title: Health status, quality of life, residential stability, substance use, and health care utilization among adults applying to a supportive housing program.
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.
authors.affiliation: Centre for Research on Inner City Health, Keenan Research Centre in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada. hwangs@smh.ca
authors.forename: Stephen W
authors.initials: SW
authors.lastname: Hwang
authors.forename: Evie
authors.initials: E
authors.lastname: Gogosis
authors.forename: Catharine
authors.initials: C
authors.lastname: Chambers
authors.forename: James R
authors.initials: JR
authors.lastname: Dunn
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Hoch
authors.forename: Tim
authors.initials: T
authors.lastname: Aubry
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000453:epidemiology; D002170:Canada; D004522:Educational Status; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006304:Health Status; D006703:Ill-Housed Persons / Q000523:psychology / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D011446:Prospective Studies; D011638:Public Housing / Q000706:statistics & numerical data*; D011788:Quality of Life; D044469:Racial Groups; D012947:Social Work / Q000458:organization & administration / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult