Housing and Food: two sides of the health coin for people living with HIV

house-and-food

In 2013, a diverse team of community-based researchers completed the Food Security Study, which explored the relationship between food, nutrition, and health for people living with HIV in Ontario, Quebec, and British Columbia. Recently they published postcards and fact sheets with their study findings. They also shared some of their housing-related data from BC with our team at Positive Living, Positive Homes.

Regions and Demographics

The BC arm of the Food Security Study talked to 329 HIV+ people in four regions of the province (recruited primarily from ASOs), which overlap nicely with PLPH’s case study communities. Here is the breakdown of participant numbers in the four regions:

  • Region A: Vancouver/Richmond (n = 154)
  • Region B: Burnaby/Coquitlam/Surrey/New Westminster (n = 63)
  • Region C: Prince George (n = 25)
  • Region D: Kamloops/Merritt/Louis Creek (n = 23)

The remainder of participants were scattered across other regions of the province. In terms of ethnic/cultural background, the two most common participant groups were Caucasian and Aboriginal. In Prince George, 92% of participants identified as Aboriginal. In the Kamloops area, 57% of participants identified as Aboriginal. Only Regions A and B had participants who identified as African/Caribbean/Black and Latin American/Asian (1% and 4% respectively in Vancouver/Richmond, and 8% and 8% respectively in Burnaby/Coquitlam/New West/Surrey). All participants were people living with HIV who accessed the services of community-based organizations, so it’s important to recognize that their experiences are not necessarily reflective of all people living with HIV in BC.

What we can learn about housing from the Food Security Study

Data from the four regions tells us that people are living in a range of different housing types, from high-rise apartments, to single-room occupancy buildings, to detached homes. Findings reflect the high cost of housing in larger centres:

  • Vancouver/Richmond saw 86% of participants clustered in three main types of housing:
    • high-rise apartments (44%)
    • low-rise apartments (20%)
    • room in a self-contained hotel, motel, or boarding house (22%)
  • Prince George, with the lowest housing costs, saw the widest diversity of housing type.

Some of the findings indicate a relationship between food security and housing. Participants were:

  • 3 times as likely to be food insecure if they had moved at least once in the last year
  • 6 times as likely to be food insecure if they also had difficulty meeting their housing costs

Higher levels of food insecurity were also associated with:

  • Unemployment in the 30 days prior to being interviewed
  • Having an annual income of under $20,000

Housing and food as important determinants of health

These findings point to the fact that food and housing are expensive necessities, and that many HIV-positive people have trouble affording them. Our preliminary analysis of PLPH data is also showing that food is a priority for participants, but that many struggle with food costs and often have to choose between paying rent or buying enough food.

The cost of food seems to take a higher toll in certain regions. Prince George, for example, had the highest rate of food insecurity, even though its participants had the lowest housing costs, which reflects how food is more expensive the farther north one goes.

Although its participants were less worried about paying housing expenses, Prince George had the highest rate of participants who worried about having to move (36%) and who felt a lack of control over their housing situation. These numbers suggest that affordable housing is not always long-term, nor is it necessarily adequate or appropriate for everyone.

Conversely, in the Kamloops region, participants had the highest rate of difficulty in meeting housing-related expenses (tied with Burnaby/New Westminster etc. at 59%). However, it also had the highest rate of feeling a sense of belonging in one’s neighbourhood (89%), as well as higher numbers of participants who felt that their housing was suitable for them and who felt a sense of control over their living situation (78% for both).

Conclusions

What’s clear from these findings is that how people living with HIV across BC experience food, housing, and other health and social issues varies from region to region.

Analysis of our initial interviews for PLPH similarly show this diversity of experience: participants may have HIV in common, but they are individuals with varying needs and desires, and trying to create “one-size-fits-all” programs and services are usually not appropriate or sustainable long-term solutions.  One thing to agree on is that too many people living with HIV are struggling to have their basic needs met, and that policies and programs must start from the ground up – ensuring access to adequate, appropriate housing and access to nutritious food so that better health can be achieved and sustained.

My photoQuestions? Feedback? Get in touch!

Heather Picotte, PLPH Research Manager

plph@pacificaidsnetwork.org