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. 2025 Mar 25;65(4):gnaf021.
doi: 10.1093/geront/gnaf021.

An Intersectional Perspective on Digital Health: Longitudinal Narratives and Observations With Older and Middle-Aged Women Experiencing Homelessness

Sophie Nadia Gaber  1   2 , Elisabet Mattsson  1   3 , Anna Klarare  1   3 , Joanna Dawes  4 , Penny Rapaport  2 ; Women’s Advisory Board for Inclusion Health
Affiliations

An Intersectional Perspective on Digital Health: Longitudinal Narratives and Observations With Older and Middle-Aged Women Experiencing Homelessness

Sophie Nadia Gaber et al. Gerontologist. .

Abstract

Background and objectives: People experiencing homelessness and older people encounter barriers as health and social care services are increasingly delivered online, however, there is limited knowledge about how this relates to older and middle-aged women experiencing homelessness, especially those from minoritized and/or migrant communities. We aimed to explore how technology, including digital health, can help or hinder older and middle-aged women to navigate paths through and out of homelessness.

Research design and methods: This 16-month qualitative longitudinal study utilized narrative interviews and participant observations with seven older and two middle-aged women experiencing homelessness, in London, England. Additionally, we observed interactions between the women experiencing homelessness and 2 information and communications technology class facilitators. We collected and analyzed data using a narrative, interpretative approach. An advisory board of women with lived experiences of homelessness supported the interpretation of findings and development of practice and policy recommendations.

Results: We present our findings as 3 composite narrative vignettes co-constructed with the participants: (1) "No, I'm not taking this telephone appointment"; (2) "Technology doesn't judge you"; and (3) "You have to be a digital person now." The findings illuminate determinants of digital health equity related to aging, gender, and migration status among older and middle-aged women experiencing homelessness.

Discussion and implications: Using an intersectional lens, we provide recommendations about how to better align digital health to the needs of older and middle-aged women experiencing homelessness. The findings will inform intervention development.

Keywords: Women’s health; digital divide; eHealth; homeless; qualitative research.

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Conflict of interest statement

None.

Figures

Figure 1.
Figure 1.
Overview of the study timeline and participants at each data collection. ICT = Information and communications technology.
Figure 2.
Figure 2.
Digital health recommendations to better support women experiencing homelessness, co-constructed with women with lived experiences of homelessness.
See this image and copyright information in PMC

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