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Interview: Stable Housing Improves Health of Homeless Canadian Women


Dr. Natilie Waldbrook

A new study reveals how stable housing boosted the well-being of formerly homeless older women living in urban Toronto. With women’s homelessness in Canada on the rise, the research sheds light on the complex challenges facing homeless older women.

Author Natalie Waldbrook is a CIHR postdoctoral fellow in the department of geography at Queen’s University in Kingston, Ont., Canada.

The findings appeared online in the Journal of Women & Aging on Oct. 11, 2013.

To learn more, AHB reached Dr. Waldbrook at Queen’s University.

Ruth Dempsey: What got you interested in women’s homelessness?

Natalie Waldbrook: I have been studying various facets of homelessness for about seven years. I first became interested in the issue during my undergraduate studies at Laurentian University.

Sudbury, Ont., was going through an economic boom in the mining sector around 2004 and 2005. An influx of temporary workers created a demand for affordable, quality rental housing in the city. I noticed increased reports of homelessness among lower income persons, particularly women and those with children.

As a female student, I had experienced discrimination in the housing market myself, based mainly on earning a student income. I began to think about how women with even fewer resources than myself must be struggling to find decent, affordable housing.

For my MA thesis, I used Sudbury as a case study to examine women’s experiences of homelessness in a resource-dependent community.

Along the way, I began to conduct research on the aging population. So, for my dissertation in human geography, I focused on experiences of health, housing and aging among older persons with histories of homelessness in Toronto’s urban core. The article is based on interviews I conducted with the female participants during my PhD research.

RD: Can you give me a snapshot of the women?

NW: At the time of the study, most of the women were living in either a rented or subsidized apartment or in a supportive housing facility. Each of the women had been homeless at some point in their lives. About half were homeless once, often for an extended period of time. In other cases, the women were homeless multiple times but for shorter periods.

The women became homeless for the first time at a wide range of ages. Some women became homeless beginning as early as 12 years of age. Others were in their 50s when they became homeless for the first time.

Roughly two-thirds of the women were single. The rest were separated or divorced. Some had relatively strong relationships with their children and other family members. But many were estranged from family.

Most of the women earned less that $20,000. Incomes came largely from government social assistance and disability support benefits. Although some women had part-time jobs, many suffered from chronic disease and disability. This hampered their ability to be employed in full-time jobs.

RD: How did they become homeless? Were there common reasons?

NW: In fact, each woman followed a unique pathway into and out of homelessness.

Many women became homeless after leaving home at an early age. In many cases, physical and emotional abuse played a role. Some ran away to avoid further abuse or neglect.

In the adult years, family troubles, separation and divorce contributed to homelessness, usually though the loss of financial resources and support.

Physical health problems can lead to homelessness, especially if illness and disability results in job loss and lower income.

Not every homeless person suffers from an addiction or mental illness, but these were underlying factors in some cases among the women.

One episode of homelessness can lead to future housing loss by undermining a woman’s economic and social ties. For example, a woman evicted from an apartment, at an some point in her life, may find it difficult to get positive references or secure a good credit rating.

In other words, homelessness is rarely caused by a single factor. Homelessness is the outcome of both intersecting personal difficulties and broader systemic barriers, such as lack of affordable housing.

RD: Some struggled to feel at home in the new setting . . .

NW: Yes, the women reported a greater sense of personal safety and security in stable housing, but as you say, some struggled to feel "at home."

Lingering health effects and the emotional trauma linked to homelessness had long-lasting effects on several of the women.

Some viewed their current housing as temporary until they could afford more "desirable" accommodation.

Many women had lived in transitory accommodations in the past, and they feared becoming homeless again, especially now that they were getting older.

RD: The women’s health improved once they were in stable housing. Is that right?

NW: Most of the women experienced an improvement in their health and well-being when they moved into stable housing.

They had better access to food and they were able to utilize more health services. Some woman talked about developing better eating and sleeping habits.

Protection from the physical environment was a key factor in better health. For example, one woman said that she had suffered several bouts of pneumonia when she was on the street. But none since she had moved into her own place.

Generally speaking, the women thought their health would continue to improve the longer they were housed.

RD: How did they cope with little money?

NW: They continued to rely on support from community and social service organizations. Many women visited food banks, free meal programs and charity clothing shops to reduce their expenses and ensure they had enough money to pay the rent.

That said, several women went without the basic necessities: medications, fruits and vegetables and dental care. They simply couldn’t afford them.

Indeed, the findings point to a low income as a major barrier to healthy aging.

RD: You talk about supportive housing making it easier for the women to access community services. Can you give me an example?

NW: The women talked about the support they received from workers at the various facilities. Members of the staff sometimes accompanied the women to appointments. And they helped them to manage their finances and even medications.

Supportive housing typically offers private accommodation, shared kitchen facilities and on-site supports. The supports usually include counseling and health and social care services. This helped to reduce alcohol and drug consumption among those who tended to overuse.

RD: How did the women see their later years?

NW: Many worried that past experiences of homelessness might lead to poorer health in the future. Indeed, studies show that homeless people often experience "accelerated aging" due to poor nutrition, disrupted sleep patterns and higher risk of chronic conditions.

The women were also concerned about their financial futures. Sporadic employment meant minimal contributions to the Canadian Pension Plan. And many had lost financial assets, such as a house, earlier in life.

RD: The story of homelessness is complicated for older women. What can be done?

NW: Too often, researchers and policy makers look at the experiences of aging through a normative lens.

As a result, society gives little consideration to the experiences of older persons who have not followed a "normal" or expected life course.

Current policies on aging have overlooked the situations of older persons with a history of poverty and homelessness. This includes marginalized groups, such as homeless women, transgendered persons and ethnic minorities.

Research shows that Aboriginal women and women of visible minorities are most affected by discrimination in both the housing and job markets. Women with visible and invisible disabilities find it especially difficult to find housing that could accommodate their needs.

We must work towards developing better policies and programs for the more marginalized, oppressed segment of the older population.

Recognizing that not every older person is "healthy" and "wealthy" is a major step toward the development of more inclusive policies around aging.