Quality of life among homeless individuals in Barcelona: gender differences and key determinants

Abstract Background Homelessness significantly impacts individuals’ quality of life, affecting both their physical and mental well-being. Social exclusion, economic instability, and health disparities contribute to a lower perceived quality of life among homeless populations. Gender differences may further shape these experiences, influencing subjective well-being and specific health-related outcomes. This study examines the perceived quality of life among homeless in Barcelona, focusing on gender-related differences and key factors affecting their well-being. Methods A total of 195 men and 91 women experiencing homelessness participated in a structured survey assessing their quality of life using the EQ-5D-5L instrument. This tool evaluates five dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Additionally, the Visual Analogue Scale (VAS) was used to measure participants’ self-rated health (0: worst possible health to 100: best possible health). For the analysis, the EQ-5D-5L dimensions were recategorized into two groups: moderate or severe problems vs. mild or no problems, allowing for a clearer comparison of gender-based differences. Results No significant differences were found in overall self-perceived quality of life between men and women (mean VAS score: 58.6 ± 26.6 for men vs. 56.6 ± 26.6 for women; p = 0.462). However, gender disparities emerged in specific domains. Women reported significantly higher levels of depression (57.8% vs. 36%; p < 0.001) and pain (51.1% vs. 37.1%; p = 0.024) compared to men. Conclusions This study underscores the complex interplay between homelessness, gender, and quality of life. While overall self-perceived quality of life did not differ significantly between genders, women experienced greater psychological distress and physical pain. These findings suggest the importance of targeted interventions addressing mental health and pain management in homeless populations, particularly for women. Key messages • Study in Barcelona finds homeless women report more depression and pain than men, despite similar overall quality of life. • Public health policies must prioritize mental health and pain relief for homeless populations, with tailored programs for women.