by Megan Deyman
Life is often said to be defined by a series of choices. Day after day, month after month, year after year, we make choices about every detail of our lives. We make choices about what to eat, what to wear, what to say and how to say it, how to react, who to support, who to love, how to treat people, what to think… and the list goes on and on. Some choices are small, while others carry more considerable weight. Having the ability to make choices doesn’t mean that everything goes our way, but we are often left feeling empowered and feeling a little more secure. However, when it comes to housing, and choosing where we want to live and how to live comfortably, what if we don’t have as many choices as we would like?
Using data from PAN’s community-based research study, Positive Living, Positive Homes (PLPH), I did a participatory analysis to better understand what the meaningful dimensions of housing were for people living with HIV/AIDS in Greater Vancouver. Through this analysis I found choice (or lack thereof) to be a common thread running through many participants’ narratives. Whether people defined their home as a Single Room Occupancy (SRO) hotel, a bed in a women’s shelter, or a one-bedroom apartment in West End, choice (and the ability to choose) was one of the most fundamental elements in the construction of “home.”
Positive Living, Positive Homes study participants named a handful of ways that enabled them to exercise a greater degree of choice with regard to their housing.
In the PLPH study, participants named a handful of ways that enabled them to exercise a greater degree of choice with regard to their housing. Some participants described the benefit of portable housing subsidies that helped them afford market rental housing in locations of their own choosing. Other participants explained how access to their own kitchen space empowered them to not only take control over their food choices, but also their health. And many participants discussed the importance of being able to control the entry of visitors, as well as having the freedom to choose how they arranged and designed their interior space – all of these elements having a positive impact on how they lived at home.
Independent living environments gave people more choice and control over many aspects of their day-to-day life. However, there were many factors that influenced people’s ability to access independent living situations. For instance, the financial constraint of living with a chronic illness in a city with high housing costs often reduced people’s options for appropriate and meaningful housing.
Other factors that impacted people’s housing choices and their sense of home become evident when participants explained where they live and their particular reasons for choosing their current living accommodation. Such factors include:
- the location of HIV and housing services
- access to and availability of public amenities (i.e. washrooms and public kitchens)
- access to transportation
- the cost of housing and income (as many participants were on a fixed income)
- health and medical needs (needing to reside close to clinics)
- prior experiences in other housing situations
- personal preferences (i.e., living in a substance use-free building)
Decisions about where to live are complex and situational. People need to be fully aware of their options for housing, as well as their limitations, to allow them the capacity to make more informed decisions.
While responding to the social and economic factors that shape people’s health may seem like a big challenge, findings from PLPH suggest a number of ways to help in this process. Living with an illness can be perceived as uncontrollable to a person, but having access to safe and appropriate housing can provide the opportunity to regain a sense of control and independence (Dupuis & Thorns, 1998). It is also important to consider the prior experiences that people have had and their stage of life in order to best meet their housing needs and help them attain independence. Housing needs should be assessed on an ongoing basis and different levels of support should be offered when looking at residential accommodations. Services and policies must consider an empowerment approach to increase the abilities of people living with HIV/AIDS to make decisions for themselves about their housing. It is clear that what makes a house a home for many people is related to choice and whether a person was empowered to make their choice a reality.
For more information on these research findings, please email [email protected]
Dupuis, A., & Thorns, D. C. (1998). Home, home ownership and the search for ontological security. The Sociological Review, 46(1), 24-47. doi:10.1111/1467-954X.00088
Dover, R. V. H., & Lambert, E. V. (2016). “Choice set” for health behavior in choice-constrained settings to frame research and inform policy: Examples of food consumption, obesity and food security. International Journal for Equity in Health, 15, 48. doi:10.1186/s12939-016-0336-6