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‘We stick people in a house and say okay, you're housed. The problem is solved’: A qualitative study of service provider and organisational leader perspectives on thriving following homelessness

For individuals experiencing homelessness, securing housing is one important step towards improved well-being. However, community integration, mental well-being, meaningful activity engagement, and adequate income are also important to help individuals thrive, rather than merely survive, following homelessness. Systemic barriers that prevent thriving following homelessness represent a social justice and health equity issue.

This study presents qualitative findings from community-based participatory research on conditions for thriving following homelessness and includes perspectives of service providers and leaders from organizations who are providing social services and mental health supports in two Ontario cities.

The findings emphasize that to thrive following homelessness, additional supports are needed – i.e., sticking people in a house is not enough. Authors recommend addressing loneliness and social exclusion experienced during and following homelessness, recognizing that social inclusion and community belonging are influential determinants of health. Leaving these needs unmet, and focusing solely on securing or sustaining tenancy, can perpetuate the cycle of homelessness, decrease housing stability, and prolong social and health challenges.

The study highlights that service providers are currently embedded within a crisis-oriented and under-resourced system that places them at risk of moral distress and injury, prevents a focus on thriving following homelessness or homelessness prevention, and undermines efforts at ending homelessness.

The study concludes with implications for future research, practice and policy that align with public health roles and responsibilities. For example, in public health practice, peer support specialists can be incorporated (and adequately supported) in programs supporting people with lived experience of homelessness. Public health professionals can also advocate for affordable housing or income supports, as poverty interferes with thriving. Through these strategies and others, this article contributes to the evidence base for promoting thriving following homelessness, reducing health inequities, and preventing ongoing homelessness.

Use this resource to:

  • deepen understanding of how determinants of health such as housing, community integration, social inclusion, and belonging intersect to influence wellbeing;
  • explore the impact that peer support specialists can have in the housing and homelessness sector and consider the wellbeing of peer support specialists; and
  • develop evidence-informed strategies to support people to thrive following homelessness and address inequities experienced by people with lived and living experience of homelessness.

 

Alignment with NCCDH work:

Housing is a core social determinant of health, which intersects with many other determinants of health.

In 2018, we released a blog post entitled “Housing: An area for public health action on equity” and an accompanying curated resource list to support public health practitioners in actioning housing as a determinant of population health and health equity.

Also in 2018, NCCDH released a report that outlines the implications of the RentSafe findings for public health practitioners in Canada. This report explores if action on unhealthy housing falls within public health’s scope or roles.

In 2021, as part of our efforts to support an equity-driven response to COVID-19, we generated a report entitled “Supporting COVID-19 vaccine uptake among people experiencing homelessness or precarious housing in Canada.”

In 2022-23, we profiled stories about intersectoral action to support underhoused populations through the Learning from Practice series and the Equity in Action project. These stories provide practical examples of public health collaboration with service providers from other sectors for advancing equity for populations experiencing housing precarity or homelessness.

 

Click here for more resources on housing and health equity.


Marshall, C. A., Phillips, B., Holmes, J., Todd, E., Hill, R., Panter, G., Easton,. C., Landry, T., Collins, S., Greening, T., O’Brien, A., Jastak, M., Ridge, R., Goldszmidt, R., Shanoff, C., Laliberte Rudman, D., Carlsson, A., Aryobi, S., Perez, S. et Oudshoorn, A. (2022). ‘We stick people in a house and say okay, you're housed. The problem is solved’: A qualitative study of service provider and organisational leader perspectives on thriving following homelessness. Health & Social Care in the Community. 30(6), e6018-e6029. https://doi.org/10.1111/hsc.14035

Tags: Housing, Structural determinants, Academic Institution, Document, Journal Article