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. 2024 Feb 8;21(2):195.
doi: 10.3390/ijerph21020195.

Using Photovoice to Explore Determinants of Health among Homeless and Unstably Housed Women

Jessica L Mackelprang  1 , Janessa M Graves  2   3 , Halle M Schulz  3   4
Affiliations

Using Photovoice to Explore Determinants of Health among Homeless and Unstably Housed Women

Jessica L Mackelprang et al. Int J Environ Res Public Health. .

Abstract

The lived experiences of homeless and unstably housed women, including their health-related priorities, are understudied in smaller metropolitan and rural communities. In this study, we partnered with a day center for women who experience homelessness in Spokane, Washington. We used Photovoice, a community-based participatory action research method, to explore the health-related concerns, needs, and behavior of women who are homeless or unstably housed. Participant-generated photographs and group interview data were analyzed using thematic analysis. Three themes were generated: "These are my supports", "I'm trying to make my health better", and "[My] choices are very limited". The themes illustrated individual, interpersonal, community, and societal strengths and vulnerabilities aligned with the social ecological model. Participants demonstrated resourcefulness, creativity, and hope as they strived toward health improvement. Trauma-informed, strengths-based approaches that respect the autonomy of homeless and unstably housed women and that amplify their voices are needed to minimize power imbalances in research, policy, and practice. This includes an imperative for healthcare and social work programs to ready graduates to deliver effective, empathic services by increasing their knowledge of social determinants of health and of the stigma faced by marginalized communities. Moreover, collaborating with these communities when designing, implementing, and evaluating services is critical.

Keywords: Photovoice; homelessness; housing instability; social ecological model; women.

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Conflict of interest statement

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
“One of the things that help me stay emotionally healthy is all the good friends. They help me sort through all the things that make me upset or irritable. I have a lot of good friends that are positive influences on me”.—Nina. Photo by Joan.
Figure 2
Figure 2
“My bed [when I was homeless] was always the bottom bunk [at the shelter] because I got some health problems where I cannot climb the top bunk”.—Nina. Photo by Nina.
Figure 3
Figure 3
“I take my shot every night before I go to bed. I got my meds ready for the next day”.—Cheryl. Photo by Cheryl.
Figure 4
Figure 4
“Dinner”—Joan. Photo by Joan.
See this image and copyright information in PMC

References

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