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Health Status, Quality of Life, Residential Stability, Substance Use, and Health Care Utilization among Adults Applying to a Supportive Housing Program

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Abstract

Supportive housing, defined as subsidized housing in conjunction with site-based social services, may help improve the health and residential stability of highly disadvantaged individuals. This study examined changes in health status, quality of life, substance use, health care utilization, and residential stability among 112 homeless and vulnerably housed individuals who applied to a supportive housing program in Toronto, Canada, from December 2005 to June 2007. Follow-up interviews were conducted every 6 months for 18 months. Comparisons were made between individuals who were accepted into the program (intervention) and those who were wait-listed (usual care) using repeated-measures analyses. Individuals who were accepted into the housing program experienced significantly greater improvements in satisfaction with living situation compared with individuals in the usual care group (time, F 3,3,261 = 47.68, p < 0.01; group × time, F 3,3,261 = 14.60, p < 0.01). There were no significant differences in other quality of life measures, health status, health care utilization, or substance use between the two groups over time. Significant improvement in residential stability occurred over time, independent of assigned housing group (time, F 3,3,261 = 9.96, p < 0.01; group × time, F 3,3,261 = 1.74, p = 0.17). The ability to examine the effects of supportive housing on homeless individuals was limited by the small number of participants who were literally homeless at baseline and by the large number of participants who gained stable housing during the study period regardless of their assigned housing status. Nonetheless, this study shows that highly disadvantaged individuals with a high prevalence of poor physical and mental health and substance use can achieve stable housing.

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Acknowledgements

Dr. Hwang is the recipient of a New Investigator Award from the Canadian Institutes of Health Research. The Centre for Research on Inner City Health is supported in part by a grant from the Ontario Ministry of Health and Long-Term Care. We wish to thank Joseph Taylor, Marcela Fresolone, and all the staff at Evangel Hall Mission for collaborating on this project and for their assistance in participant recruitment and follow-up. We also wish to thank the shelter, drop-in, and municipal and provincial staff who also assisted in participant follow-up. This project was supported by an Advanced Grant from the Wellesley Institute and by an Interdisciplinary Capacity Enhancement Grant on Homelessness, Housing, and Health from the Canadian Institutes of Health Research. The authors wish to thank Marko Katic (Department of Research Design and Biostatistics, Sunnybrook Health Sciences Centre) for his help with programming and data analyses.

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Authors and Affiliations

  1. Centre for Research on Inner City Health, Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada

    Stephen W. Hwang, Evie Gogosis, Catharine Chambers, James R. Dunn & Jeffrey S. Hoch

  2. Department of Health, Aging and Society, McMaster University, Toronto, ON, Canada

    James R. Dunn

  3. Centre for Research on Educational and Community Services, University of Ottawa, Ottawa, ON, Canada

    Tim Aubry

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  1. Stephen W. Hwang
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  2. Evie Gogosis
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  3. Catharine Chambers
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  4. James R. Dunn
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  5. Jeffrey S. Hoch
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  6. Tim Aubry
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Correspondence to Stephen W. Hwang.

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Hwang, S.W., Gogosis, E., Chambers, C. et al. Health Status, Quality of Life, Residential Stability, Substance Use, and Health Care Utilization among Adults Applying to a Supportive Housing Program. J Urban Health 88, 1076–1090 (2011). https://doi.org/10.1007/s11524-011-9592-3

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