The extent to which non-conditional housing programs improve housing and well-being outcomes: a systematic review

Purpose To reduce rates of homelessness, recent efforts have been directed toward developing non-conditional supported housing programs that prioritize the delivery of housing support and individual services, without tenancy conditions (i.e. maintaining sobriety and adhering to mental health treatment). As promising as these programs are, findings generally show that while housing stability is improved, other individual outcomes remain largely unchanged. No review to date has synthesized the collective evidence base of non-conditional housing programs, rather the focus has been on specific programs of delivery (e.g. Housing First) or on specific population groups (e.g. those with mental illness). The purpose of this paper is to evaluate the extent to which non-conditional housing interventions improve housing and well-being outcomes for all persons. Design/methodology/approach A systematic search of the literature was conducted for randomized controlled studies that evaluated the effectiveness of a non-conditional housing intervention in improving housing and health outcomes among any participant group. Findings A total of 31 studies were included in this review. Non-conditional supported housing programs were found to be most effective in improving housing stability as compared to health and well-being outcomes. Policymakers should consider this when developing non-conditional supported housing programs and ensure that housing and other health-related outcomes are also mutually supported. Originality/value This is the first review, to the authors’ knowledge, to synthesize the collective impact of all non-conditional supported housing programs. The current findings may inform the (re)design and implementation of supported housing models to prioritize the health and well-being of residents.

Sustainability and Social Interest Housing

The article describes the concepts of sustainability in a historical view of the subject. The text assesses the evolution of the Minha Casa Minha Vida program (MCMV) and its relevant production for Social Interest Housing (HIS) in Brazil in this century. The research also lists the impacts of sustainable practices applied to that program. In the methodology, consultations in secondary sources (books, articles and theses) and the research of documents from the state, municipal and federal spheres stand out. This analysis of these documents is responsible for a more precise investigation on the subject. The conclusions highlight how the concept of sustainability applied to housing programs can generate increasingly higher standards of housing, suitable for the target audience.

Hospital-to-Shelter/Housing Interventions for Persons Experiencing Homelessness

Persons with lived and living experiences of homelessness (PWLEs) commonly use hospitals and emergency departments to access healthcare yet support for transitions from hospital to shelter/housing can be challenging to access. To improve the continuity of care and health outcomes for PWLEs who are being discharged from hospital, a more complete understanding of two hospital-to-shelter/housing programs in Metro Vancouver, Canada was sought. Using a community-based participatory research approach, we conducted in-depth interviews in-person or by phone. Participants included eight healthcare and shelter/housing decision-makers and providers and a convenience sample of ten program participants (two females and eight males who ranged in age from 31 to 74 years old; average = 50 years old). Data were analyzed in NVivo 12 to identify successes including: 1) achieving health stability and recovery following hospital discharge; 2) having privacy and freedom while in the program; 3) building relationships with providers; 4) having formal support to find housing; and 5) cross-sector relationships between providers. Challenges included: 1) limited availability of affordable and appropriate housing; 2) other guests’ ways of life; 3) complex needs versus limited after-care resources; and 4) inequities in program access. While hospital-to-shelter/housing programs can serve as intervention opportunities to connect PWLEs to permanent housing, discharge plans need to acknowledge the local limitations on housing availability and offer short-term options for patients who require sub-acute rest and convalescence.

Re-Envisioning Aging in the Right Place to Disrupt Homelessness for Older People

Recent developments in the aging-in-place literature have recognized the significance of aging-in-the-right-place. That is, aging in a place that supports an individual’s unique values, vulnerabilities, and lifestyles. This symposium will build upon existing research by critically examining the potential for older persons with experiences of homelessness (OPEH) and/or housing insecurity to age-in-the-right-place. Presenters will include interdisciplinary researchers with a diversity of perspectives stemming from gerontology, social work, and environmental design. The symposium will begin with Weldrick and Canham presenting a conceptual framework for aging-in-the-right-place that has been developed to outline indicators relevant to OPEH and housing-insecure older people. Elkes and Mahmood will then discuss findings from a study of service providers working with OPEH to consider the relative benefits and challenges of temporary housing programs. Following, Brais and colleagues will present findings from an environmental audit, developed as a novel assessment tool to evaluate the accessibility and physical design of housing programs for OPEH. A final presentation by Kaushik and Walsh will highlight findings from a photovoice study on perspectives of aging-in-the-right place among OPEH during the Covid-19 pandemic. Joyce Weil, an expert in measurement of person-place fit and life course inequalities, will discuss the implications of these papers and reflect on the potential for the aging-in-the-right-place framework to address the diverse needs of the growing population of OPEH through policy and practice. Together, the participants of the symposium will advance this emerging scholarship using a wide range of methods and perspectives.

Realization of the key aspects of the right to adequate housing in affordable housing programs in Egypt

The realization of the right to adequate housing is a critical issue that countries seek to achieve through affordable housing projects. However, there is a discrepancy in fulfilling the right to adequate housing between countries, which has surfaced the dilemma of defining adequate housing. In this respect, scanning relevant literature figured out seven key aspects to meet the right to adequate housing. Using a questionnaire launched to experts in the field, they figured out to what extent the seven aspects have been realized in the affordable housing programs in Egypt. The results showed a significant percentage of realization of the seven key aspects of the right to adequate housing. The findings showed an apparent variation in the completion of the seven key aspects, which decision-makers can improve at different scales with the progression of the programs. Future research can build on this direction to consider aspects like accessibility and cultural adequacy of these programs.

Future Directions: Study Protocol for an Effectiveness-Implementation Hybrid Evaluation of a State-based Social Housing Strategy and Three Social Housing Programs

Background: In the Australian state of New South Wales nearly 60,000 approved applicants are waiting for social housing. Future Directions for Social Housing is a response to this challenge. This collection of housing programs aims to provide more social housing, support and incentives for leaving social housing and a better social housing experience. This document presents the protocol of the evaluation of these programs and the overarching Future Directions Strategy. Methods/Design: The evaluation will use a Type 1 effectiveness-implementation hybrid design, with an integrated, dual focus on assessing the effectiveness of Future Directions and better understanding the context for reform implementation. Program effectiveness will be examined using quasi-experimental techniques applied to linked administrative data. The implementation context will be examined via program level data, qualitative interviews and focus groups with stakeholders and tenants. Some quantitative survey and administrative data will also be used. Findings from the implementation evaluation will be used to inform and interpret the effectiveness evaluation. Economic evaluations will also be conducted. Discussion: This methodology will produce a high-quality evaluation of a large, complex government program which aims to facilitate rapid translational gains, real-time adoption of effective implementation strategies and generate actionable insights for policymakers.