Housing First is an evidence-based approach to addressing chronic homelessness that provides permanent, low-barrier housing. Previous literature on the health of tenants of Housing First programs has primarily focused on mental health, substance use, and health care. Using the social-ecological model, we conducted a community-based participatory research (CBPR) PhotoVoice study to better understand what Housing First residents in Detroit identify as factors that impact their health. Seventeen participants were provided cameras and photography training and asked to take photos on the theme “What impacts your health and wellness?” Group sessions were held to discuss photos. Results were organized into four themes: (a) loss of jobs hurts people and communities; (b) blight, more than just abandoned buildings; (c) being pushed out by development; and (d) experiencing the “battlefield” versus feeling peaceful. The social-ecological model was used to indicate potential interventions indicated by study findings.
BaileyZ. D.KriegerN.AgénorM.GravesJ.LinosN.BassettM. T. (2017). Structural racism and health inequities in the USA: Evidence and interventions. The Lancet, 389, 1453–1463. doi:10.1016/S0140-6736(17)30569-X
2.
BranasC. C.CheneyR. A.MacDonaldJ. M.TamV. W.JacksonT. D.Ten HaveT. R. (2011). A difference-in-differences analysis of health, safety, and greening vacant urban space. American Journal of Epidemiology, 174, 1296–1306. doi:10.1093/aje/kwr273
3.
CarlsonE. D.EngebretsonJ.ChamberlainR. M. (2006). Photovoice as a social process of critical consciousness. Qualitative Health Research, 16, 836–852. doi:10.1177/1049732306287525
4.
CatalaniC.MinklerM. (2010). Photovoice: A review of the literature in health and public health. Health Education & Behavior, 37, 424–451. doi:10.1177/1090198109342084
5.
CheezumR. R.CoombeC. M.IsraelB. A.McGranaghanR. J.BurrisA. N.Grant-WhiteS.. . . AndersonM. (2013). Building community capacity to advocate for policy change: An outcome evaluation of the neighborhoods working in partnership project in Detroit. Journal of Community Practice, 21, 228–247. doi:10.1080/10705422.2013.811624
6.
CollinsJ. M. (2011). The role of default counseling for mortgage borrowers in financial distress. In LamdinDouglas J. (ed.) Consumer knowledge and financial decisions (pp. 165–182). New York: Springer. doi:10.1007/978-1-4614-0475-0_11
7.
DassahE.AlderseyH. M.NormanK. E. (2017). Photovoice and persons with physical disabilities: A scoping review of the literature. Qualitative Health Research, 27, 1412–1422. doi:10.1177/1049732316687731
8.
Evans-AgnewR. A.RosembergM. S. (2016). Questioning photovoice research: Whose voice?Qualitative Health Research, 26, 1019–1030. doi:10.1177/1049732315624223
HanS. C.OliffeJ. L. (2016). Photovoice in mental illness research: A review and recommendations. Health, 20, 110–126. doi:10.1177/1363459314567790
11.
HenwoodB. F.ByrneT.ScriberB. (2015). Examining mortality among formerly homeless adults enrolled in housing first: An observational study. BMC Public Health, 15(1), 1209–1216. doi:10.1186/s12889-015-2552-1
12.
HenwoodB. F.LaheyJ.HarrisT.RhoadesH.WenzelS. L. (2018). Understanding risk environments in permanent supportive housing for formerly homeless adults. Qualitative Health Research, 28, 2011–2019. doi:10.1177/1049732318785355
13.
HenwoodB. F.StanhopeV.BrawerR.WeinsteinL. C.LawsonJ.StwordsE.CrossanC. (2013). Addressing chronic disease within supportive housing programs. Progress in Community Health Partnerships: Research, Education, and Action, 7(1), 67–77. doi:10.1353/cpr.2013.0005
14.
HillT. D.RossC. E.AngelR. J. (2005). Neighborhood disorder, psychophysiological distress, and health. Journal of Health and Social Behavior, 46, 170–186. doi:10.1177/002214650504600204
15.
HoborG. (2012). Surviving the era of deindustrialization: The new economic geography of the urban rust belt. Journal of Urban Affairs, 35, 417–434. doi:10.1111/j.1467-9906.2012.00625.x
16.
IsraelB. A.CoombeC. M.CheezumR. R.SchulzA. J.McGranaghanR. J.LichtensteinR.. . . BurrisA. (2010). Community-based participatory research: A capacity-building approach for policy advocacy aimed at eliminating health disparities. American Journal of Public Health, 100, 2094–2102.
17.
IsraelB. A.SchulzA. J.ParkerE. A.BeckerA. B. (1998). Review of community-based research: Assessing partnership approaches to improve public health. Annual Review of Public Health, 19(1), 173–202. doi:10.1146/annurev.publhealth.19.1.173
18.
JurkowskiJ. M.Paul-WardA. (2007). Photovoice with vulnerable populations: Addressing disparities in health promotion among people with intellectual disabilities. Health Promotion Practice, 8, 358–365. doi:10.1177/1524839906292181
19.
KwartengJ. L.SchulzA. J.MentzG. B.ZenkS. N.OppermanA. A. (2013). Associations between observed neighborhood characteristics and physical activity: Findings from a multiethnic urban community. Journal of Public Health, 36, 358–367. doi:10.1093/pubmed/fdt099
20.
LarimerM. E.MaloneD. K.GarnerM. D.AtkinsD. C.BurlinghamB.LonczakH. S.. . . MarlattG. A. (2009). Health care and public service use and costs before and after provision of housing for chronically homeless persons with severe alcohol problems. Journal of the American Medical Association, 301, 1349–1357. doi:10.1001/jama.2009.414
21.
McLeroyK. R.BibeauD.StecklerA.GlanzK. (1988). An ecological perspective on health promotion programs. Health Education & Behavior, 15, 351–377. doi:10.1177/109019818801500401
22.
MerriamS. B.TisdellE. J. (2016). Qualitative research: A guide to design and implementation. San Francisco: Jossey-Bass.
23.
PadgettD. K.SmithB. T.DerejkoK. S.HenwoodB. F.TideringtonE. (2013). A picture is worth…? Photo elicitation interviewing with formerly homeless adults. Qualitative Health Research, 23(11), 1435-1444.
24.
PruittA. S.BarileJ. P.OgawaT. Y.PeraltaN.BuggR.LauJ.. . . MoriV. (2018). Housing first and photovoice: Transforming lives, communities, and systems. American Journal of Community Psychology, 61, 104–117. doi:10.1002/ajcp.12226
25.
QuerciaR.CowanS. M. (2008). The impacts of community-based foreclosure prevention programs. Housing Studies, 23, 461–483. doi:10.1080/02673030802020627
26.
RosenD.GoodkindS.SmithM. L. (2011). Using photovoice to identify service needs of older African American methadone clients. Journal of Social Service Research, 37, 526–538. doi:10.1080/01488376.2011.607369
27.
SchillingJ.LoganJ. (2008). Greening the rust belt: A green infrastructure model for right sizing America’s shrinking cities. Journal of the American Planning Association, 74, 451–466. doi:10.1080/01944360802354956
28.
SeitzC. M.StrackR. W. (2016). Conducting public health photovoice projects with those who are homeless: A review of the literature. Journal of Social Distress and the Homeless, 25(1), 33–40. doi:10.1080/10530789.2015.1135565
29.
SomersJ. M.MoniruzzamanA.PattersonM.CurrieL.RezansoffS. N.PalepuA.FryerK. (2017). A randomized trial examining housing first in congregate and scattered site formats. PLoS ONE, 12(1), e0168745. doi:10.1371/journal.pone.0168745
30.
SrebnikD.ConnorT.SyllaL. (2013). A pilot study of the impact of housing first–Supported housing for intensive users of medical hospitalization and sobering services. American Journal of Public Health, 103, 316–321. doi:10.2105/AJPH.2012.300867
31.
StraussA.CorbinJ. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Newbury Park, CA: Sage.
32.
SpelmanW. (1993). Abandoned buildings: Magnets for crime?. Journal of Criminal Justice, 21(5), 481-495. doi: 10.1016/0047-2352(93)90033-J
33.
SugrueT. J. (2014). The origins of the urban crisis: Race and inequality in postwar Detroit. Princeton, NJ: Princeton University Press. doi:10.2307/20173746
34.
TsemberisS. JGulcurL.NakaeM. (2004). Housing first, consumer choice, and harm reduction for homeless individuals with a dual diagnosis. American Journal of Public Health, 94, 651–656. doi:10.2105/AJPH.94.4.651
35.
TsemberisS. J.MoranL.ShinnM.AsmussenS. M.ShernD. L. (2003). Consumer preference programs for individuals who are homeless and have psychiatric disabilities: A drop-in center and a supported housing program. American Journal of Community Psychology, 32, 305–317. doi:10.1023/B:AJCP.0000004750.66957.bf
36.
U.S. Department of Housing and Urban Development. (2007, September). Defining chronic homelessness: A technical guide for HUD programs. Washington, DC.
37.
U.S. Department of Housing and Urban Development. (2017, December). The 2017 Annual Homeless Assessment Report (AHAR) to Congress; Part 1: Point in time estimates of homelessness. Washington, DC.
38.
WallaceR.WallaceD. (1990). Origins of public health collapse in New York City: The dynamics of planned shrinkage, contagious urban decay and social disintegration. Bulletin of the New York Academy of Medicine, 66, 391–434.
39.
WangC.BurrisM. A. (1994). Empowerment through photo novella: Portraits of participation. Health Education & Behavior, 21, 171–186. doi:10.1177/109019819402100204
40.
WangC.BurrisM. A. (1997). Photovoice: Concept, methodology, and use for participatory needs assessment. Health Education & Behavior, 24, 369–387. doi:10.1177/109019819702400309
41.
WangC. C.CashJ. L.PowersL. S. (2000). Who knows the streets as well as the homeless? Promoting personal and community action through photovoice. Health Promotion Practice, 1(1), 81–89. doi:10.1177/152483990000100113
42.
WeinsteinL. C.HenwoodB. F.MatejkowskiJ.SantanaA. J. (2011). Moving from street to home: Health status of entrants to a housing first program. Journal of Primary Care & Community Health, 2(1), 11–15. doi:10.1177/2150131910383580
43.
WilliamsD. R.CollinsC. (2001). Racial residential segregation: A fundamental cause of racial disparities in health. Public Health Reports, 116, 404–416. doi:10.1093/phr/116.5.404
44.
WrenC.StoreyD. J. (2002). Evaluating the effect of soft business support upon small firm performance. Oxford Economic Papers, 54, 334–365. doi:10.1093/oep/54.2.334
