Building H.O.U.S.E (Healthy Outcomes Using a Supportive Environment): Exploring the Role of Affordable and Inclusive Housing for LGBTQIA+ Older Adults

Healthcare needs and assets of gender diverse older adults: A systematic integrative review

INTRODUCTION

Gender diverse older adults often endure health disparities, encounter discrimination in healthcare settings, and experience lack of access to healthcare. However, members of this population also have assets that help to mitigate these healthcare challenges. A systematic integrative review was performed to synthesize recent studies of the healthcare needs and assets of gender diverse older adults living in the United States.

METHODS

A search of PubMed, CINAHL, Web of Science, PsycINFO, and Google Scholar was conducted. Findings from selected studies were organized by theme and subtheme.

RESULTS

Thirty-five articles met inclusion criteria. Seven themes were identified: (1) Inclusivity and acceptance, (2) Antidiscrimination protections, (3) Community, (4) Care of mind, body, and spirit, (5) End of life preparations, (6) Financial security, and (7) Intersectionality. These themes were further divided into 20 healthcare needs and 9 healthcare assets.

CONCLUSION

The findings call for increased training for healthcare providers to provide safe, gender-inclusive care environments; policy to combat discrimination across all healthcare settings; supportive community resources and healthcare advocacy; empowerment of gender diverse older adults through acknowledgment of their healthcare assets; and more research to discern the role of intersectionality in the applicability of the identified themes to gender diverse older adults of various sociodemographic backgrounds.

CLINICAL RELEVANCE

This review benefits clinicians by suggesting practice changes to address healthcare needs of gender diverse older adults while describing healthcare assets of this population for integration into health promotion initiatives.

Subsidized Senior Housing in the US: A Scoping Review

Subsidized senior housing (SSH) is important to support healthy aging among vulnerable subgroups of older adults, yet progress in developing and expanding SSH has been limited. This scoping review had two research questions: (1) What are the trends in SSH empirical studies? (2) What are the main topics in the existing literature on SSH in the US? We reviewed a total of 61 articles and found several notable trends, including a focus on racial and ethnic minorities, cognitive impairment among SSH residents, and collaborative partnerships between housing operators and healthcare providers. More than half of the studies were quantitative, while the rest were qualitative or mixed-methods. The lack of longitudinal or causal design research reflects the limited empirical knowledge of SSH. Four themes emerged: health and well-being, healthcare use and health behaviors, social relations, and housing relocation. We discussed implications for future research and program development efforts in SSH.

Aging in the Right Place for Older Adults Experiencing Housing Insecurity: An Environmental Assessment of Temporary Housing Program

Research on programs offering senior-specific housing supports and enabling "aging in the right place" (AIRP) for "older persons with experiences of homelessness" (OPEH) is limited. This paper presents an environmental assessment of a "transitional housing program" (THP) in Metro Vancouver, Canada, for OPEH to AIRP. Data were collected using Aging in the Right Place Environmental (AIRP-ENV) and Secondary Observation (AIRP-ENV-SO) audit tools designed to evaluate multi-unit housing for OPEH. The 241-item AIRP-ENV tool was used to assess the built environmental features of four multi-unit buildings of the THP. The AIRP-ENV-SO tool was used to collect contextual data on the function, safety, and land use of the surrounding neighborhood. Findings identified built environment and urban design features that support THP residents' safety, security, accessibility, functionality, social activity, autonomy, and identity. The THP buildings were rated 'Good' for accessibility, functionality, autonomy and identity, while 'Satisfactory' or 'Poor' for safety, security, and social activity. Findings point to the built environmental features (e.g., size and layout of spaces) required in the THP to create opportunities for increased social engagement among residents and enhanced safety and security. The AIRP-ENV and AIRP-ENV-SO audit tools can help inform programs across the housing continuum to develop supportive built environments that promote AIRP for OPEH.