“Nobody cares about you as a group of people”: a mixed methods study of women living in congregate social housing in Ontario, Canada

ABSTRACT

Guided by the social model of disability, we carried out this exploratory study to understand the health and psychosocial needs of women living in social housing in Ontario, Canada. Using a sequential, mixed-methods design, we interviewed 19 women using a 126-item quantitative interview including six standardized measures exploring indicators of psychosocial well-being. From these findings, we designed a qualitative interview protocol and returned to participants. We calculated descriptive statistics for quantitative variables and analyzed qualitative data using thematic analysis. Participants reported a median of six unmet basic psychosocial needs (range 1–16; IQR = 6), a high prevalence of health conditions and associated disability with scores falling above the 80^th percentile on all subtests of a disability measure. Qualitative findings revealed that participants were living in an environment that made it challenging to meet their basic needs and felt abandoned by community supports. A persistent lack of safety led to self-isolation, which negatively influenced mental well-being. Social housing is aimed at alleviating poverty and its associated harms, yet women face multiple barriers to meeting their basic needs through existing supports and continue to experience poverty. Social housing can be disabling environments for women living in poverty.

KEYWORDS:

• Public housing
• poverty
• women
• disabled persons
• health equity

Disclosure statement

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Queen’s University Health Sciences Research Ethics Board #6021236 and the Western University Non-medical Research Ethics Board #112436)

Additional information

Funding

This study was funded, in part, through an internal grant provided to the principal investigator by Western University (Grant #R5840A03)

Notes on contributors

Carrie Anne Marshall

Dr. Carrie Anne Marshall is an Assistant Professor in the Faculty of Health Sciences, School of Occupational Therapy, at Western University in London, Ontario, Canada. Her research is focused on issues related to mental health, poverty, housing, and homelessness. She currently holds several grants from the Social Sciences and Humanities Research Council of Canada (SSHRC), Canadian Institutes of Health Research, and the Ontario Society of Occupational Therapists. Dr. Marshall worked for 8 years in a low barrier shelter supporting homeless persons, and as an occupational therapist in community mental health, where she supported many individuals living in poverty and social housing. Methodologically, she has expertise in the design, conduct, and analysis of scoping and systematic reviews, and in both mixed methods and qualitative research. She has specific expertise in interpretive phenomenology, integrating qualitative and quantitative data, and analytic strategies associated with phenomenology and thematic analysis. Further, Dr. Marshall has led multiple community development and research projects that included collaborating with a range of stakeholders to facilitate social change.

Carina Tjörnstrand

Carina Tjörnstrand is an Assistant Professor, Occupational Therapy and Occupational Science, Department of Health Sciences, Lund University in Lund, Sweden.

Emily Downs

Emily Downs affiliated in the Queen's University, Kingston, ON, Canada.

Rebecca Devries

Rebecca Devries affiliated in the Queen’s University, Kingston, ON, Canada.

Fiona Drake

Fiona Drake affiliated in the Manager of Support Services, Kingston & Frontenac Housing Corporation, Kingston, ON, Canada.