International Journal of Public Health

, Volume 56, Issue 6, pp 609–623 | Cite as

The health and housing in transition study: a longitudinal study of the health of homeless and vulnerably housed adults in three Canadian cities

  • Stephen W. HwangEmail author
  • Tim Aubry
  • Anita Palepu
  • Susan Farrell
  • Rosane Nisenbaum
  • Anita M. Hubley
  • Fran Klodawsky
  • Evie Gogosis
  • Elizabeth Hay
  • Shannon Pidlubny
  • Tatiana Dowbor
  • Catharine Chambers
Original Article



While substantial research has demonstrated the poor health status of homeless populations, the health status of vulnerably housed individuals is largely unknown. Furthermore, few longitudinal studies have assessed the impact of housing transitions on health. The health and housing in transition (HHiT) study is a prospective cohort study that aims to track the health and housing status of a representative sample of homeless and vulnerably housed single adults in three Canadian cities (Toronto, Ottawa, and Vancouver). This paper discusses the HHiT study methodological recruitment strategies and follow-up procedures, including a discussion of the limitations and challenges experienced to date.


Participants (n = 1,192) were randomly selected at shelters, meal programmes, community health centres, drop-in centres, rooming houses, and single-room occupancy hotels from January to December 2009 and are being re-interviewed every 12 months for a 2-year period.


At baseline, over 85% of participants reported having at least one chronic health condition, and over 50% reported being diagnosed with a mental health problem.


Our findings suggest that, regardless of housing status, participants had extremely poor overall health.


Homeless persons Vulnerable populations Housing Health Mental health Quality of life Longitudinal studies 



This project was supported by an operating grant (MOP-86765) and an Interdisciplinary Capacity Enhancement Grant on Homelessness, Housing and Health (HOA-80066) from the Canadian Institutes of Health Research. The Centre for Research on Inner City Health in the Li Ka Shing Knowledge Institute at St. Michael’s Hospital gratefully acknowledges the support of the Ontario Ministry of Health and Long-Term Care. The authors thank Ying Di, Centre for Research on Inner City Health, for her expert programming and analyses. We would like to acknowledge the following individuals from our community partner organizations: Laura Cowan, Liz Evans, Sarah Evans, Stephanie Gee, Clare Haskel, Erika Khandor, and Wendy Muckle. The authors also thank the shelter, drop-in, and municipal and provincial staff for their assistance with participant recruitment and follow-up. The views expressed here are the views of the authors and do not necessarily reflect the views of the Ontario Ministry of Health and Long-Term Care or any of the other named individuals or organizations.


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Copyright information

© Swiss School of Public Health 2011

Authors and Affiliations

  • Stephen W. Hwang
    • 1
    • 2
    Email author
  • Tim Aubry
    • 3
  • Anita Palepu
    • 4
  • Susan Farrell
    • 5
  • Rosane Nisenbaum
    • 1
  • Anita M. Hubley
    • 6
  • Fran Klodawsky
    • 7
  • Evie Gogosis
    • 1
  • Elizabeth Hay
    • 3
  • Shannon Pidlubny
    • 4
  • Tatiana Dowbor
    • 1
  • Catharine Chambers
    • 1
  1. 1.Centre for Research on Inner City Health, The Keenan Research Centre at the Li Ka Shing Knowledge Institute, St. Michael’s HospitalTorontoCanada
  2. 2.Division of General Internal Medicine, Department of MedicineUniversity of TorontoTorontoCanada
  3. 3.Centre for Research on Educational and Community ServicesUniversity of OttawaOttawaCanada
  4. 4.Centre for Health Evaluation and Outcome Studies, Division of General Internal MedicineUniversity of British ColumbiaVancouverCanada
  5. 5.Royal Ottawa Health Care GroupOttawaCanada
  6. 6.Measurement, Evaluation, and Research Methodology, Department of Educational and Counselling Psychology, and Special EducationUniversity of British ColumbiaVancouverCanada
  7. 7.Department of Geography and Environmental StudiesCarleton UniversityOttawaCanada

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