Alaazi Dominic A, Masuda Jeffrey R, Evans Joshua, Distasio Jino
Department of Public Health Sciences, School of Public Health, University of Alberta, Canada.
Department of Geography and School of Kinesiology and Health Studies, Queen's University, Canada; Centre for Environmental Health Equity, Canada.
Soc Sci Med. 2015 Dec;147:30-7. doi: 10.1016/j.socscimed.2015.10.057. Epub 2015 Oct 26.
In this paper, we explore Indigenous perspectives of culture, place, and health among participants in a landmark Canadian Housing First initiative: At Home/Chez Soi (AHCS) project. Implemented from 2009 to 2013 in Winnipeg and four other Canadian cities, AHCS was a multi-city randomized control trial that sought to test the effectiveness of Housing First as a model for addressing chronic homelessness among people living with mental illnesses. As Winnipeg's homeless population is over 70% Indigenous, significant efforts were made to accommodate the culturally specific health, spiritual, and lifestyle preferences of the project's Indigenous participants. While a daunting challenge from an intervention perspective, Winnipeg's experience also provides a unique opportunity to examine how Indigenous participants' experiences can inform improved housing and mental health policy in Canada. In our study, conducted independently from, but with endorsement of the AHCS project, we utilized a case study approach to explore the experiences of the project's Indigenous participants. Data were collected by means of in-depth qualitative interviews with Indigenous participants (N = 14) and key informant project staff and investigators (N = 6). Our exploratory work demonstrates that despite relative satisfaction with the AHCS intervention, Indigenous peoples' sense of place in the city remains largely disconnected from their housing experiences. We found that structural factors, particularly the shortage of affordable housing and systemic erasure of Indigeneity from the urban sociocultural and political landscape, have adversely impacted Indigenous peoples' sense of place and home.
在本文中，我们探讨了加拿大一项具有里程碑意义的“住房第一”倡议项目“在家/ chez Soi（AHCS）”的参与者对文化、地点和健康的原住民观点。AHCS于2009年至2013年在温尼伯和加拿大其他四个城市实施，是一项多城市随机对照试验，旨在测试“住房第一”模式作为解决患有精神疾病的人长期无家可归问题的有效性。由于温尼伯的无家可归人口中超过70%是原住民，因此做出了重大努力来适应该项目原住民参与者在文化上特定的健康、精神和生活方式偏好。虽然从干预角度来看这是一项艰巨的挑战，但温尼伯的经验也提供了一个独特的机会，来审视原住民参与者的经历如何为加拿大改善住房和心理健康政策提供信息。在我们独立于AHCS项目但得到其认可的研究中，我们采用了案例研究方法来探索该项目原住民参与者的经历。数据是通过对原住民参与者（N = 14）以及关键信息提供者项目工作人员和调查人员（N = 6）进行深入定性访谈收集的。我们的探索性工作表明，尽管对AHCS干预相对满意，但原住民在城市中的归属感在很大程度上仍与他们的住房经历脱节。我们发现，结构性因素，特别是经济适用房短缺以及城市社会文化和政治格局中对原住民身份的系统性抹杀，对原住民的归属感和家的感觉产生了不利影响。
