Single Room Occupancy Research Articles

Beyond individual factors: a critical ethnographic account of urban residential fire risks, experiences, and responses in single-room occupancy (SRO) housing

BackgroundBurn injuries are a significant public health concern, closely linked to housing conditions and socioeconomic status. Residents in socioeconomically deprived neighbourhoods are at increased risk of exposure to hazards due to older and poorer housing conditions and limited access to fire protection measures. Individual behaviours such as substance use, smoking, and hoarding are often highlighted as primary causes of residential fires, overshadowing the broader socioeconomic and structural factors that also play a significant role in housing safety. This paper explores the correlation between inadequate housing conditions and heightened fire risks leading to burn injuries, focusing on the contextual factors shaping everyday urban fire risks, experiences, and responses of residents living in Single-Room Occupancy (SRO) housing in Vancouver’s Downtown East Side (DTES) and staff working in the fire, health, housing (social and private), and non-profit sectors.MethodsAs part of an ongoing ethnographic study, we partnered with the Vancouver Fire Rescue Services (VFRS) to conduct participant observations in private, non-profit, and government-owned SROs, modular homes, and a temporary shelter. This paper synthesizes insights from participant observations from the first author’s self-reflexive journals, including informal conversations with approximately fifty-nine individuals such as SRO tenants, SRO managers/caretakers, health workers, burn survivors, municipal staff, not-for-profit staff, and firefighters.ResultsUrgent housing-related issues contributing to inequitable everyday urban fire risks were identified, such as structural deficiencies in SRO buildings and systems, inadequate waste management and storage, and inequitable approaches to addressing hoarding. Additionally, disparities in access to information and the interaction between interpersonal and structural stigmas were significant factors, underscoring the pressing need for intervention.ConclusionCommunities like DTES, facing precarious housing conditions, disadvantaged neighbourhoods, and complex health and social challenges, necessitate a comprehensive and holistic approach to fire prevention and safety. Recognizing the interplay between housing instability, mental and physical health issues, unregulated toxic drug supply, drug criminalization, and structural inequities allows practitioners from various sectors to develop contextually driven fire prevention strategies. This multifaceted approach transcends individual-level behaviour change and is crucial for addressing the complex issues contributing to fire risks in underserved communities.

Secondary attack rate following on-site isolation of patients with suspected COVID-19 in multiple-bed rooms

The implementation of isolation precautions for patients with suspected Coronavirus Disease 2019 (COVID-19) and pending test results is resource intensive. Due to the limited availability of single-bed rooms at our institution, we isolated patients with suspected COVID-19 together with patients without suspected COVID-19 on-site in multiple-bed rooms until SARS-CoV-2-test results were available. We evaluated the likelihood of SARS-CoV-2 transmission to individuals sharing the room with patients isolated on-site. This observational study was performed at the University Hospital Basel, Switzerland, from 03/20 − 11/20. Secondary attack rates were compared between patients hospitalized in multiple-bed rooms and exposed to individuals subjected to on-site isolation precautions (on-site isolation group), and patients exposed to individuals initially not identified as having COVID-19, and not placed under isolation precautions until the diagnosis was suspected (control group). Transmission events were confirmed by whole-genome sequencing. Among 1,218 patients with suspected COVID-19, 67 (5.5%) tested positive for SARS-CoV-2. Of these, 21 were isolated on-site potentially exposing 27 patients sharing the same room. Median contact time was 12 h (interquartile range 7–18 h). SARS-CoV-2 transmission was identified in none of the patients in the on-site isolation group vs. 10/63 (15.9%) in the control group (p = 0.03). Isolation on-site of suspected COVID-19-patients in multiple-bed rooms avoided single-room occupancy and subsequent in-hospital relocation for many patients without confirmed SARS-CoV-2-infection. The absence of secondary transmission among the exposed patients in the on-site isolation group allows for assessment of the risk/benefit ratio of this strategy given the limitation of a small sample size.

Characterising individuals with a substance use disorder accessing hospital-based addiction care: Preliminary description of the outcomes for patients accessing addiction care prospective cohort study.

Individuals with a substance use disorder (SUD) often face barriers to accessing health care, resulting in unmet needs and delayed care. Hospital-based services have the potential to engage individuals with a SUD in ongoing treatment, but there is limited literature characterising this population. The Outcomes for Patients Accessing Addiction Care study was a prospective hospital-based cohort study conducted at St. Paul's Hospital in Vancouver, Canada. Participants were recruited from January 2018 to March 2020. Data were collected through an interviewer-administered questionnaire, including socio-demographic information, substance use history and mental health screening. The cohort included 536 participants, with 31% aged 30-39 years, 63% identifying as White and 74% reporting male sex at birth. Nearly half of the participants were either homeless or living in single room occupancy. Use of substances more than once per week was reported for tobacco/nicotine (86%), marijuana (43%), non-medical use of prescription drugs (29%), illicit stimulants (52%) and illicit opioids (61%). This preliminary report provides a description of a hospital-based cohort of individuals with a SUD accessing addiction care. The findings highlight demographic characteristics, mental health issues, substance use patterns and barriers to accessing services. Understanding these factors can inform the development of patient-centred interventions and improve engagement and retention in addiction care. Further research is needed to explore interventions and program effectiveness in this population.

Using drugs alone in single room occupancy housing: Understanding environmental drivers of overdose risk

BackgroundAcross North America most overdose deaths occur in housing, largely due to individuals using drugs alone. In cities, fatalities are disproportionately concentrated in low-income housing, including single room occupancy (SRO) housing. While research has highlighted how SROs operate as risk environments for various poor outcomes, there has been little attention to specific drug use practices (i.e., using alone) associated with overdose vulnerability in these spaces. This study explores how environmental contexts of SROs shape overdose risks, with specific attention to practices of using drugs alone. MethodsIn-depth semi-structured interviews were conducted with 30 people who use drugs (PWUD) living in Vancouver SROs. Interviews covered topics such as social-structural environments of housing, drug use practices, and housing-based harm reduction. Thematic analysis drew on the intersectional risk environment framework. ResultsNarratives positioned SROs as extensions of public space, with similar expectations of risks and behaviours as in public spaces. For some participants, using alone in their room was characterized as a practice in claiming privacy within the context of a public existence. Participants highlighted how certain features of SRO's social-structural environments were routinely leveraged against them (e.g., security cameras, staff surveillance), suggesting using alone as a tactic to minimize risks of hyper-surveillance and punitive policies. Further, participants discussed using alone as “safer,” describing how this practice mitigated place-based risks of social-structural harms (e.g., violence, criminalization) in ways that eclipsed overdose risk. ConclusionUsing drugs alone may be understood as a spatial negotiation of vulnerability to diverse harms produced by environmental contexts of SROs. Interventions accounting for broader contextual factors (e.g., improvements housing quality/quantity, providing a safer supply of drugs) that render using alone as instrumental to survival, and that reduce the implicit threat of punishment from intensive surveillance and control practices are critical to reduce vulnerability to overdose and other harms.

Exploring COVID-19 vaccine uptake and hesitancy among vulnerable populations in inner city Vancouver, Canada: Insights into characteristics and clinical outcomes

The COVID-19 pandemic is having a profound impact on the health, social and economic well-being of people in Canada and around the world. To address vaccine disparity among vulnerable populations facing social-structural challenges, it is crucial to provide evidence-based information on the importance of completion of the recommended vaccination schedule. In this study, we investigated vaccination rates and variables as facilitators or barriers to COVID-19 vaccination among vulnerable populations living in Vancouver’s inner-city residents. On a weekly basis, a team (including health care providers [HCPs] and support staff) conducts a Community Pop-up Clinic (CPC) event at single room occupancy dwellings in Vancouver’s inner city to provide COVID-19 vaccine and/or related information. Participants also completed a survey about their COVID-19 vaccination status and COVID knowledge, including knowledge about COVID vaccination. We collected data from 892 CPC participants between January 2021–August 2023. The median age at baseline was 45 (IQR 36–55) years, with 317 (35.5 %) female and 285 (31.9 %) self-identified as Indigenous. Within the population, 512 (57.4 %) reported unstable housing and 441 (49.5 %) were active injection drug users. Regarding COVID-19 vaccinations, 235 (26.3 %) were unvaccinated, 119 (13.3 %) had received one dose of the COVID-19 vaccine, 432 (48.4 %) had received 2 doses, and 106 (11.8 %) had received at least 3 doses. Variables such as age (AOR 2.28, 95 % CI 1.37–3.80, p < 0.001) and HCV seropositivity (AOR 1.91, 95 % CI 1.20–3.04, p = 0.005) were significantly associated with higher odds of vaccination uptake. Conversely, unstable housing was significantly associated with a lower odds of vaccination uptake (AOR 0.53, 95 % CI 0.35–0.79, p = 0.002). Results from this study suggest that targeted community focused initiatives are crucial to address vaccine disparity among vulnerable populations living in Vancouver’s inner city facing unstable housing and drug use injection.

Spatial Disparity and Residential Assessment of Housing Cost-Burdened Renters

With the expanding rental sector and rising housing expenses, this research aims to compare the socio-demographic, economic, and housing statuses of renters burdened by housing costs in four regions, and also to explore predictors affecting their residential assessment. Using data from the 2020 Korean Housing Survey, this cross-sectional study identified 245 cost-burdened households whose housing expenses accounted for more than 25% of their total gross income and living expenses. The results revealed that the majority of renters were single-person households residing in single-room occupancy units of multifamily housing, primarily comprising unemployed older adults aged 50 and over. While earning less than half of the minimum wage, the renters’ living expenses fell well below the minimum cost of living, and more than 40% of the expenditure was spent on housing costs, resulting in cost-overburdened households. With the correlation between income, deposit, and rent, the burden of housing costs and the quality of the residential environment varied among regions. Indeed, the residential assessment of the renters was significantly influenced by urban amenities, and both income deficits and excessive housing cost burdens required inclusive and prompt housing interventions including housing assistance, provision of affordable public housing, income transfer, and transitions from renting to Chonsei arrangements.

Rituals of Survival in Single-Room Occupancy Hotels

This article works with a definition of care that encompasses expansive models of kinship and collective and communal life. Specifically, it explores representations of such interdependencies in the liminal space of the single‐room occupancy hotel (SRO) through the literary and artistic creations of two understudied African American artists. Fiction writer Robert Dean Pharr and visual artist Frederick Weston created their work in SROs in New York City beginning in the 1960s, during a time of massive transformation of the city's built environment in the name of urban renewal. Their novels and artwork, respectively, provide some of the only uncovered (to date) literary and cultural representations of New York City's SROs. Pharr's and Weston's works memorialize rituals of survival that center care and interdependencies over and against competitive individualism and a climate of uncare. Further, both explicitly articulate this vision by working with conceptual and material waste. Trash is their literal and metaphoric medium. These artists relied upon what is seen as surplus value by the city. But as Pharr and Weston use it, trash offers a critique of negative assumptions about the lives of SRO residents. The pandemic has shocked us into awareness of our inescapable interdependencies. Therefore, it behooves us to revisit these understudied, early proponents of care—an ethics that today's mutual aid and other liberation movements often center. Pharr's and Weston's documentation and interpretation of care offer us ways to survive within our current environments in crisis without repeating the death‐making logic and history of urban renewal.

44 Cognitive Intraindividual Variability as a Predictor of Functional Outcomes in a Sample of Precariously Housed Individuals

Objective:Precariously housed individuals are exposed to multiple adverse factors negatively impacting neurocognitive functioning. Additionally, this population is subjected to poor life outcomes, such as impaired psychosocial functioning. Neurocognitive functioning plays an important role in psychosocial functioning and may be especially critical for precariously housed individuals who face numerous barriers in their daily lives. However, few studies have explicitly examined the cognitive determinants of functional outcomes in this population. Cognitive intraindividual variability (IIV) involves the study of within-person differences in neurocognitive functioning and has been used as marker of frontal system pathology. Increased IIV has been associated with worse cognitive performance, cognitive decline, and poorer everyday functioning. Hence, IIV may add to the predictive utility of commonly used neuropsychological measures and may serve as an emergent predictor of poor outcomes in at-risk populations. The objective of the current study was to examine IIV as a unique index of the neurocognitive contributions to functional outcomes within a large sample of precariously housed individuals. It was hypothesized that greater IIV would be associated with poorer current (i.e., baseline) and long-term (i.e., up to 12 years) psychosocial functioning.Participants and Methods:Four hundred and thirty-seven adults were recruited from single-room occupancy hotels located in the Downtown Eastside of Vancouver, Canada (Mage = 44 years, 78% male) between November 2008 and November 2021. Baseline neurocognitive functioning was assessed at study enrolment. Scores from the Social and Occupational Functioning Assessment Scale (SOFAS), the Role Functioning Scale (RFS), the physical component score (PCS) and the mental component score (MCS) of the 36-Item Short Form Survey Instrument were obtained at participants’ baseline assessments and at their last available follow-up assessment to represent baseline and long-term psychosocial functioning, respectively. Using an established formula, an index of IIV was derived using a battery of standardized tests that broadly assessed verbal learning and memory, sustained attention, mental flexibility, and cognitive control. A series of multiple linear regressions were conducted to predict baseline and long-term social and role functioning (average across SOFAS and RFS scores), and PCS and MCS scores from IIV. In each of the models, we also included common predictors of functioning, including a global cognitive composite score, age, and years of education.Results:The IIV index and the global composite score did not explain a significant proportion of the variance in baseline and long-term social and role functioning (p &gt; .05). However, IIV was a significant predictor of baseline (B = -3.84, p = .021) and long-term (B = -3.58, p = .037) PCS scores, but not MCS scores (p &gt; .05). The global composite score did not predict baseline or long-term PCS scores.Conclusions:IIV significantly predicted baseline and long-term physical functioning, but not mental functioning or social and role functioning, suggesting that IIV may be a sensitive marker for limitations in everyday functioning due to physical health problems in precariously housed individuals. Critically, the present study is the first to show that IIV may be a useful index for predicting poor long-term health-related outcomes in this population compared to traditional neuropsychological measures.

68 Neurocognitive Functioning and Symptoms of Psychosis in Precariously Housed Adults with Multimorbidity

Objective:In persons with severe psychiatric disorders, distinct neurocognitive profiles hold differential associations to positive, negative and disorganized symptom dimensions of psychosis. These patterns portend specific functional outcomes, treatment efficacy, and prognoses. Similar associations have not been established in multimorbid samples in which persons present with a complex array of psychiatric symptoms. The objective of this study was to (1) establish neurocognitive profiles in a multimorbid, marginalized sample and (2) investigate their pattern(s) of association with psychiatric symptom dimensions and psychosocial outcomes.Participants and Methods:Participants (n=370; Mage = 45 years; 74% male) were precariously housed, substance-using adults with multimorbidity, recruited from Single-Room Occupancy hotels and a community court within the Downtown Eastside of Vancouver, BC, Canada. Data were collected as part of a longitudinal examination consisting of annual, bi-annual, and monthly neurocognitive, psychosocial, and psychiatric assessments. Neurocognitive scores were combined into five cognitive domains (Attentional Control [AC]; Processing Speed [PS]; Fluid Reasoning [Problem Solving and Reversal Learning; Gf]; Encoding and Retrieval [ER]; and Decision Making [DM]) and submitted to a latent profile analysis. The resulting profiles capturing neurocognition were validated on sociodemographic and clinical variables. Finally, the profiles were compared across previously validated, population-distinct factors derived from the Positive and Negative Syndrome Scale (PANSS), as well as on measures of psychosocial functioning.Results:An optimal goodness-of-fit was reached for a three-profile model (BLRT=127.86, p=.01). Profile 1 (n=207, 55.9%) showed stronger neurocognition (all p&lt;.05), with a within-profile strength in Gf (p&lt;.001). With the exception of ER, Profile 2 (n=109, 29.5%) exhibited inferior neurocognition across all indicators compared to Profile 1 (all p &lt;.05); yet showed a relative, within-profile strength in Gf (p &lt; .01). Profile 3 (n=54, 14.6%) generally displayed comparable impairments to Profile 2. Additionally, their performance on Gf was remarkably low compared to Profiles 1 and 2 (p&lt;.001). Psychiatrically, compared to Profile 1, Profile 2 exhibited more positive/disorganized symptoms and general psychopathology, as well as higher total PANSS (all p &lt;.05), whereas Profile 3 showed the poorest insight/awareness (p&lt;.01). Profiles 2 and 3 had lower levels of adaptive functioning and work productivity compared to Profile 1 (all p&lt;.01).Conclusions:Three neurocognitive profiles were detected in a sample of precariously housed adults with multimorbidity: one profile of comparatively higher neurocognitive capacity, with less symptoms of psychosis and better psychosocial functioning; a second profile of comparatively poorer neurocognition and psychosocial functioning, with more symptoms of psychosis; and a third profile with a severe deficit in fluid reasoning and poor insight and awareness. Given their poor insight, the third profile may be comprised of particularly vulnerable persons at greater risk of unmet healthcare needs. Interventions to improve these individuals' understanding of their personal health risks might facilitate their capacity to access services. Conversely, individuals from Profile 2 may benefit from outreach programs focusing on medication access and adherence to address their symptoms of psychosis. In sum, our findings suggest that the confluence of neurocognition and psychiatric symptoms may implicate unique treatment approaches and outcomes in precariously-housed persons with multimorbid conditions.

Housing-based syringe services programs to improve access to safer injecting equipment for people who inject drugs in Vancouver, Canada: a spatially oriented qualitative study

BackgroundHousing environments shape injection drug-related risks and harms and thus represent a critical implementation setting for syringe services programs (SSPs). As critical harm reduction measures, SSPs provide safe injecting equipment to people who inject drugs (PWID). Vancouver, Canada, has well-established syringe distribution programs through which PWID have low-threshold access to unlimited syringes and related injecting equipment, including through non-profit operated supportive housing and single-room occupancy hotels. This study examines the role of housing-based SSPs in distributing injecting equipment to PWID in Vancouver.MethodsBetween January and March 2020, semi-structured, in-depth interviews were conducted in Vancouver with 26 PWID. Interviews were audio-recorded, transcribed, and coded. Salient themes were identified using inductive and deductive approaches.ResultsMany participants accessed SSPs in housing facilities and expressed preference for these programs over those offered at other locations and through other health and social services. Three major themes emerged to explain this preference. First, most participants injected in the buildings where they resided, and housing-based SSPs made injecting equipment available when and where it was most needed. Second, many participants preferred to avoid carrying syringes outside of the places where they inject due to fears that syringe possession may lead to criminal charges or confiscation of syringes and/or illicit drugs by police. Third, for some participants, anti-drug user stigma and concerns over unwillingly disclosing their drug use hindered access to SSPs outside of housing settings. Programs operated within housing facilities often offered greater client anonymity along with more supportive and less stigmatizing environments, particularly in the presence of peer staff.ConclusionThe current study advances understanding of access to injecting equipment in a setting with city-wide syringe distribution programs. Our findings underscore the benefits of housing-based SSPs and encourage the expansion of such services to maximize access to harm reduction supports for PWID.

Saving lives in our homes: Qualitative evaluation of a tenant overdose response program in supportive, single-room occupancy (SRO) housing.

People using opioids alone in private settings are at elevated risk of dying in the event of an overdose. In San Francisco, single room occupancy (SRO) tenants are 19 times more likely to die of overdose than non-SRO residents. The "SRO Project" pilot aimed to reduce fatal overdoses in SROs by recruiting and training tenants to distribute naloxone and provide overdose education in their buildings. We explore the implementation and program impacts of the SRO Project pilot in two permanent supportive housing SROs. We conducted eight months of ethnographic fieldwork (May 2021 - Feb 2022), including 35 days observing SRO Project pilot activities, and semi-structured interviews with 11 housing staff and 8 tenant overdose prevention specialists ('specialists'). Data were analyzed using a grounded theory approach to characterize program impacts, implementation strengths, and implementation challenges from the perspective of specialists and housing staff. We found that the SRO project increased awareness, access to, and understanding of naloxone; facilitated other mutual-aid practices; supported privacy and autonomy of tenants regarding their drug use; and improved rapport, communication and trust between tenants and housing staff. Strengths of the implementation process included involvement of tenants with diverse social locations and skill sets and, at one site, a team-based approach that fostered program innovation, tenant solidarity and a sense of collective ownership over the project. Program implementation was challenged by frequent turnover and capacity constraints of housing staff, particularly during overnight shifts when overdose risks were greatest. Additional challenges arose due to the psychosocial burden of overdose response work, gendered violence, issues with compensation methods, and scope creep in specialists' roles. This evaluation contributes further evidence regarding the effectiveness of tenant-led naloxone distribution and overdose education in permanent supportive and SRO housing environments. Findings indicate program implementation and sustainability can be improved by expanding tenant specialist training, compensating specialists in cash, and building stronger psychosocial support for tenants responding to overdoses in their homes.

Znevýhodnění mezi znevýhodněnými? Prediktory bydlení na ubytovnách v českých sociálně vyloučených lokalitách

This study explores the relationship between social exclusion and housing tenure. It seeks to identify the factors that increase the chance that inhabitants of socially excluded localities (SELs) in Czechia will live in a hostel (a single room occupancy hotel). Do these factors indicate a higher intensity of social exclusion among people who live in hostels? Do hostels house the more disadvantaged segment of the disadvantaged population, such as the inhabitants of SELs? Our aim is to produce a more nuanced understanding of the different needs of the heterogeneous population of socially excluded localities, which can be used to implement socially inclusive measures. We analyse data obtained in a survey of the population of SELs. We apply binary logistic regression using socio-demographic and socio-economic characteristics of respondents and their households and variables measuring victimisation and respondents&#8217; risk behaviour as predictors. Along with descriptive statistics we present the results of the simple and multiple binary logistic regressions. The multiple model revealed the following predictors to be statistically significant: the share of rent in household income, household size, residential mobility, citizenship, labour status, criminal activity not punished by imprisonment, nationality/ethnicity, and property victimisation of the household. Except for the last two, these factors increase the chance of socially disadvantaged persons living in a hostel. Future research directions and the political implications of our findings are discussed in the conclusion.

“Vancouver’s Favourite Country Music Pub,” Single Room Occupancy Hotels, and the Context of International Frameworks: Mapping Vancouver’s Urban Law and Cultural Policy

“Vancouver’s Favourite Country Music Pub,” Single Room Occupancy Hotels, and the Context of International Frameworks: Mapping Vancouver’s Urban Law and Cultural Policy

Using Geocoding to Identify COVID-19 Outbreaks in Congregate Residential Settings: San Francisco's Outbreak Response in Single-Room Occupancy Hotels.

More than 500 single-room occupancy hotels (SROs), a type of low-cost congregate housing with shared bathrooms and kitchens, are available in San Francisco. SRO residents include essential workers, people with disabilities, and multigenerational immigrant families. In March 2020, with increasing concerns about the potential for rapid transmission of COVID-19 among a population with disproportionate rates of comorbidity, poor access to care, and inability to self-isolate, the San Francisco Department of Public Health formed an SRO outbreak response team to identify and contain COVID-19 clusters in this congregate residential setting. Using address-matching geocoding, the team conducted active surveillance to identify new cases and outbreaks of COVID-19 at SROs. An outbreak was defined as 3 separate households in the SRO with a positive test result for COVID-19. From March 2020 through February 2021, the SRO outbreak response team conducted on-site mass testing of all residents at 52 SROs with outbreaks identified through geocoding. The rate of positive COVID-19 tests was significantly higher at SROs with outbreaks than at SROs without outbreaks (12.7% vs 6.4%; P < .001). From March through May 2020, the rate of COVID-19 cases among SRO residents was higher than among residents of other settings (ie, non–SRO residents), before decreasing and remaining at an equal level to non–SRO residents during later periods of 2020. The annual case fatality rate for SRO residents and non–SRO residents was similar (1.8% vs 1.5%). This approach identified outbreaks in a setting at high risk of COVID-19 and facilitated rapid deployment of resources. The geocoding surveillance approach could be used for other diseases and in any setting for which a list of addresses is available.

Student housing design implications for single-room occupancy during COVID-19 in Ghana

PurposeThe adaptation of emerging building designs for single room occupancy in off-campus university student housing during the COVID-19 pandemic is evolving. However, assessing its effects on student satisfaction to compensate for COVID-19-associated impacts is missing. As a result, the study examines the satisfaction of students with emerging building designs in single-room off-campus student housing in Ghana.Design/methodology/approachThe study is quantitatively based on positivist philosophical thinking. A purposive sample of 202 purpose-built student housing facilities was selected across public and private universities in Ghana. Using systematic stratified sampling, the study sampled 1,212 student residents through a survey. A principal component method (PCM) was used to assess the availability of 10 emerging building design and basic building services variables across the study location. Multiple regression was employed to determine the satisfaction and predict potential variables for policy formulation.FindingsThe analysis revealed that private space for social distancing, the availability of hands-free fittings in the toilet and bathroom, and the availability of hands-free fixtures in the kitchen unit was common single-room self-occupancy support systems. However, there is a huge gap in the availability of key emerging building designs and basic building services and their associated effects on students' satisfaction across the study locations. Therefore, relevant proposals to serve as fundamental requirements for developing an off-campus student housing model during pandemics were indicated.Research limitations/implicationsIt is seen that emerging building designs across the housing sector are equally evolving among off-campus student housing. The study helped to understand that student satisfaction with emerging building designs and basic services is a motivational need for students. However, the preparedness of student housing owners to adopt and satisfy the requirements of these design require further studies.Originality/valueWhile COVID-19 and its associated effect keep evolving in building design requirements, it is equally relevant to assess the students' satisfaction with these designs and services among single room occupancy-made off-campus student housing. This research is limited to Africa.

Making the Third Ghetto: Race, Gender, and Family Homelessness in Washington, DC, 1977–1989

This article posits that the emergency shelter system which emerged in the 1970s, first as an informal network of local and faith-based assistance and then institutionalized by the late 1980s, was Washington, DC's third ghetto. Defining this “new,” visible homelessness in the context of the third ghetto exposes its points of convergence with the second ghetto in the increasing use of welfare hotels. This study revisits Arnold Hirsch's Making the Second Ghetto to examine housing precarity and racial subordination in Washington, DC's first and second ghettos. Additionally, I argue that acknowledging the resilience of the black female heads of household (FHHs) living in the public housing of the 1970s and 1980s in the second ghetto and examining homeless families living in welfare hotels in connection with neoliberal policies and practices in homeless assistance service provision during the 1980s are essential to understanding the making of the third ghetto in Washington, DC.

Imagined Histories

Imagined Histories

155 CHARACTERISTICS AND PREDICTORS OF INPATIENT FALLS IN A GERIATRIC REHABILITATION UNIT

Abstract Background Falls are one of the most frequent complications on geriatric rehabilitation wards. In addition to having adverse consequences for patients, falls also result in prolonged hospitalisation and increased healthcare costs. Therefore, identification of risk factors and development of successful falls prevention strategies targeted at this population are essential. The aim of this study is to identify predisposing or situational risk factors contributing to falls in older adults completing post-acute inpatient rehabilitation. Methods Retrospective review of all inpatient falls on two geriatric rehabilitation units over a one year period identified from incident forms. Chi-squared test was used to calculate differences between fallers and non-fallers. Results One in five patients admitted to the unit suffered a fall (average age 81, 52% male) with a total of 95 falls involving 56 patients. Of these, only 77% (n = 43) were identified as high risk on falls screening. 61% (n = 34) had one fall and 39% (n = 22) had two or more falls. Nearly one in three (n = 15) falls resulted in injury. More falls occurred in the single bedded unit (14.8 per 1,000 bed-days) as compared to the multi-bedded unit (6.8 per 1,000 bed days). Use of a Zimmer frame or rollator was associated with more falls than use of other mobility aids. Fallers tended to have a previous history of falls (75%, n = 42) and polypharmacy (average 10 medications). Delirium and dementia were present in one third of fallers. Falls were associated with a higher risk of discharge to long-term care, with 70% of fallers discharged home compared to 89% of non-fallers (p = 0.0006). Conclusion Previous falls, single room occupancy, polypharmacy and a medium level of dependency when mobilizing were identified as predictors of falls in our review. Nearly a quarter of fallers were not identified as high falls risk on screening further questioning the utility of falls risk screening assessments.

MAKING PROPERTY OUTLAWS: Law and Relegation

AbstractDrawing from community‐based research in the Downtown Eastside, the poorest part of Vancouver, Canada, a neighbourhood long demonized as an ‘outlaw zone’, we suggest that what may appear to be illegal property practices in the area's infamous Single Room Occupancy (SRO) hotels are, in fact, harder to detach from formal legality than supposed. We characterize the state's withdrawal of tenancy law from SRO in the 1970s as productive of property outlaws. A form of legal relegation, outlawry places SRO residents in a space of lesser protection, stripping them of rights. A space of decades of systematic legal relegation, the outlaw zone is a product of law, not its antithesis, predicated on organized forms of devaluation and discrimination.

Abandoning the SRO: Public Health Withdrawal from Sanitary Enforcement in Vancouver's Downtown Eastside.

This paper situates a ten-year period of political upheaval in addressing the problem of Single Room Occupancy (SRO) housing in Vancouver, Canada, within an epistemic transformation of public health. Until 1970, the Vancouver Health Department exemplified a colonial history of public health in establishing the city's skid road as a cordon sanitaire. But the 1970s saw a sudden fading of the Department's authority just as a more collaborative approach to housing policy was emerging. The sunsetting of sanitary enforcement was driven in part by the arrival of a "new public health" that became primarily concerned with defining public health problems and solutions through the regulation of racialized bodies and behaviors-a cordon thérapeutique. By the 1980s, this shift constituted an epistemic and regulatory abandonment of SRO housing, leading to the accelerated deterioration of the entire housing stock and costing incalculable human suffering and the loss of lives.