Understanding housing and health through the lens of transitional housing members in a high-incarceration Baltimore City neighborhood: The GROUP Ministries Photovoice Project to promote community redevelopment

Housing and health in vulnerable social groups: an overview and bibliometric analysis

Previous studies have confirmed that poor living conditions can lead to a wide range of health problems. However, in the context of the COVID-19 pandemic, vulnerable groups in unstable housing are more susceptible to disease. This study aims to systematically examine the housing and health problems of vulnerable groups using a bibliometric approach to explore how housing causes health problems, types of health illnesses, and coping strategies. It is found that the poor housing mechanism, persistent inequalities, and poor housing environments have a significant impact on the health of vulnerable groups. Therefore, the government must make concerted efforts across all sectors to ensure that the housing and health care needs of vulnerable groups are improved, and that housing security standards and related policies are improved; targeted safety plans are formulated with community as the carrier, taking into account the characteristics of vulnerable groups; and new information technology is widely used to provide medical convenience for vulnerable groups. It is hoped that the research in this paper can arouse social attention to the health of vulnerable groups and improve their health from the perspective of housing, so as to point out the direction for solving the housing health problems of vulnerable groups in the future.

"I don't know what home feels like anymore": Residential spaces and the absence of ontological security for people returning from incarceration

Housing is central to health equity, and mass incarceration is an important but understudied aspect of housing vulnerability and health inequity. One way in which housing can be linked to health and health inequity is through ontological security. Ontological security, or a sense of feeling at home, is comprised of constancy, daily routines, privacy, and a basic security that enables the development of one's identity. It has been theorized as a mechanism by which people reap the health benefits of housing. Based on two waves of interviews in 2017-2018 with a sample of 27 people returning from incarceration in a northeast U.S. city, we describe participants' residential experiences during the first two years after release. Participants lived in residential group settings, with friends, partners and family, or were homeless. They experienced impermanence, punitive place rules, surveillance, and a lack of control. In contrast, participants spoke about their idea of home, imagined from the past or for the future, as a place of privacy, control, and wellbeing. This analysis expands the study of ontological security by detailing its absence among people returning from incarceration. The concept of ontological security holds promise in delineating the ways in which housing provides health benefits, and is particularly useful for understanding the needs and experiences of those returning from prison and seeking to restart their lives in the community. Relatedly, participant narratives point to the expansion of the carceral state beyond prison, including into residential space, with implications for the intersection of housing and health equity.

Stressed, anxious, and sick from the floods: A photovoice study of climate extremes, differentiated vulnerabilities, and health in Old Fadama, Accra, Ghana

Although there is a large and growing literature on anticipated climate change impacts on health, we know very little about the linkages between differentiated vulnerabilities to climate extremes and adverse physical and mental health outcomes. In this paper, we examine how recurrent flooding interacts with gendered vulnerability, social differentiation, and place-related historical and structural processes to produce unequal physical and mental health outcomes. We situated the study in Old Fadama, Ghana, using a Photovoice approach (n = 20) and theoretical concepts from political ecologies of health and feminist political ecology. Overall, the study revealed several adverse physical and mental health impacts of flooding, with vulnerability differentiated based particularly on gender and age, but also housing, class, and income. Our findings suggest the need for greater attentiveness to social differentiation in scholarship involving political ecologies of health. The paper builds on the health and place literature by linking the social and contextual to the medical.

Questioning Photovoice Research: Whose Voice?

Photovoice is an important participatory research tool for advancing health equity. Our purpose is to critically review how participant voice is promoted through the photovoice process of taking and discussing photos and adding text/captions. PubMed, Scopus, PsycINFO, and Web of Science databases were searched from the years 2008 to 2014 using the keywords photovoice, photonovella, photovoice and social justice, and photovoice and participatory action research. Research articles were reviewed for how participant voice was (a) analyzed, (b) exhibited in community forums, and (c) disseminated through published manuscripts. Of 21 studies, 13 described participant voice in the data analysis, 14 described participants' control over exhibiting photo-texts, seven manuscripts included a comprehensive set of photo-texts, and none described participant input on choice of manuscript photo-texts. Photovoice designs vary in the advancement of participant voice, with the least advancement occurring in manuscript publication. Future photovoice researchers should expand approaches to advancing participant voice.

New spatially continuous indices of redlining and racial bias in mortgage lending: links to survival after breast cancer diagnosis and implications for health disparities research

Racial health disparities continue to be a serious problem in the United States and have been linked to contextual factors, including racial segregation. In some cases, including breast cancer survival, racial disparities appear to be worsening. Using the Home Mortgage Disclosure Act (HMDA) database, we extend current spatial analysis methodology to derive new, spatially continuous indices of (1) racial bias in mortgage lending and (2) redlining. We then examine spatial patterns of these indices and the association between these new measures and breast cancer survival among Black/African American women in the Milwaukee, Wisconsin metropolitan area. These new measures can be used to examine relationships between mortgage discrimination and patterns of disease throughout the United States.

Picture Your Nursing Home: Exploring the Sense of Home of Older Residents through Photography

The quality of the built environment can impact the quality of life and the sense of home of nursing home residents. This study investigated (1) which factors in the physical and social environment correlate with the sense of home of the residents and (2) which environmental factors are most meaningful. Twelve participants engaged in a qualitative study, in which photography was as a supportive tool for subsequent interviews. The data were analysed based on the six phases by Braun and Clarke. The four themes identified are (1) the physical view; (2) mobility and accessibility; (3) space, place, and personal belongings; and (4) the social environment and activities. A holistic understanding of which features of the built environment are appreciated by the residents can lead to the design and retrofitting of nursing homes that are more in line with personal wishes.

Dreaming of toilets: using photovoice to explore knowledge, attitudes and practices around water-health linkages in rural Kenya

As part of a knowledge, attitudes, practices and empowerment (KAPE) project implemented by the United Nations University Institute for Water, Environment and Health (UNU-INWEH) in the Lake Victoria Basin, this paper reports findings from a photovoice study with women in Usoma, a lakeshore community in Western Kenya. Drawing on ecosocial and political ecology theory, findings reveal that access to water, perceptions and practices were shaped by ecological and broader structural factors. Further, collective actions to improve access were constrained by institutional and economic structures, thus (re)enforcing inequalities.

The association between neighborhood residential rehabilitation and injection drug use in Baltimore, Maryland, 2000-2011

This study utilized multilevel cross-classified models to longitudinally assess the association between neighborhood residential rehabilitation and injection drug use. We also assessed whether relocating between neighborhoods of varying levels of residential rehabilitation was associated with injection drug use. Residential rehabilitation was categorized into three groups (e.g. low, moderate, high), and lagged one visit to ensure temporality. After adjusting for neighborhood and individual-level factors, residence in a neighborhood with moderate residential rehabilitation was associated with a 23% reduction in injection drug use [AOR=0.77; 95% CI (0.67,0.87)]; residence in a neighborhood with high residential rehabilitation was associated with a 26% reduction in injection drug use [AOR=0.74; 95% CI (0.61,0.91)]. Continuous residence within neighborhoods with moderate/high rehabilitation, and relocating to neighborhoods with moderate/high rehabilitation, were associated with a lower likelihood of injection drug use. Additional studies are needed to understand the mechanisms behind these relationships.

An exploration of social justice intent in photovoice research studies from 2008 to 2013

In an age where digital images are omnipresent, the use of participant photography in qualitative research has become accessible and commonplace. Yet, scant attention is paid to the social justice impact of photovoice amongst studies that have used this innovative method as a way to promote social justice. There is a need to review this method to understand its contributions and possibilities. This literature review of photovoice research studies (i) explores whether authors implicitly or explicitly related the methodologies to their aims of promoting social justice (methodology-method fit) and (ii) outlines the social justice research impact of photovoice findings using the framework of social justice awareness, amelioration and transformation. PubMed, Scopus, PsycINFO and Web of Science databases were searched from the years 2008-13 using the following keywords: photovoice; photonovella; photovoice and social justice; and photovoice and participatory action research. Of the 30 research studies reviewed, only thirteen identified an underlying methodology guiding the photovoice method. The social justice impacts emphasized were more related to social justice awareness (n = 30) than amelioration (n = 11) or transformation (n = 3). Future researchers using photovoice as a way to promote social justice are encouraged to assess and plan for the social justice impact desired.