Housing and Homelessness: Two Models of the Relationship Between Quality of Life, Physical Health, and Mental Health

Abstract

With the increase in quality of life (QoL) research in recent years and its relationship to physical and mental health, building a model of these relationships is an important pursuit for researchers with the aim of creating targeted social policy and programs. Two studies were designed to test a model of the relationship between quality of life, physical health, and mental health on two different groups in the National-Capital region: a housed sample and a homeless and vulnerably housed sample. Study 1 consisted of 1,339 adults who took part in the 2007-2008 Canadian Community Health Survey and were stably housed in either a rented or owned residence. Study 2 consisted of 395 single adults who participated in the City of Ottawa baseline measure of the Health and Housing in Transition (HHiT) study (Hwang, Aubry, et al., 2011) and were homeless or vulnerably housed. Subjective levels of various physical and mental health indicators were measured for each of the samples, along with subjective quality of life indicators. Of interest in each of the studies was: 1) The effect that physical and mental health factors have on quality of life in each of the samples, and 2) determining if mental health or physical health is a better predictor of quality of life. Structural analysis of the housed sample model resulted in both physical and mental health having a significant positive effect on QoL, although neither physical nor mental health was a better predictor of quality of life. For the homeless and vulnerably housed model, structural analysis determined mental health to have a significant direct positive effect on QoL, while physical health showed a non-significant negative effect. Mental health was determined to be a significantly better predictor of QoL in the homeless and vulnerably housed model, accounting for 30.47 percent of the variance in quality of life. Implications of this research are discussed. HOUSING STATUS, QOL, AND HEALTH iii Statement of the Contributions of Collaborators The two manuscripts included in this dissertation were prepared in collaboration with my primary dissertation supervisor, Dr. Susan Farrell. The second manuscript also involved the contributions of Drs. Stephen Hwang, Tim Aubry, Anita Palepu, and Anita Hubley, as portions of their original participants were recruited in the study. As the primary author on all manuscripts, I was responsible for the conceptualization of research questions and methods, planning and executing of statistical analyses, and preparation of the manuscripts. Dr. Farrell provided guidance and assistance in all aspects of the project. HOUSING STATUS, QOL, AND HEALTH iv Acknowledgements First, I am forever indebted to my thesis supervisor, Dr. Susan Farrell. Thank you for fostering a supportive and safe learning environment that allowed me to grow at my own pace. I am especially grateful for your patience, encouragement, and your ability to see the finish line and remind me that it was always there. Second, I would like to thank my thesis committee members, Drs. Tim Aubry, John Sylvestre and Fran Klodawsky, for their invaluable input and suggestions in shaping this dissertation. Third, I would like to thank Dwayne Schindler for providing multiple statistical consultations. In pursuing this degree, I have had the privilege to befriend a number of wonderful and brilliant people. I am particularly grateful to members of the iBEAM team: Irene Vitoroulis, Brahm Solomon, Emily Lecompte, and Michele Mantha for sharing in our experiences throughout this journey and keeping it all in perspective. I thank my long-time girlfriends, Kristina Lalonde, Susie Presutti, and Tara Kelly-Hass for their steadfast friendship and support in my endeavours. This journey would not have been as rewarding without the unwavering love and patience of my partner in crime, and in life, Stephen Rimac, whose patience and encouragement helped me see just how far I could go. Finally, I thank my family for instilling in me the belief that anything is possible. To my parents, who came to this country in search of a better life, this is for you. HOUSING STATUS, QOL, AND HEALTH v