Capturing and addressing challenges of health promotion among marginalized groups

Description

Background. Health-promoting infrastructure, such as drinking water, sanitation and hygiene (WASH) and related health benefits are widely enjoyed in high-income countries. WASH is closely related to housing, and its management the responsibility of property owners. Marginalized population groups, including people experiencing homelessness sleeping rough, in encampments or in shelters in urban areas, are often excluded. For hundreds of thousands of homeless people in Europe, homeless shelters and public toilets are sometimes the option to access appropriate health-promoting infrastructure. Despite the high societal relevance according to the United Nations Sustainable Development Goal 6 to “ensure water and sanitation for all”, and despite the human right to water and sanitation, the needs of people experiencing homelessness are not yet fully met; WASH inequalities and the resulting burden of disease remain hidden and under-researched, particularly in high-income countries.

Method. With our ongoing exploratory study we aim to (i) understand challenges of health promotion that people experiencing homelessness are facing, and (ii) identify solutions to address these challenges. Data are being collected in Bonn, Germany, from and with people experiencing homelessness with different methods (in-depth walking interviews, photovoice, mental maps, arts-based research workshops and group discussions, participatory mapping), from their service providers (social workers), and from public urban drinking water, sanitation an hygiene infrastructure based on spot checks, combining approaches from social sciences, public health, planning and geography. The target group of this research, people experiencing homelessness, is involved throughout the research.

Results. Preliminary results of mapping health-promoting infrastructure indicate the undersupply of publicly accessible drinking water dispensers, toilets and showers. Preliminary findings of interviews with people experiencing homelessness and their social workers highlight a variety of challenges related to WASH insecurity, and exposure to associated health risks. Our insights point not only to the urgent need of improving access to health-promoting infrastructure for marginalized population groups, and underline the importance of involving those at risk, and those in a position to change the situation. They also show difficulties of working in data-scarce contexts with a population group as vulnerable and mobile as people experiencing homelessness, and the implications and complications for planning, and the choice of data collection tools.

Conclusions. Our high risk, high gain research project has several novelties. It (i) considers WASH and health challenges in an understudied marginalized target group, (ii) provides the first evidence on water and health insecurity experiences among people experiencing homelessness in Germany, (iii) combines and integrates two knowledge gaps on WASH among homeless people and climate-resilient public WASH in urban areas, (iv) employs a citizen science approach and (v) further develops a participatory planning and mapping tool and inclusive co-design approach in a novel context.

Period	Nov 2024
Event title	16th International Symposium on Geospatial Health, GnosisGIS 2023
Event type	Conference
Conference number	16
Location	Enschede, NetherlandsShow on map
Degree of Recognition	International