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Despite a significant evidence base illustrating the issue of housing insecurity and homelessness experienced by women over the age of 55 in Australia [Pawson et al., 2018; Australian Institute of Health and Welfare (AIHW), 2021b; Mission Australia 2022; Per Capita 2022], there continues to be a knowledge gap in the representation of older women in current Federal and New South Wales (NSW) State Government housing and homelessness policies and initiatives. This paper aims to identify the extent and ways in which older women were represented (or not represented) in the Federal and NSW State housing and homelessness policies in 2022.

Of the total primary and supplementary Federal and NSW State policy and strategy documents, 16 were collected through a systematic review and then analysed using a Critical Discourse Analysis (CDA) framework and feminist lens to explore quotes, phrases, keywords and language choices which suggested prevalent themes, rhetorical devices and dominant discourses.

Three significant themes were identified by the analysis (1) “relinquished responsibility”, (2) “inconsistent rhetoric” and (3) “homogenising and ideological cherry picking”. These themes presented the authors with three main discussion points to inform policy reform which we have addressed in relation to policy implications, evidence-based policy decision-making and impacts on older women.

The combination of a systematic review with CDA provides a unique approach to exploring homelessness policy for older women.

The purpose of this paper is to provide rationale, methodological guidance and clarity in the use of case study designs and theory driven approaches to evaluation of interventions to end homelessness.

Using an evaluation of a transitional shelter program aiming to support permanent exits from homelessness as an example, the authors show how case study designs and theory driven evaluation is well suited to the study of the effectiveness of homelessness interventions within the broader socio-political and economic context in which they are being implemented.

Taking account of the context as part of program evaluation and research on homelessness interventions moves away from blaming programs and individuals for systemic failures to better understanding of how the context influences successes and failures. Case study designs are particularly useful for studying implementation and the context which influences program outcomes. Theory driven evaluations and the use of realist evaluation as an approach can provide a broader understanding of how homelessness interventions work particularly for whom and under what conditions. These methodological and theoretical approaches provide a consistent strategy for evaluating programs aimed at ending homelessness.

There is a need for greater capacity in the homelessness sector to apply approaches to evaluation that take into account the broader socio-political and economic context in which programs are being implemented. Through the use of a case example, the authors provide guidance for application of case study design and theory driven approaches as a strategy for approaches programs aimed at ending homelessness.

The purpose of this paper is to compare homelessness policies in Portugal and Greece.

After a brief overview of the relationship between welfare regimes and homelessness, the characteristics of homelessness policies within the South-European regime are studied. Subsequently, by employing empirical data, a comparison between the homelessness policies of these two countries is attempted through three axes of analysis: the historical emergence of homelessness policies; the impact of the memoranda, as a series of fiscal measures associated with welfare retrenchment, on the deterioration of homelessness; and the characteristics of the social policies being developed.

It is noted that the two countries consolidate a residual social intervention model that fails to address homelessness adequately.

This is the first attempt to compare homelessness policies between Portugal and Greece.

Homelessness has many causes and also is stigmatized in the United States, leading to much misunderstanding of its causes and what policy solutions may ameliorate the problem. The problem is of course getting worse and impacting many communities far removed from the West Coast cities the authors examine in this study. This analysis examines the socioeconomic variables influencing homelessness on the West Coast in recent years. The authors utilize a panel fixed effects model that explicitly includes measures of healthcare access and availability to account for the additional health risks faced by individuals who lack shelter. The authors estimate a spatial error model (SEM) in order to better understand the impacts that systemic shocks, such as the COVID-19 pandemic, have on a variety of factors that directly influence productivity and other measures of welfare such as income inequality, housing supply, healthcare investment, and homelessness.

Homelessness is a colossal issue, precipitated by a wide array of social determinants, and mirrored in substantial health disparities and a revolving hospital door. Connecting people to safe and secure housing needs to be part of the health system response. The paper aims to discuss these issues.

This mixed-methods paper presents emerging findings from the collaboration between an inner city hospital, a specialist homeless medicine GP service and Western Australia’s inaugural Housing First collective impact project (50 Lives 50 Homes) in Perth. This paper draws on data from hospitals, homelessness community services and general practice.

This collaboration has facilitated hospital identification and referral of vulnerable rough sleepers to the Housing First project, and connected those housed to a GP and after hours nursing support. For a cohort (n=44) housed now for at least 12 months, significant reductions in hospital use and associated costs were observed.

While the observed reductions in hospital use in the year following housing are based on a small cohort, this data and the case studies presented demonstrate the power of care coordinated across hospital and community in this complex cohort.

This model of collaboration between a hospital and a Housing First project can not only improve discharge outcomes and re-admission in the shorter term, but can also contribute to ending homelessness which is itself, a social determinant of poor health.

Coordinated care between hospitals and programmes to house people who are homeless can significantly reduce hospital use and healthcare costs, and provides hospitals with the opportunity to contribute to more systemic solutions to ending homelessness.

This paper presents an analysis of how health intersects with the experience of housing insecurity and homelessness, specifically for migrant women. The authors argue that it is important to understand the specificities of the interplay of these different factors to continue the advancement of our understanding and practice as advocates for health and housing security.

An exploratory, qualitative, methodological approach was adopted, using a broad definition of housing insecurity: from absolute homelessness (e.g. residing rough) to invisible homelessness (e.g. couch surfing) to those at risk of homelessness. In total, 26 newcomer (foreign-born women who came to live in Canada during the previous ten years, regardless of their immigration status) women were recruited in Montreal, Canada. Participants were recruited directly through advertisements in public places and in collaboration with community organizations (women’s centers, homeless shelters, crisis centers, domestic violence shelters, immigrant settlement agencies and ethnic associations) and they self-identified as having experienced housing insecurity. Efforts were made to include a diversity of immigrant statuses as well as diversity in ethnicity, race, country of origin, family composition, sexual orientation, age and range of physical and mental ability. Women were engaged in semi-structured, open-ended interviews lasting approximately 1 h. Interviews were conducted in English or French in a location and time of participants’ choosing.

The findings are presented around three themes: how health problems instigate and maintain migrant women’s housing insecurity and homelessness; ways in which women’s immigration trajectories and legal status may influence their health experiences; and particular coping strategies that migrant women employ in efforts to maintain or manage their health. The authors conclude with implications of these findings for both policy and practice in relation to migrant women who experience or are at risk of housing insecurity and homelessness.

Intersections of women experiencing migration and housing insecurity in Canadian contexts have rarely been examined. This paper addresses a gap in the literature in terms of topic and context, but also in terms of sharing the voices of migrant women with direct experience with housing insecurity.

The purpose of this paper is to explore the lived experiences of women without children experiencing housing instability and homelessness in Calgary, Canada; and narratives of what triggered their journeys were constructed according to the tenets of hermeneutic phenomenology, and suggest a framework for assisting these women.

The design for this study is qualitative, approached through hermeneutic phenomenology rooted in Gadamerian philosophical hermeneutics (Gadamer, 2004). Hermeneutic phenomenology, as a research method has provided insight into understanding phenomena and human experiences that are important to human science professionals.

The experience of homelessness for women without children started while they still lived at home, but after they lost all sense of “being at home” as a consequence of identifiable negative home experiences, such as abuse. The effects or impacts of stable childhood or adult home experiences and the implications of such in contributing to the feelings of homelessness were pervasive in the stories told by these women.

Access to housing does not mean getting out of the feeling of homelessness, because the trauma that triggers the experience for the clients often last for a life time. Long-term engagement with the client will be synonymous to increasing the possibility that they can be stabilized permanently. Resources dedicated to these clients must be tailored to each client’s needs, with strong agency collaboration with the mainstream systems.

Community health nurses and other support workers for individuals experiencing homelessness need to build bridges with inter-professional groups to close the gap created by societal attitudes toward women and domestic abuse survivors through advocacy and education, especially in countries where women are still treated as second class citizens.

Although there has been a considerable amount of research conducted on the determinants of homelessness and housing instabilities in women or their pathways into homelessness, the plight of women without children and their experiences while homeless have received little attention in literature. This study explored the lived experiences of women without children experiencing homelessness and narratives of what triggered their journeys were constructed according to the tenets of hermeneutic phenomenology, and suggest a framework for assisting these women.

People experiencing homelessness are high-users of hospital care in Canada. To better understand the scope of the issue, and how these patients are discharged from hospital, a national survey of key stakeholders was conducted in 2017. The paper aims to discuss this issue.

The Canadian Observatory on Homelessness distributed an online survey to their network of members through e-mail and social media. A sample of 660 stakeholders completed the mixed-methods survey, including those in health care, non-profit, government, law enforcement and academia.

Results indicate that hospitals and homelessness sector agencies often struggle to coordinate care. The result is that these patients are usually discharged to the streets or shelters and not into housing or housing with supports. The health care and homelessness sectors in Canada are currently structured in a way that hinders collaborative transfers of patient care. The three primary and inter-related gaps raised by survey participants were: communication, privacy and systems pressures.

The findings are limited to those who voluntarily completed the survey and may indicate self-selection bias. Results are limited to professional stakeholders and do not reflect patient views.

Identifying systems gaps from the perspective of those who work within health care and homelessness sectors is important for supporting system reforms.

This survey was the first to collect nationwide stakeholder data on homelessness and hospital discharge in Canada. The findings help inform policy recommendations for more effective systems alignment within Canada and internationally.

The purpose of this paper is to describe the development, by incarcerated women who were members of a prison participatory health research team, of a survey tool regarding homelessness and housing, the survey findings and recommendations for policy.

A survey was developed by incarcerated women in a minimum/medium security women's prison in Canada. Associations were examined between socio‐demographic factors and reports of difficulty finding housing upon release, homelessness contributing to a return to crime, and a desire for relocation to another city upon release. Open‐ended questions were examined to look for recurrent themes and to illuminate the survey findings.

In total, 83 women completed the survey, a 72 per cent response rate. Of the 71 who were previously incarcerated, 56 per cent stated that homelessness contributed to their return to crime. Finding housing upon release was a problem for 63 per cent and 34 per cent desired relocation to another city upon release. Women indicated that a successful housing plan should incorporate flexible progressive staged housing.

The present study focuses only on incarcerated women but could be expanded in future to include men.

Incarcerated women used the findings to create a housing proposal for prison leavers and created a resource database of the limited housing resources for women prison leavers.

Lack of suitable housing is a major factor leading to recidivism. This study highlights the reality of the cycle of homelessness, poverty, crime for survival, street‐life leading to drug use and barriers to health, education and employment that incarcerated women face.

Housing is a recognized basic determinant of health. No previous studies have used participatory research to address homelessness in a prison population.

Recently, Managed Alcohol Programs (MAPs have emerged as an alcohol harm reduction model for those living with severe alcohol use disorder (AUD) and experiencing homelessness. There is still a lack of clarity about the role of these programs in relation to Housing First (HF) discourse. The authors examine the role of MAPs within a policy environment that has become dominated by a focus on HF approaches to addressing homelessness. This examination includes a focus on Canadian policy contexts where MAPs originated and are still predominately located. The purpose of this paper is to trace the development of MAPs as a novel response to homelessness among people experiencing severe AUD and to describe the place of MAPs within a HF context.

This conceptual paper outlines the development of discourses related to persons experiencing severe AUD and homelessness, with a focus on HF and MAPs as responses to these challenges. The authors compare the key characteristics of MAPs with “core principles” and values as outlined in various definitions of HF.

MAPs incorporate many of the core values or principles of HF as outlined in some definitions, although not all. MAPs (and other housing/treatment models) provide critical housing and support services for populations who might not fit well with or who might not prefer HF models.

The “silver bullet” discourse surrounding HF (and harm reduction) can obscure the importance of programs (such as MAPs) that do not fully align with all HF principles and program models. This is despite the fact that MAPs (and other models) provide critical housing and support services for populations who might fall between the cracks of HF models. There is the potential for MAPs to help fill a gap in the application of harm reduction in HF programs. The authors also suggest a need to move beyond HF discourse, to embrace complexity and move toward examining what mixture of different housing and harm reduction supports are needed to provide a complete or comprehensive array of services and supports for people who use substances and are experiencing homelessness.