Abstract: Beyond Housing: An Exploration of Neighborhood Socio-Spatial Context on Permanent Supportive Housing Tenantsã¢â‚¬â„¢ Overall Health and Wellbeing (Society for Social Work and Research 28th Annual Conference - Recentering & Democratizing Knowledge: The Next 30 Years of Social Work Science)

Schedule:

Sunday, January 14, 2024

Marquis BR Salon 13, ML 2 (Marriott Marquis Washington DC)

* noted as presenting author

Bikki Tran Smith, Phd, Postdoctoral Fellow, University of Wisconsin-Madison, WI

Howard Padwa, PhD, Research Scientist, University of California, Los Angeles, Los Angeles, CA

Roya Ijadi-Maghsoodi, MD, ASSISTANT PROFESSOR-IN-RESIDENCE, UCLA, CA

Maria Patanwala, MD, Postdoctoral Fellow, University of California, Los Angeles

Taylor Harris, MA, Doctoral Student, University of Southern California, Los Angeles, CA

Lillian Gelberg, MD, Professor, University of California, Los Angeles, Los Angeles, CA

Ben Henwood, PhD, Associate Professor, University of Southern California, Los Angeles, CA

Background and Purpose: Permanent supportive housing (PSH) is intended to be safe and affordable for individuals experiencing homelessness yet zoning laws, NIMBYISM, and stigma limit opportunities to develop and place PSH units in neighborhoods with optimal amenities and low crime rates. Given the role of a neighborhood’s socio-spatial context on residents’ health and wellbeing, it is important to understand how PSH location shapes tenants’ experiences transitioning from homelessness into community-based, stable housing. As part of a larger mixed-methods comparative effectiveness study of scatter-site vs. place-based PSH on COVID-19-related health and social outcomes for persons experiencing homelessness (PEH), this inquiry explores the impact of the neighborhood environment on residents’ social, behavioral, and physical well-being.

Methods: We conducted in-depth phone interviews (N=28) with newly housed PSH residents in Los Angeles County. Interviews averaged 60 minutes in length. Interview recordings were transcribed verbatim and entered in Dedoose for data management and analysis. Transcripts were analyzed using hybrid thematic analysis.

Results: We found that PSH residents consistently mentioned the socio-spatial context of the neighborhood in which PSH is embedded as a central factor related to their health and well-being. Three major themes emerged in this analysis: 1) fear of leaving home 2) the dual nature of people, places, and things, and 3) compromising choice for housing. These themes were common across residents in both single-site and scatter-site settings. The majority of PSH tenants conveyed the lack of safety and security both within their apartment building as well as their neighborhood and the mental health toll it took on them. Despite this, residents viewed their PSH placement as “good enough for now” as it would be temporary until they could receive a Section 8 voucher. Residents also discussed the tension between needing to avoid people, places, and things to get sober while also needing people, places, and things to stay sober. Hence, those who found themselves in areas completely unfamiliar were grateful to be in a new environment away from negative influences, but also lamented the loss of old routines and the social isolation that came with moving to a new neighborhood. Finally, many tenants also spoke of accepting the first PSH unit they were matched with regardless of the desirability or convenience of the location simply to exit homelessness more quickly.

Conclusions and Implications: Findings demonstrate the importance of neighborhood setting on the health and quality of life of permanent supportive housing residents, with likely impacts on housing tenure, recidivism, and use of acute and costly healthcare services like hospitals. Policymakers and service providers must consider the socio-spatial context of PSH placements, prioritizing safety and access to transportation, social supports, relevant services, and employment, when siting and developing housing. Systematically placing PSH into high-quality neighborhoods that facilitate safety and well-being will require confronting and addressing NIMBYism through mechanisms of both policy and advocacy.