Pathways and Trajectories Linking Housing Instability and Poor Health among Low-Income Women Experiencing Intimate Partner Violence (IPV): Towards a Conceptual Framework

We used grounded theory to understand pathways and trajectories to housing instability (HI) and poor health among low-income women with experiences of intimate partner violence (IPV). We conducted in-depth interviews during 2010-11 with 41 women (ages 18-45 years) living in Ontario, Canada. 

All women reported depressive symptoms in combination with other health problems. In addition to the direct pathway of IPV to poor health, thematic analysis revealed an indirect multi-tiered pathway with complex trajectories among IPV, HI and poor health. These trajectories included material HI (homelessness, high mobility, evictions, problems paying rent, hiding and landlord discrimination), psychological HI (feeling unsafe, low self-esteem, and poor control) and social trajectories (financial problems, loss of employment, income or social networks and leaving school). 

These trajectories elevated stress and decreased self-care (unhealthy behaviors, substance abuse, and reduced medical compliance) and exacerbated poor health already compromised by IPV. Depending on her specific context, each woman experienced these pathways and trajectories differently. Moreover, the women's experiences differed across three time periods: before, immediately after, and long after leaving an abusive relationship. Finally, we found that for these women, achieving stable housing was crucial for stabilizing their health.

Via: http://ht.ly/SaGQS 

By: Daoud N1,2, Matheson FI1,3,4, Pedersen C1, Hamilton-Wright S1, Minh A1, Zhang J1, O'Campo P1,4.

• 1a Centre for Research on Inner City Health , The Keenan Research Centre in the Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto , Ontario , Canada.
• 2b Department of Public Health, Faculty of Health Sciences , Ben-Gurion University , Beer Sheva , Israel.
• 3c Institute for Clinical Evaluative Sciences.
• 4d Dalla Lana School of Public Health , University of Toronto , Toronto , Ontario , Canada.