and contexts that they face (Eissmann and Cuadra, 2018; Office of the United Nations High Commissioner for Human Rights [OHCHR], 2009), both academics and policymakers categorize homelessness into two large subpopulations. The first refers to those who are living on the street and in shelters or receive other similar services. The second group includes people at risk of being homeless (Canadian Observatory on Homelessness [COH], 2012; Johnson et al., 2018). This second group presents a greater diversity of situations and contexts within the category. For instance, people may be confronted with eviction, abandonment, or expulsion from their home. Certain situations intersect with social problems, such as a woman fleeing from domestic violence who enters a care center. In this case, a person is not always considered as homeless, but rather as a victim of violence. This makes it difficult to establish conceptual limits on defining which situations are homelessness and which are not.

North America and Europe have a substantial foundation of theoretical and empirical research on homelessness. Latin America has had a much smaller body of research on the topic. However, even in countries with high research development, there is a gap in empirical findings on the situation of homeless women. Homeless women have remained hidden, mainly because the homelessness problem has been masculinized. Existing research has largely focused on the observation of places and dynamics that are more representative of the homelessness of men. For example, the use of shelters and living on the street are strategies used more by men compared to women (Baptista, 2010; Maki, 2017; Mayock et al., 2012, Mayock and Sheridad, 2015).

In Chile, from the literature reviewed, it is only possible to highlight some case studies addressed in theses, or some specific section or mentions in research that address the total population (Bustamante, 2014; Ferrada et al., 2018; Fuentes, 2008; STATCOM, 2017). In these works, it is agreed to recognize that within everyday experiences of living without a home, women are more exposed to risks and suffer damage, abuse, and sexual attacks, as well as other acts of violence, compared to homeless men. In this way, they present greater vulnerability, which they must face with very few resources. However, these studies do not go in depth into these situations or the impact they have on the lives of women. The official data of the Government of Chile (MDS, 2017b) indicate the average age of homeless women is 42 years. Regarding the place where they spend the night, only 49 percent use public or private services for the homeless, and the rest remain on the street. Similarly, within their daily lives, to varying degrees they make use of different services such as public bathrooms, public showers, access to drinking water, as well as accommodation and shelter services during the winter, and keep regular contact with professionals of public and private services (MDS, 2017b).

Because in Chile there is little research on homeless women, the current article aims to fill this gap by identifying the factors associated with the level of daily life capabilities of homeless women in Chile. Due to a paucity of research on women’s homelessness, there are many characteristics that have remained hidden. Therefore, knowing the level of these capabilities is a contribution to social work’s approach to work with homeless women. It provides a broader perspective of this social problem and can help in the design of more accurate indicators of well-being and social integration for this population, both for the social research field and for intervention.

Literature review

Homelessness

Homelessness in western countries has been defined using different approaches by scholars. In the literature, it is possible to distinguish between those authors who define the homeless as strictly those who sleep on the street, versus those who visualize the presence of other more complex processes and with different types of scenarios within homelessness (Ciapessoni, 2013; Levinson and Ross, 2007). This distinction also works to create internal categories that separate those who are literally homeless and those who are at risk of becoming homeless (COH, 2012; Johnson et al., 2018). Another important concept has been to understand homelessness as a violation of basic human rights that can and should be ended (Farha, 2015; FEANTSA and European Commission, 2010; OHCHR, 2009). The definition used in the analyzed dataset understands the homeless as those who

[a]re staying overnight in public or private places, without having an infrastructure that can be characterized as a home, even if it is precarious (a precarious home means, at least, walls and ceilings that grant some privacy, it allows to lodge belongings and generate a relatively stable situation). [People who] [l]ack fixed, regular and adequate accommodation for the night and find night accommodation in shelters/hostels run by public or private entities that function as commercial lodgings (paying or not for this service) and provide temporary shelter. (MDS, 2017a: 5)

Regarding the causes of homelessness, in Latin America there is an emphasis on family problems and breakdowns (Eissmann and Estay, 2006; MDS, 2012). Official information indicates that the breaking of familial ties is one of the main causes of the beginning of the homelessness trajectory. However, many authors have put the focus of the problem of homelessness on the difficulties in accessing and maintaining housing (Johnson et al., 2018; Padget et al., 2016). This emphasis implies not only a material dimension but also legal, social, and security dimensions (Amore et al., 2011; Busch-Geertsema et al., 2015; FEANTSA, 2006; Johnson et al., 2018). These authors have created typologies of people that range from those who live in the street to those in precarious homes with a high probability of becoming homeless (Busch-Geertsema et al., 2015; FEANTSA, 2006; Johnson et al., 2018). The main criticisms of these typologies point to the difficulty of distinguishing between homelessness, housing exclusion, and other situations of poverty (Sahlin, 2012).

Homeless women

Homeless women are largely invisible at the level of research and design and development of social policies, as the issue of homelessness is strongly masculinized (Baptista, 2010; Fabian, 2016; Johnson et al., 2017; Mayock et al., 2015; Mostowska, 2016). In much of the existing research, measurements conducted among homeless populations have been conducted mainly in public spaces on the streets and shelters or temporary residences, which are used mainly by homeless men (Baptista, 2010; Mayock and Sheridan, 2016). Some authors point out that these social services have been designed to meet the needs of men, and therefore are not suitable for women. In the case of domestic violence, most of the services are not adequately equipped; in fact, some shelters do not receive women fleeing violence (Maki, 2017: 5).

However, living on the street implies exposure to risks, such as sexual assault, which is much higher among women compared to men. These risks push women to avoid being in these spaces for prolonged periods of time, or to look for other places to live (Johnson et al., 2017; Novac et al., 1996). However, other authors propose that there is a group that generates dependence of some social services, to give them safety and security (Finfgeld-Connett, 2010). This is most common in the case of women who have suffered violence or mothers with children (Finfgeld-Connett, 2010; Maki, 2017; Mayock et al., 2015).

There is agreement in the literature that women’s homelessness is not the product of a single cause but is the result of an extensive process of stressful experiences and residential instability (Bretherton, 2017; Finfgeld-Connett, 2010; Mayock and Sheridan, 2012). In this sense, many studies recognize the presence of multiple adversities in childhood (Mayock and Sheridan, 2012). In fact, in many cases, the first episodes of homelessness occur in adolescence (Mayock and Sheridan, 2012; Mayock et al., 2015). Multiple episodes of abuse and violence are also recognized at home, on the street, and even within social services (Bretherton, 2017; Maki, 2017; Mayock and Sheridan, 2012; Mayock et al., 2015). Some of these episodes occur because women seek the protection of a man, who then establishes a relationship of dominance and violence in exchange for providing protection (Novac et al., 1996). However, it is very difficult to establish a causal effect between abuse, violence, and homelessness, because homelessness does not necessarily occur immediately, but rather may be a result of a longer process.

Another relevant aspect in which there is agreement in the literature is that many women use multiple strategies before resorting to living on the street or using accommodation for the homeless (Bretherton, 2017; Finfgeld-Connett, 2010; Maguire and Semancik, 2016; Mayock and Sheridan, 2012; Mayock et al., 2015). For example, women often live in the homes of friends and acquaintances for a long time before going to a shelter. Also, they can resist problematic situations for a longer time than men, especially if there are children under their care.

In turn, the way in which residential instability is experienced is also unique among women. The idea of a home does not necessarily represent the feeling of security and stability for women, but rather it can be linked to the establishment of a relationship of a couple or family, rather than the possession of a physical home (Novac et al., 1996). Similarly, facing evictions, difficulty in accessing housing, or making the decision to live on the street and/or in emergency shelters are also different for women (Johnson et al., 2017) and result in different trajectories toward homelessness (Novac et al., 1996). Related to risk exposure, some authors argue that homeless women have a higher prevalence of disease compared to men in the same situation and to women with housing (Maguire and Semancik, 2016; Novac et al., 1996).

Homeless women develop various self-protection strategies (Finfgeld-Connett, 2010), both in the so-called hidden homelessness (living in the homes of acquaintances or relatives, paying hostels, among others) and in shelters, temporary housing programs or on the street (Baptista, 2010). In these places, different capabilities are put into operation both to develop daily life and to achieve and maintain residential stability (Finfgeld-Connett, 2010), which tends to deteriorate due to homelessness (Baptista, 2010; Mayock et al., 2015), especially in cases where homelessness intersects with other problems of high severity and complexity, such as sexual abuse and violence (Maki, 2017; Mayock et al., 2015).

Daily life capabilities

The capabilities required in order to face daily life are key to social integration into different spaces and social institutions. For instance, global employment statistics indicate that the inactivity rate of workers with difficulties or disabilities tends to be much higher than that of other workers (O’Reilly, 2007; Organización Internacional del Trabajo [OIT], 2017; Servicio Nacional de la Discapacidad [SENADIS], 2017). Likewise, women are more at risk and vulnerable than men because they face multiple sources of discrimination, both as women and possibly as people with disabilities or homelessness (O’Reilly, 2007: 52).

A useful perspective in understanding the capabilities of homeless women to face their daily lives is the International Classification of the Functioning of Disability and Health (OMS, 2001). The main objective of this classification is to provide a standardized and unified language, and likewise to provide a comparable conceptual framework between countries and different health disciplines, which allows for the description of health and health-related states (OMS, 2001 in MDS, 2016). The contribution of this perspective is that it does not focus only on people with disabilities, but also on the larger population. In this sense, what is observed is the situation of a person within the set of health or health-related domains (OMS, 2001 in MDS, 2016), providing a description of situations related to human functioning and its restrictions.

In this way, the functioning of a person is a complex relationship between their health status and contextual factors (MDS, 2016: 27). Functioning is used as ‘a generic term that includes bodily functions, body structures, activities and participation. It indicates the positive aspects of the interaction between an individual and their contextual factors’ (OMS, 2001: 231 in MDS, 2016: 29). However, the concept of ‘capability’ (and how it is understood in this research), indicates ‘the maximum possible level of functioning that a person can reach at any given time, in any of the domains included in activity and participation’ (OMS, 2001: 232), in this case homelessness.

The literature on homeless women shows that there is a significant gap in information about them, which makes the social facts of homeless women incomplete and underrepresented. In Chile, little information exists on the particular situation of homeless women. Accordingly, the current study seeks to fill this gap through the analysis of factors associated with capability level for the activities of daily life.

Methodology

Dataset

Data were drawn from the Annex Questionnaire for People in Street Situations from the Household Social Registry, Government of Chile. Its objective is to register information that allows the identification, characterization, monitoring, and analysis of the trajectory of people in street situations (homeless people) through a complementary instrument by the Household Social Registry (MDS, 2017b).

The application of the questionnaire has been carried out continuously since 2016 in all regions of Chile. The questionnaire is cross-sectional and is applied to people 18 years of age or older, who are able to understand and answer the questionnaire. Because the goal of this instrument is to register homeless people to include them in social policies, a sample is not used but it seeks to include all people who are in this situation. The survey was made by public workers (in some communities in collaboration with nongovernmental organizations [NGOs] that work with homeless people). In most cases, the public workers went to the places where the homeless were, and in just a few cases, it as the people themselves who requested that the survey be applied. In all cases, the ‘Application Manual Annex Questionnaire for People in Street Situation’ (MDS, 2017a) was used as support, in which there are special guidelines and protocols.

The database contains updated information as of December 2017. The dataset includes 12,677 people, of which 1869 are homeless women. The final analytic sample focuses only on homeless women. It includes 1580 valid cases due to missing values (289 cases) in the variables incorporated into the analysis.

The following three hypotheses were tested to examine the capabilities homeless women have in order to face their daily lives in Chile:

Hypothesis 1: Individual characteristics of homeless women (health status, age, and duration of homelessness) predict the capability to face their daily life.

Hypothesis 2: The use of resources related to support networks and places to sleep, by homeless women, predicts the capability to face their daily life.

Hypothesis 3: The association between individual characteristics and the use of resources among homeless women and ability level is not equal across the regions of Chile.

Measures

The dependent variable is an index of the capability level faced by homeless women in Chile. The index is based on 12 items (See Table 1) from the International Classification of Functioning, Disability and Health, developed by the OMS (2001). This classification covers all aspects of health and some components of well-being. It organizes the information in two parts: (1) functioning and disability and (2) contextual factors. Thus, the functioning of a person is understood as a complex relationship or interaction between health status and contextual factors (OMS, 2001). The variables include responses for the difficulties that people declare with certain daily activities (MDS, 2017a). In this way, a high score on these questions represents a high level of difficulty, signifying a lower capability level to face their daily lives. The index has a range from 12 to 60 points. The scores closest to 12 represent a higher capability level, while scores closer to 60 imply a lower capability level. The index had a Cronbach’s alpha score of 0.84.

Hypothesis 1 included the following independent variables: age (years), time homeless (years), participation in a mental health institution more than 3 months at any time of their life (yes/no), and presence of a chronic disease (yes/no).

Hypothesis 2 included the following independent variables: the place where they slept the previous night (street, shelter, or other housing), whether they have contact with friends, neighbors, or acquaintances (yes/no), and whether they have contact with a professional from the public institution (yes/no).

For Hypothesis 3, codes were created for zones of Chile. Chile is administratively divided into 16 regions of different sizes and populations. Considering only the number of homeless women in each zone, three groups were defined: the Metropolitan region, in which almost 50 percent of the population is concentrated; the Valparaíso region, in which 13 percent of this population is concentrated; and the remaining regions that account for 37 percent of the population.

Table 1.

Variables for the construction of the capability index (MDS, 2017a).

During the last month, due to your health, how much difficulty did you have?(1 = No difficulty, 2 = Little difficulty, 3 = Medium difficulty, 4 = Much difficulty, 5 = Extreme difficulty/cannot do it)
Variable	Missing values (%)
Seeing, without using glasses or contact lenses	2.14
Hearing, without using hearing aids	2.35
Walking or climbing steps	2.46
Remembering things or concentrating	2.41
Washing or dressing	2.35
Understanding what others are talking about or that they understand what I am saying	2.41
Getting along with people close to you, including your family and friends	2.35
Holding small objects or opening a container	2.46
Working, studying, or doing other tasks	8.56
Sleeping	2.41
Breathing	2.41
Caring for or giving support to others	12.79

In order to develop the analysis I followed two stages. First, I did a descriptive analysis of all the variables included in the research hypotheses to observe their distribution. Also, I evaluated the differences between individual characteristics (Hypothesis 1) and the use of resources related to support networks and places to sleep (Hypothesis 2) by geographical areas defined in Hypothesis 3. ANOVA test and chi-square tests were used for continuous or categorical variables, respectively. The aim was to evaluate whether there are indeed differences that could be observed in the regression model applied for zones.

Second, in order to test the associations between individual characteristics of homeless women (Hypothesis 1) and the resources they use (Hypothesis 2) with their daily life capabilities, I used a multiple regression model. Also, to observe the differences between regions, I ran the model both nationally and for each of the regions included in Hypothesis 3, in order to compare them.

In addition, I did a logistic regression, with the aim of evaluating differences in the results due to the problem with the grade of homoscedasticity level of the linear model. To that, I recoded the capabilities index into two categories, taking as a cut-off point the value of the 50th percentile (the value of 16 in a range of 12–60). In the logistic model, age, reporting having been in a mental health institution, and having a chronic disease were significantly related to capability level. In the case of variables associated with resources, only contact with a public institution professional remained statistically significant. Thus, in both the linear and logistic models, Hypothesis 1, but not Hypothesis 2, was supported. With respect to Hypothesis 3, the differences between the geographical zones observed in linear model were maintained in the logistic model.

Results

Descriptive data overall and geographical zone are provided in Table 2. Regarding the capability index, composed of the variables presented in Table 1, a tendency toward low values of the range (12–60), means a better level of capabilities to face daily life. This occurs in a similar way both at the national level (average of 18 points) and in the three zones.

Table 2.

Descriptive statistics of variables.

Variable	Chile	Other regions	Valparaiso region	Metropolitan region
Capability index (mean, SD)	18.15 (7.07)	18.38 (6.52)	17.62 (6.07)	18.10 (7.77)
Age (mean, SD)	42.79 (14.64)	40.89 (12.31)	42.54 (13.95)	44.30 (16.21)
Time being homeless (mean, SD)	4.91 (7.48)	5.56 (8.00)	5.24 (7.45)	4.33 (7.02)
Spent time in a mental health institution (%)	13.59	14.81	12.10	13.06
Chronic disease (%)	46.71	46.44	43.55	47.77
Place slept previous night (%)
Street	50.72	46.44	59.27	51.69
Shelter	33.17	29.77	22.58	38.63
Other	16.10	23.79	18.15	9.68
Contact with friends, neighbors, or acquaintances (%)	28.36	31.20	37.50	23.72
Contact with a professional of a public institution (%)	31.73	37.75	55.65	20.67
Region (%)
Other	37.56
Valparaíso	13.27
Metropolitan	49.17

The average age of homeless women was 43 years (SD = 14.6) and homeless duration was 4.9 years overall (SD = 7.4). In total, 14 percent of the population had been in a mental health institution for more than 3 months, which implies having had a mental health problem that needed treatment, that may or not have been completed. Overall, 47 percent of homeless women declared having a chronic disease.

In order to evaluate differences in individual characteristics by geographical zone, analysis of variance (ANOVA) and chi-square tests were used for continuous or categorical variables, respectively. Statistical differences were observed by geographical zone for age (p ⩽ 0.001) and time being homeless (p = 0.003). No statistically significant relationship was observed between geographical zone and having been in a health institution (p = 0.452) or having a chronic disease (p = 0.489).

In turn, 51 percent of homeless women spent the previous night on the street, 33 percent in a shelter, including transitional housing, and 16 percent in another type of housing, which may include temporarily living in the homes of friends, family, or neighbors. Overall, 28 percent of women reported having contact with friends, neighbors, or acquaintances. In turn, 32 percent of women reported having contact with a professional from a public institution. Statistical differences were observed by geographic zone for where women spent the previous night (p < 0.001), having contact with someone close (p < 0.001) and having contact with a professional from a public institution (p < 0.001).

The multiple regression model tested the associations between individual characteristics of homeless women (Hypothesis 1) and the resources they use (Hypothesis 2) with the capability to face daily life (Table 3). The model was statistically significant (adjusted R² of 0.31, p < 0.001). This indicator is higher in the Metropolitan region (0.37, p < 0.001), then in the Valparaiso region (0.32, p < 0.001), and finally in the other regions (0.26, p < 0.001).

Table 3.

Multiple regression models, overall (Chile) and by region.

Capabilities index	Chile		Other		Valparaíso		Metropolitan
Capabilities index	Coefficient	Beta	Coefficient	Beta	Coefficient	Beta	Coefficient	Beta
Age	0.15***	0.30	0.09***	0.18	0.11***	0.26	0.18***	0.36
Time being homeless	0.05**	0.05	0.06*	0.07	0.03	0.04	0.04	0.03
Time spent in a mental health institution	2.87***	0.13	2.60***	0.14	1.92	0.11	3.10***	0.12
Chronic disease	4.58***	0.32	4.46***	0.34	5.53***	0.45	4.21***	0.26
Place slept previous night (ref = street)
Shelter	0.74*	0.04	–0.61	–0.04	–1.34	–0.09	1.69**	0.10
Other	0.75	0.03	–0.29	–0.01	0.91	0.05	1.99*	0.07
Contact with friends, neighbors, or acquaintances	–0.83*	–0.05	–0.64	–0.04	0.88	0.07	–1.27*	–0.07
Contact with a professional of a public institution
Yes	1.25***	0.08	2.36***	0.17	−.41	−0.03	0.73	0.03
_cons	8.53***		11.15***		9.89		7.09***
Obs	1580	638	212	730
Prob > F	0.000		0.000		0.000		0.000
Adj R²	0.31		0.26		0.32		0.37

p < 0.05; **p < 0.01; ***p < 0.001.

With respect to Hypothesis 1, women who were older, who had been homeless longer, and those who reported having a chronic disease had a lower level of capability. The results showed that, keeping other variables constant, the increase in age (years) was associated with a worsening level of capabilities (p < 0.001). A similar relationship was observed with the increase in the time homeless (years; p = 0.003), but with a lower explanatory level within the model. Second, homeless women who reported having been in a mental health institution for more than 3 months had a worse capability level in comparison with those who did not report ever being in this type of institution (p < 0.001). Finally, those who had a chronic disease had a worse capability level in comparison to those who did not have a chronic disease (p < 0.001). Despite having the same overall result, there were differences between geographical zones. In the case of the Valparaíso (p = 0.429) and Metropolitan zones (p = 0.182), time being homeless was not statistically related to capability level. Also, in the case of Valparaíso, reporting having been in a mental health institution was not related to capability level (p = 0.056).

Results of the regression model did not confirm the second hypothesis. At the national level, it was observed that, keeping other variables constant, women who spent the previous night in a shelter (p = 0.031) had a lower capability level than those who slept on the street. Women who reported having had contact with a friend, neighbors, or acquaintances (p = 0.015) had a higher capability level than those who did not have this contact. Finally, women who had contact with public institution professionals (p < 0.001) had a lower capability level compared to those who did not report this contact.

These results were different in each zone. In the ‘other’ zone, only having contact with a public institution professional was statistically significant (p < 0.001). In the case of the Valparaíso zone, no variable was statistically significant. In the Metropolitan zone, both those who spent the last night in a shelter (p = 0.001) and in another type of housing (p = 0.020) had a worse capability level compared to those who slept on the street. Those who had contact with a friend, neighbors, or acquaintances (p = 0.018) had a higher capability level than those who did not have this relationship. Contact with a public institution professional was not statistically significant (p = 0.196).

Discussion

This article reported factors related to the capability of homeless women to face their daily lives. Age, chronic disease, and mental illness related to lower capability levels among homeless women in Chile. This finding suggests that homelessness is a long process or a trajectory and not necessarily defined by a current episode or stage. These findings align with empirical literature that indicates that the pathway to becoming homeless among women – as it is traditionally understood – is longer than for men. In addition, considering the existing literature, the trajectory could also involve a set of actions and previous situations related to the search and maintenance of unstable and informal housing in contexts of high risk and vulnerability for homeless women (Bretherton, 2017; Finfgeld-Connett, 2010; Maki, 2017; Mayock and Sheridan, 2012; Mayock et al., 2015; Novac et al., 1996).

At the national level, the length of time women had been homeless had marginal statistical significance, and in the regions where most of the population was concentrated, this variable was not statistically significant. These findings imply that the capability level relates more to longitudinal factors associated with women’s health and biological development than being homeless at a point in time. It is important to highlight that findings do not imply that life as a homeless person does not cause damage or a negative impact on health, but, at least in the case of the capability level analyzed, it appears to be a consequence of longer and more complex processes, which goes beyond homelessness.

The factors associated with the resources women use were marginally related to capability to face daily life. Territorial differences may require a more detailed analysis in the future. For instance, women who slept the previous night in shelters and other types of housing scored worse on the capability index than those who slept on the street – a difference that was statistically significant at national level and for the Metropolitan region. An explanation could be the great difference in the kind and amount of shelters (including transitional housing) between regions and the lack of awareness of female characteristics and needs in majority of emergency shelters. Some housing services, mainly in the Metropolitan region, are specialized in intervention with women with special needs, therefore those who access these services have some mental illness or disability. The literature highlights that, in the context where housing is unstable or lacking, the first option for women is the search for alternatives within their community or family, and then in social services (Bretherton, 2017; Finfgeld-Connett, 2010; Maguire and Semancik, 2016; Mayock and Sheridan, 2012; Mayock et al., 2015). Hence, when women go to these centers, one could suppose a level of dependence on external support to develop their daily life.

Relationships with other people are a type of social capital (Durston, 2003; Sunkel, 2003). Homeless women who reported having social relationships had a higher capability level, which was statistically significant for the Metropolitan region. In this case, this supposes that these persons would be a relevant support for the care of their health, and that the level of breakage of their social bonds is not as deep as among those who do not have any type of contact. In turn, the fact that women who have contact with professionals from public institutions had a lower capability level can be explained by the fact that this relationship is with primary public health professionals, which implies the presence of health problems.

Regarding regional differences, the Metropolitan region is the one that concentrates the largest number of homeless people and about 50 percent of the total population of the country. For this reason, it also presents a greater diversity of situations, and concentrates the largest amount of accommodation and social programs for the homeless, unlike all other regions of Chile. Valparaíso, meanwhile, is a region that includes a large number of small communities and cities, many of which do not have accommodation services and programs for the homeless, except in its main cities. The other regions, grouped in the ‘other’ category, have a wide diversity of contexts, but share the common characteristic of having fewer social services available for this population. From this, the findings suggest that those results associated more with the individual characteristics, such as age and presenting chronic diseases, occur similarly in all regions; however, the type of accommodation only shows results significant in the Metropolitan region, since only here is there a high diversity of such, unlike the rest of the regions. The above suggests giving importance to the characteristics and types of services that are present in the places where homeless women live, and how this can be associated with their capabilities for daily living. However, given the high social and cultural diversity within Chile, the analysis of the differences of the other variables requires further development and deepening, including new categories to characterize the regions.

Finally, it is important to discuss the use of the capability index. The use of some measures of the International Classification of the Functioning of Disability and Health allowed overcoming the health dimension and linking it with the development of daily life activities, which are especially relevant to cope with the demands of homelessness. However, the International Classification of the Functioning of Disability and Health uses more variables than those included in the dataset used here, hence it will be necessary to go deeper into this analysis, and recognize that these first findings must be complemented in the future.

Limitations

This study has several limitations. First, the dataset does not include a longitudinal design and thus is not possible to identify a trajectory of homelessness or assess change, and causality cannot be established. The instrument also has some limitations. A full accounting of the various dimensions of health cannot be established. There were more missing data from the ‘other region’ zone. There is a tendency in half of the variables used in the capacity-level index to have values lower than that of the analyzed data. Therefore, the index could have a lower level if these cases were included. Finally, the sample only included women who met the conventional definition of homelessness. Women who use spaces other than shelters or the street were not included. Accordingly, the full breadth of the capabilities of homeless women in Chile is still not well understood. Despite these limitations, this study provides much-needed research on and policy insights into the factors linked to capabilities among homeless women in Chile.

Conclusion

The capabilities of homeless women in Chile seem to be part of a longer process, rather than any particular homelessness stage. The conditions in which homeless women live and the services they use were not strongly associated with capability level. It was also observed that capabilities were associated with where women live. One of the aspects that may generate differences is the type and quantity of services that exist, especially housing and shelters in different regions of Chile.

These findings have implications for social work. First, they indicate the need to comprehensively understand the homelessness of women, considering not only their current situation but also the trajectory of housing instability, as well as the importance of having prevention strategies in place before women are forced to live on the street or in emergency shelters. Second, if considering the capabilities of functioning as barriers or facilitators of social integration, the results could contribute to designing indicators and intervention strategies that have a positive impact on them. Thus, social work as a discipline, especially in the Chilean context, among both scholars and public policymakers, needs to approach the issue of female homelessness in a more complex and integral way.

Finally, these findings contribute to filling the gap in Chile regarding the realities faced by homeless women. It makes explicit the complexity of the lives of homeless women and the need to develop other lines of research including the life trajectories of homeless women, especially in those moments or spaces that literature has called hidden homelessness.

Footnotes

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Ignacio Eissmann

Author biographies

Ignacio Eissmann is a sociologist and master of the Alberto Hurtado University and PhD © of Social Welfare at Boston College and Alberto Hurtado University. Associate researcher at Moviliza-Ciscal in Chile. (www.ciscal.org/ )

David Takeuchi has extensive research experience in different community and institutional settings and been a key investigator of some of the largest studies of different racial and ethnic groups. Professor Takeuchi has written extensively on issues related to the unequal distribution of health and illness in society, particularly around race, ethnicity, immigration, and socio-economic status (SES).

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