“I Got Nothing” – Findings from the Young Adult Photovoice Project Examining Food Insecurity Among Formerly Homeless Young Adults in San Francisco

Background and Purpose: Food insecurity is a critical issue among homeless and unstably housed minors and young adults. In the 2013 San Francisco Point in Time count, 61% of unaccompanied minors and homeless young adults ages 8-24 reported food as their greatest need. Even for homeless youth who manage to obtain permanent supportive housing, many continue to face barriers to obtaining healthy and adequate nutrition. In our prior work, we found that among youth living in San Francisco’s first city-funded permanent supportive housing building specifically designated for transitional aged youth (aged 18-24), 71% of residents scored at a level of severe food insecurity on the Household Food Insecurity Access Scale (USAID, 2007), and an additional 16% were moderately food insecure.

PhotoVoice is a research methodology that combines photography and group discussion in order to amplify the voices and visions of marginalized communities. The Young Adult Photovoice Project (YAPP) is a community-based participatory research (CBPR) study designed to assess, document, and disseminate an understanding of the barriers to obtaining adequate healthy food faced by formerly homeless youth.

Methods: Nine young adult residents between the ages of 18-25 participated in the YAPP study. The project consisted of eleven 2.5-hour long sessions over a period of four months. Study participants were given digital cameras and received training in photography as well as in the safety and ethics of taking pictures. Each week participants chose a prompt to guide their photo taking, and participated in critical reflection and dialogue around their photos. Participants subsequently created captions and wrote narratives for their photographs. All group discussions were audio recorded and transcribed verbatim, and were coded using thematic analysis. The project culminated in a final photography exhibit in downtown San Francisco.

Results: Group discussions of photographs revealed several important barriers to food insecurity. These included: inadequate funding through government assistance programs to cover monthly food expenses; lack of accessible, affordable healthy food outlets near the supportive housing facility; the importance of pets as emotional support and the prioritization of limited funding on pets instead of food; challenges associated with communal living, such as the lack of hygiene in the communal kitchen; the stigma associated with seeking free meals at homeless shelters and soup kitchens; restrictions imposed by restaurants and grocery stores on giving away unused food; the lack of fresh, healthy foods included in the food boxes given out by non-profits; and health issues that impede some participants from being able to leave the building on a regular basis to seek out food.

Conclusions and Implications: Findings highlight the challenges of youth entering into permanent supportive housing related to food security. In addition, findings presented through the final photo exhibition helped to increase awareness of food insecurity among community members, businesses, and policymakers in San Francisco. Lessons learned and best practices on how to use PhotoVoice methodology among marginally housed youth will be shared.