Clouse Kate, Kimpel Christine, Chávez Lorely, Terrell Terry, Donato Julia Landivar, Hasbrooke Natalie, Frenia Makenna, Elrod Brent, Ketel Christian
Vanderbilt University School of Nursing, Nashville, TN.
Urban Housing Solutions, Nashville, TN.
medRxiv. 2025 Aug 26:2025.08.23.25334285. doi: 10.1101/2025.08.23.25334285.
Permanent supportive housing, which combines stable housing with tailored wraparound services, has emerged as a critical intervention to combat chronic homelessness and promote health equity. This study focuses on Nashville, Tennessee, an area marked by rapid growth, poverty, and housing instability, to better understand the characteristics and service needs of residents in subsidized housing.
A cross-sectional study (2023-2025) recruited 140 residents from four subsidized housing facilities using randomized selection. We administered semi-structured questionnaires assessing demographics, past experiences with homelessness and incarceration, and preferences for health and social services.
Most residents were Black/African American (63.6%) and older adults, with 80% earning under $20,000 annually. Significant experiences with both homelessness (70%) and incarceration (53.6%) were noted. Residents expressed strong interest in on-site services, particularly dental and vision care (over 90%) and adult primary care accepting TennCare/Medicaid (91.4%).
Our findings depict a population facing multiple vulnerabilities, including economic instability and social isolation, highlights the importance of combining housing with comprehensive health and social services in addressing inequities. Prioritizing resident feedback in service design can enhance the effectiveness of housing interventions. Effective interventions must be trauma-informed and community-centered, ensuring that housing serves as a foundation for health and well-being. Housing providers and policymakers should foster collaboration across sectors to facilitate sustainable, equitable health outcomes in subsidized housing settings.
永久性支持性住房将稳定住房与量身定制的全方位服务相结合，已成为应对长期无家可归问题和促进健康公平的关键干预措施。本研究聚焦于田纳西州的纳什维尔，该地区以快速发展、贫困和住房不稳定为特征，旨在更好地了解补贴住房居民的特征和服务需求。
一项横断面研究（2023 - 2025年）通过随机选择从四个补贴住房设施中招募了140名居民。我们发放了半结构化问卷，评估人口统计学特征、过去的无家可归和监禁经历以及对健康和社会服务的偏好。
大多数居民是黑人/非裔美国人（63.6%）且为老年人，80%的人年收入低于2万美元。无家可归（70%）和监禁（53.6%）的经历都很显著。居民对现场服务表现出浓厚兴趣，尤其是牙科和视力保健（超过90%）以及接受田纳西医疗保健/医疗补助的成人初级保健（91.4%）。
我们的数据描绘了一个面临多种脆弱性的群体，包括经济不稳定和社会孤立，凸显了将住房与全面的健康和社会服务相结合以解决不平等问题的重要性。在服务设计中优先考虑居民反馈可以提高住房干预措施的有效性。有效的干预措施必须考虑到创伤因素并以社区为中心，并确保住房成为健康和福祉的基础。住房提供者和政策制定者应促进跨部门合作，以便在补贴住房环境中实现可持续、公平的健康成果。
