social housing research papers

• Research article
• Open access
• Published: 20 July 2020

Housing as a social determinant of health and wellbeing: developing an empirically-informed realist theoretical framework

• Steve Rolfe   ORCID: orcid.org/0000-0003-1465-7401 1 ,
• Lisa Garnham   ORCID: orcid.org/0000-0001-9242-8095 2 ,
• Jon Godwin   ORCID: orcid.org/0000-0002-2953-3455 3 ,
• Isobel Anderson   ORCID: orcid.org/0000-0001-8601-8049 1 ,
• Pete Seaman   ORCID: orcid.org/0000-0003-4710-2568 2 &
• Cam Donaldson   ORCID: orcid.org/0000-0003-4670-5340 4  

BMC Public Health volume  20 , Article number:  1138 ( 2020 ) Cite this article

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The role of housing as a social determinant of health is well-established, but the causal pathways are poorly understood beyond the direct effects of physical housing defects. For low-income, vulnerable households there are particular challenges in creating a sense of home in a new tenancy which may have substantial effects on health and wellbeing. This study examines the role of these less tangible aspects of the housing experience for tenants in the social and private rented sectors in west central Scotland.

The paper analyses quantitative data from a mixed methods, longitudinal study of tenants from three housing organisations, collected across the first year of their tenancy. The paper postulates causal hypotheses on the basis of staff interviews and then uses a Realist Research approach to test and refine these into a theoretical framework for the connections between tenants’ broader experience of housing and their health and wellbeing.

Housing service provision, tenants’ experience of property quality and aspects of neighbourhood are all demonstrated to be significantly correlated with measures of of health and wellbeing. Analysis of contextual factors provides additional detail within the theoretical framework, offering a basis for further empirical work.

Conclusions

The findings provide an empirically-informed realist theoretical framework for causal pathways connecting less tangible aspects of the housing experience to health and wellbeing. Applying this within housing policy and practice would facilitate a focus on housing as a public health intervention, with potential for significant impacts on the lives of low-income and vulnerable tenants. The framework also offers a basis for further research to refine our understanding of housing as a social determinant of health.

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Housing is often cited as an important social determinant of health, recognising the range of ways in which a lack of housing, or poor quality housing, can negatively affect health and wellbeing [ 1 , 2 , 3 , 4 ]. However, the causal pathways from housing to health are inherently complex, as with all the social determinants of health [ 5 ], so many of these pathways are neither fully conceptualised, nor empirically understood. This paper aims to develop an empirically-informed theoretical framework to elucidate some of the possible causal pathways between less tangible aspects of housing experience and health and wellbeing, for low-income households in rented accommodation. It is concerned with the subjective experience of housing, from the perspective of low income household in rented accommodation.

The causal relationships between tangible physical housing defects and poor health outcomes are widely accepted [ 6 , 7 ], with clear evidence of negative physical health effects of toxins within the home, damp and mould, cold indoor temperatures, overcrowding and safety factors [ 4 , 6 , 7 , 8 ], and also of negative mental health effects arising from cold indoor temperatures, overcrowding/lack of personal space, and damp and mould [ 4 , 6 , 7 , 9 ]. Moreover, analysis of the impact of housing improvement interventions provides evidence for causal direction and pathways [ 10 , 11 ].

Beyond these impacts of physical aspects of housing, the literature regarding health impacts of less tangible aspects of the housing experience is relatively sparse, although the literature around the notion of ‘home’ provides some theoretical and empirical starting points. The social, psychological and cultural value of home as something more than the material object of housing has long been recognised [ 12 ], indicating the range of ways in which dwellings offer sites of control, autonomy and socialisation, and a basis for social identity and status [ 13 , 14 ]. Thus from the perspective of ‘ontological security’ [ 15 , 16 ], the home is seen as providing a secure base from which people can develop confidence in self and social identity [ 17 , 18 ]. Moreover, research across different housing sectors [ 19 , 20 ] and examining the specific experiences of different social groups [ 21 , 22 , 23 ] suggests that the subjective experience of housing and housing services can be important in creating a sense of home and underpinning ontological security.

Taking this a stage further, the work of Kearns and colleagues examining the ‘psychosocial benefits of home’ [ 24 , 25 , 26 ], has gone some way to develop theoretical and empirical connections between housing, home and wellbeing. Their findings suggest that aspects of control, autonomy, status and empowerment are related to measures of wellbeing, with some variance in relative importance between households with different characteristics, but the use of cross-sectional data restricts the examination of causality. The evidence from longitudinal panel datasets reviewed by Clapham et al. [ 27 ] provides more evidence for the causal effect of physical housing quality and tenure on measures of subjective wellbeing, but these studies face difficulty in identifying mediators, many of which appear to relate to the psychosocial aspects of home, including autonomy, security and status.

Examining health and wellbeing impacts of aspects of housing beyond bricks and mortar is particularly important in the context of declining rates of home ownership and consequent increases in renting across much of Europe and the US, following the Global Financial Crisis [ 28 , 29 , 30 ]. Aside from the obvious relevance of tenure security for this growing group of tenants, the role of landlords and housing organisations may be salient, particularly in terms of the constraints that may be placed on tenants’ agency in generating their own sense of home.

This paper attempts to make progress in this area, by developing an empirically-informed, realist theoretical framework for causal pathways linking less tangible aspects of housing as experienced by tenants to health and wellbeing outcomes. Utilising quantitative data from a mixed methods, longitudinal study of tenants in Scotland, the paper employs realist analysis [ 31 , 32 ] to test and refine four hypotheses relating to: relationships between tenants and their housing provider; tenants’ experience of property quality; affordability; and aspects of neighbourhood and social support. Firstly, we focus on whether the hypotheses are supported by the evidence. Secondly, we consider the contextual factors which play a role in determining who is most affected and in what circumstances [ 31 ]. To undertake this analysis, the study focuses on new tenants, conceptualising the change of tenancy and the related changes in housing experience and housing service as a complex intervention in the lives of participating tenants [ 33 ]. The paper is inherently exploratory, attempting to develop and refine a realist understanding of the causal pathways which may link less tangible aspects of the housing experience to health and wellbeing, on the basis of empirical data, to provide a framework for further analysis and research. Further analysis of the qualitative data from the study, to elaborate the precise nature of the causal mechanisms involved will be the subject of a later paper.

This study treats the entire housing experience as the intervention from which health and wellbeing impacts result. It seeks to understand the mechanisms through which that subjective experience generates impacts, the different contexts in which those mechanisms operate and impacts vary, and why. It focuses, in particular, on the less tangible aspects of that housing experience, owing to a lack of empirical evidence in the literature. It uses realist methodology in order to achieve this. In this section we provide an introduction to realist evaluation (RE) for readers unfamiliar with this methodology, highlighting key characteristics which are of particular relevance to this study. We explain why we selected this methodology and how we employed it in practice.

RE is an established methodology within the school of theory-based evaluation (TBE) approaches. These methodologies as a whole attempt to move away from before-and-after evaluation designs, using theory to attempt to uncover and understand the causal processes and mechanisms at play within any policy or programme [ 34 , 35 ].

Understanding causality within realist evaluation

As Gates & Dyson [ 36 ] argue, there is a ‘growing acknowledgement that there are multiple ways to think about causal relationships’ and therefore a diversity of ways to make causal claims in social science. RE starts from a realist view of causality, which has two important features. Firstly, causality is conceptualised as generative rather than successionist. Generative causation emphasises that it is the latent ‘powers and liabilities’ within things which generates effects in particular contexts [ 37 ]. Whilst methodologies based on successionist causality, such as RCTs, attempt to control for contextual influences, RE deliberately incorporates context to examine how it influences the operation of causal mechanisms. Thus, the RE position is that research needs to focus not on whether programmes work in a general sense, but on ‘what works, for whom, in what circumstances’ [ 31 ], often now extended to include questions of ‘how and why?’ This is particularly valuable in situations where ‘interventions’ and contexts are interconnected in complex ways, such as social situations where the intervention is shaped by the agency of the beneficiary.

Secondly, building on the realist notion of a ‘stratified reality’ [ 31 , 38 ], RE recognises that most mechanisms will be hidden. Whilst many elements of social reality, such as human behaviour or the existence and activities of institutions are directly observable, the mechanisms which generate social outcomes are often hidden within individual reasoning or complex organisational interactions and hence are not necessarily tangible. As Westhorp [ 37 ] argues, the invisible nature of mechanisms arises because they (often) operate at different levels of the system than the outcome, they operate at different timescales to the outcome, and they depend on relationships and interactions, some of which cannot be observed. However, the practical impossibility of directly observing such causal mechanisms does not preclude understanding, it merely highlights the need for theory to provide an explanation. In a sense, this perspective provides an additional angle to the truism that ‘correlation does not imply causation’, since the implication is that correlation requires a theory of mechanisms to identify the likelihood of a causal relationship.

Understanding realist evaluation

Building on these understandings of causality and the nature of mechanisms, RE departs from experimental methodologies that attempt to control contextual influences to isolate the effect of particular interventions or mechanisms. Rather, it explicitly recognises that mechanisms operate differently in different contexts and therefore develops causal hypotheses in the form of ‘Context-Mechanism-Outcome Configurations’ (CMOCs), attempting to identify how causal mechanisms may operate to generate outcomes within particular contexts.

In practical terms, RE proceeds in a cyclical fashion to iteratively refine our understanding of mechanisms and the contexts within which they operate to generate outcomes [ 39 ]. Initial, tentative theories in the form of hypothesised CMOCs are developed from existing evidence in the literature and stakeholder engagement, employing ‘abductive reasoning’, which Jagosh et al. [ 40 ] define as “inference to the best explanation”. Mixed methods data collection is then utilised to examine the ‘outcome regularities’ which relate to these initial CMOCs, in two phases. Firstly, quantitative data is employed to examine the patterns of outcomes across different contexts in order to test and refine the initial CMOCs. The causal theories represented by these CMOCs are then refined further by using qualitative data to elucidate the underlying mechanisms through exploring and triangulating stakeholders’ understandings. These refined CMOCs provide a more nuanced picture of what works, for whom in different circumstances, which can be utilised in practice and also provides the starting point for a further iteration of the realist research process.

Importantly, RE attempts to develop theoretical understanding at different levels. On the one hand, the aim is to develop ‘middle-range theory’ (MRT) [ 41 ] regarding causal mechanisms. MRT lies between the (impossible) grand, unified theory of social behaviour, organisation and change, and the very specific understandings of particular contexts [ 31 , 42 ]. On the other hand, individual RE studies aim to improve the specification of CMOCs, thereby “learning more and more about less and less” [ 31 ] in order to enhance our understanding of the particular contexts within which causal mechanisms work for particular groups of people. The process of knowledge cumulation within RE involves traversing repeatedly between abstraction and specification to refine the MRT and examine how it applies in particular contexts [ 31 ]. This paper focuses only on the first of these two elements, examining the outcome regularities exhibited within the quantitative data in order to develop a middle-range theoretical framework. The second stage of this analysis will be presented elsewhere.

Rationale for using RE in this study

This research attempts to examine possible causal pathways between the less tangible aspects of the housing experience and health and wellbeing outcomes. More specifically, we set out to investigate these impacts by studying tenants entering a new tenancy, conceptualising this change as a complex intervention in the lives of these tenants. A number of aspects of this area of study suggested the value of using RE.

Firstly, the the intervention being studied is both multi-faceted and complex, in the sense that there are multiple, interacting components, including the agency of tenants and housing staff [ 43 ]. Where interventions as well as outcomes are emergent, and where context is likely to be important, an evaluation approach is needed which can operate at the level of the system [ 44 ]. RE explicitly attempts to grapple with the fact that society and human behaviour are in a permanent state of self-transformation, by recognising the mutating nature of social programmes and the role of agency in generative causation [ 32 , 45 ]. Whilst we can attempt to understand the mechanisms which may generate health and wellbeing outcomes, it is neither possible nor practically useful to attempt to separate ‘intervention’ elements from the complex open system within which they take place. Rather, we used RE in order to examine the ‘interventional systems’ [ 46 ] within which health and wellbeing change may be generated for and by tenants.

Secondly, given that tenants are active agents within their housing experience, the notion of generative causality is likely to be valuable in exploring the pathways between aspects of housing experience and health and wellbeing outcomes. Moreover, whilst health and wellbeing can be measured at static points in time, there is a sense in which health and (especially) wellbeing are emergent properties which are constantly in flux. Hence, understanding the causal relationships is likely to require an exploration of multiple, inter-related mechanisms which operate on different timescales [ 37 ].

We therefore employed RE methodology in order to examine the complex, contingent and emergent nature of the less tangible aspects of housing. We aimed to examine the causal impact of the subjective housing experience, and to clarify the nature of the mechanisms involved and the contexts influencing their operation.

Project design

In order to explore a range of possible mechanisms and contexts, we worked with three quite different housing organisations, described in Table  1 . The organisations operate across the social and private rented sectors, but with a similar client group of low-income tenants. Low-income households are most likely to be at risk from poor health and wellbeing and more likely to experience poor housing. They therefore represent the portion of the population for whom it is more important to understand the relationship between housing and health and wellbeing, if we are to effectively address and reduce health inequalities.

Phase 1 – developing the initial hypotheses

In the first phase of the research, individual semi-structured interviews were carried out with 23 staff across the three organisations, in order to uncover the program theories underlying their practice, with specific reference to potential health and wellbeing impacts. Interviewees were selected in order to provide a cross-section of staff, encompassing different aspects of each organisation’s approach to working with tenants. Table  2 provides an overview of the interviewees in each organisation.

The data from these interviews provided the implicit causal understandings of practitioners, which was then combined with existing evidence from the literature to examine the plausibility of the suggested mechanisms and contextual factors, and to develop the initial, tentative CMOCs, as laid out in Table  3 . There were some differences between the organisations regarding the specific contextual factors that might be relevant, but across the interviews the same four mechanisms were seen as likely to have a notable impact on health and wellbeing. Given the similar conceptions of potential mechanisms across the organisations, we therefore set out to collect data from tenants which would enable us to test and refine these CMOCs, treating the housing organisation as just one contextual factor amongst many that might impact upon the tenants’ housing experience.

Phase 2 – data collection

Data was collected from a cohort of new tenants, over the period 2016–2018. All new tenants were invited to participate in the study, being given initial information by housing organisation staff prior to a more detailed conversation and opt-in consent process with the research team. Participation was voluntary, with around 50% of new tenants agreeing to take part in the study. Data was collected through structured interviews carried out at three time points: the start of the tenancy (Wave 1), collecting background data on tenants’ prior housing situation; 2–4 months into the tenancy (Wave 2); and 9–12 months into the tenancy (Wave 3). At each wave, quantitative data was collected on satisfaction with various aspects of the housing service, community and social networks, health and wellbeing, financial circumstances and demographics. At Waves 2 and 3, these elements were also explored qualitatively through face-to-face interviews conducted in the tenant’s home, although this data is not presented here. Table  4 sets out the numbers of tenants involved at each Wave and Table  5 provides a demographic overview of the sample, based on those completing at least the first two Waves of data collection.

The drop-out rates between the waves are largely due to two factors. At Wave 1, data was collected through a short telephone interview (around 15 min), whereas Waves 2 and 3 involved more onerous face-to-face interviews in the tenants’ home of around 30–60 min in length. The attrition at Wave 3 was exacerbated by the timescale of the project – some Wave 3 interviews could not be scheduled before data collection had to be completed. These patterns were relatively consistent across the three organisations and the number of tenants moving on or losing their tenancy was very small (< 5%). We also compared demographic data for the participant groups at each wave with each other and with the wider population of new tenants within each organisation. This analysis showed only minor differences, suggesting a limited degree of selection bias.

For the purposes of this analysis, the definition of health aligns with that of the World Health Organization: “a state of complete physical, mental and social wellbeing, and not merely the absence of infirmity” [ 47 ]. The definition of wellbeing itself is complex, but we use it to mean a combination of positive psychological state and a functional balance between individual resources and challenges [ 48 ]. Crucially, these conceptions of health and wellbeing overlap considerably, reflecting the growing evidence base indicating that psychological wellbeing is a significant determinant of physical health, particularly over the life course [ 49 ] and that measures of wellbeing are highly correlated with measures of health [ 50 , 51 ]. As both a close analogue to and a determinant of health, we suggest that wellbeing is an important outcome to consider in housing research [ 27 ].

On the basis of these definitions and given the low likelihood of significant impacts on clinical health indicators arising from social determinants within a single year, we used three self-report questions to measure health and wellbeing at each wave. Whilst self-rated health status has clear limitations, there is good evidence to suggest that it provides a reliable indicator of objectively measured health [ 52 ]. We employed the World Health Organization’s 5-point wellbeing scale (WHO5) as an internationally-validated measure of wellbeing [ 51 ]. As a general measure of health, we used a self-rated health status question drawn from the Scottish Household Survey. Unsurprisingly, the data from this question showed no significant change between waves, although it was still useful in demonstrating that our sample was somewhat more unhealthy than the general population (17% ‘bad’ or ‘very bad’ health in the sample, compared to 9% in SHS 2017 data), as would be expected for this group of vulnerable and low-income households. A focus group and pilot interviews with tenants prior to the main data collection phase had indicated that most people were likely to interpret this question relatively narrowly as relating to physical disease, which we did not expect to be substantially affected by the housing experience within a year. Moreover, this pilot work indicated that broader conceptions of health and wellbeing overlap considerably in the public mind, reflecting the connections demonstrated in the literature. We therefore included an additional question on self-rated change in overall health and wellbeing and deliberately situated it alongside qualitative exploration to create a focus on the broader conception of health and wellbeing as a combination of physical state, mental state and functioning.

Independent variables were selected from existing questions in national surveys (Scottish Household Survey and Scottish Social Housing Charter indicators) to measure aspects of the housing experience which might plausibly trigger each of the mechanisms in Table 3 . Given the RE conception of mechanisms as hidden, these variables do not attempt to measure the mechanisms directly, but to provide an indication of the potential that the theorised mechanism has been triggered, when combined with the outcome data. Additional questions relating to contextual aspects were also asked, including demographics and previous housing situations. The key outcome and independent variables are set out in Table  6 . More information on these variables and their related questions available in the supplementary material .

Phase 3 – analysis to test and refine the theories

The analysis of the quantitative data was undertaken in two stages. Firstly, the data was used to examine the outcome regularities and thereby test whether the hypothesised mechanisms appeared to be operating to generate impacts on health and wellbeing. Bivariate tests were carried out using the full sample (using Spearman’s Rho for non-parametric data) to examine correlations between the independent variables related to each hypothesis and two health and wellbeing outcome variables. Outcome regularities evidenced by correlations do not in themselves provide clear evidence of causality, but provide a basis for further investigation of the underlying mechanisms and the contextual factors which may be affecting their operation.

Importantly, the two health and wellbeing variables serve different purposes within the analysis. The WHO5 scale provides a validated, internationally-recognised measure [ 51 ], focused primarily on the positive psychological state aspect of wellbeing. Due to challenges in contacting tenants prior to their move, 42% of participants did not complete the Wave 1 WHO5 questionnaire until more than 2 weeks after their move-in date. As such, Wave 1 WHO5 does not reliably describe pre-move wellbeing for all tenants and therefore cannot be used to assess improvement pre- and post-move across the whole sample. Hence it is primarily used within the analysis to examine potential correlations within each Wave, testing for ‘static’ health and wellbeing effects of aspects of housing service, housing quality, financial coping and neighbourhood. The self-rating of health and wellbeing collected at Waves 2 and 3, provides a direct measure of tenants’ perspectives on what has changed for them since the start of their new tenancy and is therefore used within the analysis to examine potential correlations across Waves, testing for ‘change’ effects of the same aspects of housing situation. Since the question specifically asks for self-rated change since the start of the tenancy, this variable provides a direct indicator of tenants’ perceptions of the impact of their change in housing situation on their health and wellbeing.

Secondly, further tests (again using Spearman’s Rho) were conducted for sub-populations within the full sample, in order to examine potential contextual factors which may be influencing the operation of mechanisms within each hypothesised CMO-C, including demographic characteristics, socio-economic status and household type, as well as differences between the organisations. This analysis was carried out using the Wave 2 data, in order to provide a sufficient sample size at sub-population levels. All of the sub-populations defined in Table 5 above were tested in this analysis, but household type was simplified into households with children and those without, whilst the analysis based on household income categories is not presented here, as the small numbers of households outside the lowest income category makes comparison between income groups impossible. Most variables have very few missing values and analysis suggests that they are missing completely at random (with one exception highlighted in the findings), so pairwise exclusion was used. The Rent Deposit Schemes (RDS) are also excluded from the organisational breakdown analysis because the low numbers of participating tenants make it impossible to perform meaningful tests. RDS tenants are included in the other sub-population tests.

Examining outcome regularities across full sample

The data for both outcome variables indicates improvement in health and wellbeing across the first year of the tenancies. Figure  1 shows the data for tenants’ self-rated health and wellbeing change at Waves 2 and 3, showing a clear improvement at both time points.

Health and wellbeing change from start of tenancy

Figure  2 provides the data for change in tenants’ WHO5 score from the start of their tenancy to the Wave 2 and 3 time points. Footnote 1 Again, this data suggests that tenants’ wellbeing is improving over time in their new tenancy. A similar pattern can be seen for the tenants of each participant organisation when analysed separately.

Change in WHO5 wellbeing score from start of tenancy. Note:This data relates only to those tenants who completed their Wave 1 WHO5 questionnaire prior to moving in to their new tenancy

This overall picture of improving health and wellbeing by comparison with tenants’ prior situations suggests that there may be aspects of their new housing experience which are generating this change. The first stage of the data analysis examines the possible role of the hypothesised CMO-Cs by testing for correlations with related independent variables. A summary of this analysis is provided in Table  7 . The columns labelled ‘Wave 2′ and ‘Wave 3′ set out the results of the tests using the WHO5 index as the dependent variable, whilst those labelled ‘Wave 1–2′ and ‘Wave 1–3′ provide the results for tests using the variable for self-rated health and wellbeing change since the start of the tenancy.

These results provide patterns of ‘outcome regularities’ in the language of RE, which suggest a number of potential refinements to the CMOCs. For each hypothesised causal pathway, the presence or absence of significant correlations provides evidence as to whether the relevant mechanism may be operating, bearing in mind that the subsequent stage of the analysis may qualify these findings by considering the contextual factors involved.

Firstly, in terms of the experience of the property and housing service, there appears to be some support for Hypotheses 1 and 2. All the variables relating to these aspects of housing experience, with the exception of maintenance service satisfaction at Wave 2, show a significant correlation with health and wellbeing outcomes. In particular, the strength of the correlations in relation to change in health and wellbeing from Wave 1 to Wave 2 suggests the possibility of a causal connection which merits further investigation.

Secondly, the data relating to tenants’ self-rated financial coping shows that whilst overall financial coping is strongly correlated with wellbeing at Wave 2, this effect does not appear in between-wave analyses. Alongside this, there is no significant correlation between tenants’ self-rated ability to cope with paying their rent and their health and wellbeing, either within or across the Waves. This combination suggests that Hypothesis 3 is not supported by this data, since neither rent nor a change in housing situation affects health and wellbeing as measured in this study.

Thirdly, in terms of neighbourhood and social support, there is support for Hypothesis 4, since there are significant correlations between neighbourhood quality and the social support index, and health and wellbeing.

Whilst correlation does not imply causation, these patterns in the data provide indications of potential relationships which merit further investigation in order to understand whether causal mechanisms are involved and, if so, which contextual factors influence their operation.

Clearly care must also be taken in drawing conclusions about differences in correlations between the ‘static’ and ‘change’ tests, since the dependent variables measure somewhat different aspects of health and wellbeing. Nevertheless, variations in the significance level of the correlations across hypotheses suggests that it is the experience of the housing and the housing service relative to a tenant’s previous experiences, and not the current experience of the housing or service in itself, that may predict improvements in health and wellbeing. Conversely, the effects of neighbourhood quality and the availability of local social support appear to show the opposite pattern, in that current experience may predict changes in health and wellbeing outcomes, regardless of tenants’ previous housing situation(s).

The overall pattern of correlations at Wave 3 is very similar to that at Wave 2, although there appears to be some drop-off in terms of the strength of the relationships. This may be due to the smaller sample size at Wave 3 ( N  = 45), which inevitably limits the strength of possible correlations by comparison with Wave 2 ( N  = 75). Furthermore, given these relatively small sample sizes, there is a possibility that selection effects may be influencing the apparent differences between Wave 2 and Wave 3. To examine this possibility, the analysis was repeated across the two waves using data from only those tenants who had completed all three Waves. This analysis showed a very similar pattern of within-Wave correlations at Wave 2 to the analysis on the full sample. Moreover, tests for difference between the group of tenants who dropped out after Wave 2 and those who continued to Wave 3 on the independent and dependent variables, as well as demographic characteristics, show no significant difference between these two groups except for one – rating of neighbourhood quality at Wave 2 (2p = 0.04). Hence selection bias does not appear to affect the analysis outlined above to any great degree. Alongside this, the between-wave analysis in Table 7 appears to show an ‘adaptation effect’, whereby the impact of housing changes on health and wellbeing diminishes over time. However, the sub-sample analysis suggests that this apparent ‘adaptation effect’ may simply be an artefact of the smaller sample size at Wave 3. Within the sub-sample there are very limited changes in significance of correlations, suggesting that the data does not demonstrate an adaptation effect.

Exploring contextual factors

In order to explore the potential role of contextual factors in influencing the operation of the hypothesised mechanisms, the same bivariate tests were carried out on sub-populations, in order to identify potential differences in impact based on tenant characteristics and housing organisation. The analysis focuses on the change between Wave 1 and Wave 2, specifically to examine the short-term difference that a new tenancy and home with a new housing organisation makes to tenants’ health and wellbeing. Thus, the tests look for correlations between self-rated changes in health and wellbeing since the start of the tenancy and self-rated changes in various aspects of the housing experience. The outcome variable for all of the subsequent tables is therefore self-rated change in health and wellbeing. The one exception to this is overall satisfaction with the housing organisation, since this variable is not available at Wave 1. Many tenants did not have a ‘housing organisation’ at Wave 1, because they were either homeless or living with friends or family. Hence, for this test the ‘static’ variable of housing satisfaction at Wave 2 was used.

Hypothesis 1 – positive tenancy experience

Table  8 summarises the analysis by sub-population for the two key variables relating to overall tenancy experience: satisfaction with the housing organisation, and overall rental experience compared to previous experiences.

The key finding here is that the strongly significant correlations for the whole population of participants are largely reflected in the vast majority of sub-populations, for both variables. Whilst there are differences in the level of significance between sub-populations and some sub-populations which do not show a significant correlation on the overall renting experience variable, the differences in p values are small and may plausibly be explained by the smaller size of some of the sub-samples. Footnote 2 Hence tenancy experience, at least insofar as it is captured by satisfaction with the housing organisation and comparison with previous renting experiences, has a universal relationship with health and wellbeing across the different sub-populations of tenants in this study.

Hypothesis 2 – property quality

Table  9 summarises the analysis by sub-population for the two key variables relating to property quality: tenant rating of the overall condition of the property and satisfaction with the maintenance service.

Looking firstly at property quality, there are notable differences between sub-populations in terms of correlations between changes in property quality and changes in health and wellbeing. The data suggests that participants who are tenants of the Letting Agency, female, young, non-disabled, employed, not receiving Housing Benefit, with no children in the household and coming from the PRS are more likely to exhibit a correlation between change in property quality and change in their health and wellbeing. Some of these may be interconnected, inasmuch as the sub-populations are connected. For example, Letting Agency tenants are more likely to be employed, non-disabled and coming from the PRS than others in the sample. However, other characteristics, such as gender, are evenly distributed across the organisations.

Perhaps most interestingly, the data on rating of property quality at Wave 2 relative to Wave 1 does not show a significant difference between the organisations ( p  = 0.44 using Mann-Whitney U test), so it does not appear that these patterns are an artefact of differences in property standards between the housing providers in this study. That is, it appears that tenants of the Letting Agency are not more (or less) likely to be satisfied by the quality of their properties, but a change in the quality of their property is more likely to be accompanied by a change in their health and wellbeing. Further qualitative analysis is required to understand whether there is a causal link here and why this might be the case.

The patterns relating to satisfaction with maintenance are somewhat different, but again exhibit notable differences between sub-populations. Thus, participants who are tenants of the Housing Association, female, older, non-disabled, in receipt of Housing Benefit, with no children and coming from the PRS are more likely to show a correlation between change in their maintenance service satisfaction and change in their health and wellbeing. Again, some of these are likely to be related, thanks to overlaps between the sub-populations. It should be noted, however, that the data for this variable is more limited, since some tenants (e.g. those coming from the family home) did not have a maintenance service to rate at Wave 1 and others had no experience of the maintenance service in their new tenancy by Wave 2. Missing value analysis suggests that this particular variable may be somewhat biased as a result. Moreover, it could be argued that this variable is less closely related to this hypothesis than tenants’ rating of property quality, since the experience of maintenance services could also be connected to Hypothesis 1 as an element of the overall tenancy experience. Thus, any conclusions relating to the maintenance variable need to be particularly tentative.

Hypothesis 3 – affordability

As outlined earlier, the tests for the full sample show no significant correlations between changes in health and wellbeing and changes in either self-rated ability to cope with paying rent or to cope financially. Looking at the descriptive data for these variables, the lack of relationship between health and wellbeing and rent coping is perhaps unsurprising, given that more than 70% of participants show no change in their ability to cope with paying their rent. This likely reflects the number of tenants receiving full Housing Benefit, with 39% of the sample having their rent entirely covered.

The lack of correlation with change in self-rated health and wellbeing for the whole sample is mirrored in the sub-populations, with no correlations for change in rent coping for any sub-population except households with children (at the 5% level), and only the groups of employed or non-HB recipients showing a correlation with financial coping (also at the 5% level), as shown in Table  10 . This analysis therefore suggests that the overall picture of no significant relation between change in rent or financial coping and health and wellbeing is also present across the various sub-populations, with only very minor indications of variation between groups.

Hypothesis 4 – Neighbourhood and support networks

Table  11 summarises the analysis for the two key variables relating to neighbourhood quality and social support networks: tenant rating of the neighbourhood as a place to live and the index of social support indicators.

Whilst both variables are significantly correlated with a change in self-rated health and wellbeing change for the sample as a whole, the sub-population analysis reveals some differences. The correlations with neighbourhood quality are significant for Letting Agency tenants, whereas those with social support are significant for Housing Association tenants. These in turn seem to be reflected by the correlations in sub-populations split by disability, employment and Housing Benefit receipt, all of which are distributed unevenly across the organisations, as shown in Table 5 . Perhaps more interestingly, there are also differences between the sub-populations coming from different prior housing situations, which do not appear to reflect the differences between the organisations. Previously homeless tenants (who are more likely to be Housing Association tenants) show a significant correlation with neighbourhood quality whilst tenants coming from the PRS (who are more likely to be Letting Agency tenants) show a significant correlation with social support. For both variables there is a significant correlation for households without children, but not for those with children, which is perhaps counter-intuitive. It is somewhat difficult to hypothesise underlying reasons for these patterns of correlations from the quantitative data alone.

However, this analysis may be somewhat advanced by turning to more objective measures of neighbourhood quality. Data on the deprivation level of the areas that tenants have moved from (at Wave 1) and to (at Wave 2/3) shows that tenants’ rating of neighbourhood quality is not significantly correlated with the neighbourhood’s Scottish Index of Multiple Deprivation (SIMD) decile (2p = 0.6 using Spearman’s Rho). There is, however, a strongly significant correlation (2p = 0.001) between the Wave 1–2 change in tenants’ rating of neighbourhood quality and the change in SIMD decile. That is, tenants moving between areas with different levels of deprivation are more likely to describe a significant change in the quality of their neighbourhood than those who are moving between deprived areas. Thus, rating of neighbourhood quality appears to be a relative concept for tenants, likely based on a complex mixture of their neighbourhood history and expectations. In this context, it is worth noting the relatively limited degree of neighbourhood choice available to tenants in this study, given their predominantly low incomes. At Wave 1, 59% of tenants in this study were living in the most deprived SIMD quintile, whilst at Wave 2, 81% of tenants were in the most deprived quintile.

Picking apart these relationships between neighbourhood, social support and health and wellbeing clearly requires further investigation, since the patterns in the quantitative data are difficult to make sense of alone. Moreover, it seems plausible to suggest that these variables are particularly limited in terms of capturing the underlying mechanisms, since there are so many aspects of neighbourhood and social support which may be important for tenants, particularly given the probable interaction with previous housing experiences.

This analysis demonstrates that the health and wellbeing of participants in this study does appear to be affected by the change in subjective housing experience resulting from a move into a new tenancy. Moreover, where their new housing experience is positive, they are likely to describe improvements in health and wellbeing that are sustained, or even increased, over the first year. This evidence casts some doubt on notion of adaptation in the relationship between housing and wellbeing [ 27 ], although we acknowledge that longer-term data may show a different pattern.

Our analysis presents statistically significant relationships between a variety of aspects of the housing experience from tenants’ perspectives, and health and wellbeing outcomes. These enable us to identify which causal pathways are likely to be important in shaping health and wellbeing for different groups of low-income tenants in different contexts. By refining the CMO-Cs in this way, the analysis delineates a theoretical framework for ways in which less tangible aspects of housing experience can act as a social determinant of health and wellbeing. Whilst recognising that correlation is not causation and the nature of the independent variables only enables relatively broad refinements to the hypotheses, this additional specification of the causal pathways provides a strong basis for further research, particularly using qualitative data to examine the causal mechanisms involved.

This analysis suggests that tenants’ perceptions of the quality of service received from their housing provider may be an important determinant of health and wellbeing, supporting the hypothesis from the original ToC work that a version of CMO-C 1 is in operation. The results suggest that this is partly about the current service and partly about comparison with previous rental experiences, although there may be other factors which are not represented adequately by the available independent variables. This chimes with the findings from [ 26 ] that housing service satisfaction, as part of what they term ‘empowerment’, is correlated with wellbeing.

Importantly, this relationship appears to be near universal, showing significant correlations across tenants with different characteristics and backgrounds, suggesting that a positive renting experience, underpinned by a high-quality service, may be important for all tenants. It seems plausible to suggest that there may be a causal relationship here, possibly operating through mechanisms related to the sense of home that tenants can develop in a secure, stable tenancy with a housing organisation they trust to provide good service. When tenants feel that they are being treated well by their housing organisation and that their overall experience is better than previous situations, it is plausible that this will help to underpin their sense of control, autonomy and safety, with positive impacts on their wellbeing [ 13 , 24 ].

Whilst the importance of positive tenancy experience across all groups of tenants is perhaps unsurprising, this CMO-C also appears to be largely unaffected by the housing sector/organisation, suggesting that formal security of tenure may be less important as a contextual factor than might be expected, at least within the context of these organisations. Importantly, this extends the existing debate regarding the links between tenure, ontological security and wellbeing which has largely focused on the distinction between ownership and renting [ 17 , 18 , 24 , 25 , 27 ]. Just as more recent analyses have suggested that other aspects of security (e.g. financial) may be more important than ownership, so these findings suggest that aspects of the tenancy experience may be more important than the legal status of the tenancy Footnote 3 itself in some contexts, enabling tenants to feel secure and at home, with implications for health and wellbeing.

Table  12 below summarises these findings, illustrating how CMO-C 1 has been refined on the basis of this analysis.

The analysis suggests that the tenant experience of property quality may also be an important determinant of health and wellbeing, supporting the hypothesis that a version of CMO-C 2 is in operation. The existing evidence base demonstrates that physical housing quality is a determinant of health where there are negative factors, such as damp or cold, that directly damage health [ 4 , 6 , 7 ]. It may be the case that some of these issues are relevant within our sample, although there was little evidence of such issues during the face-to-face interviews at Waves 2 and 3 (to be presented in a later paper). Indeed, the variations between sub-populations suggest that there may be different mechanisms involved which relate to other aspects of property quality beyond the basic fabric of the building. Table  13 summarises these findings, illustrating how CMO-C 2 has been refined.

There is one particular aspect of the analysis of participant sub-populations for this pathway that merits further investigation. There is a significant correlation between tenants’ rating of property quality and health and wellbeing amongst Letting Agency tenants, but not Housing Association tenants, despite overall ratings of property quality between the two organisations not being significantly different (Pearson Chi-Square 2p = 0.3). Given the notion that home is a phenomenon of individual experience [ 12 ] it seems plausible to suggest that tenants’ previous experiences and personal preferences are likely to be important in shaping their reaction to different aspects of property quality. It is possible that tenants’ previous experiences and expectations vary systematically between tenants moving into to a Housing Association property and those moving into a Letting Agency property. These possibilities clearly need further examination.

Whilst the analysis for this hypothesis included tenants’ rating of maintenance services, there is a reasonable argument to suggest that this variable could fit equally well with Hypothesis 1, being at least as much about service as property quality. Indeed, there are strong correlations across the four housing variables, which suggest that these two hypotheses are closely related in tenants’ real world experiences.

Participants’ health and wellbeing is clearly correlated with their financial situation, as would be expected given the crucial role of income as a social determinant of health [ 2 , 3 ]. However, these findings suggest that, for tenants in this study, there is a limited impact on health and wellbeing arising from rent levels. This is likely due to the particular housing market context in which this study was located, whereby the majority of rents were within Local Housing Allowance Footnote 4 rates and, therefore, were either covered by Housing Benefit (for those on very low incomes) or were affordable to those in work. Amongst the three-fifths of participants who did not receive full Housing Benefit, 80% indicated that they could cope with paying their rent ‘all of the time’. Hence CMO-C 3 does not seem to be operating, at least in relation to rent payments, in this context. The hypothesis is therefore not presented here, since the lack of variation in this central element of affordable housing does not facilitate testing or refinement of the CMO-C, even though it may operate in different housing market contexts.

Nevertheless, the evidence regarding (admittedly, small) changes in tenants’ self-rated financial coping between Waves 1 and 2 suggests that there may be other aspects of finance around tenancy transitions which merit further exploration. Indeed, the strength of the correlations between overall financial coping and the WHO5 wellbeing scores suggests that any impact of housing on tenants’ financial situation has the potential to generate significant changes in wellbeing. Again, further exploration is required of precisely which aspects of tenants’ financial lives, particularly around moving home, underlie this impact on health and wellbeing.

Our analysis suggests that both neighbourhood quality and social support networks may be important determinants of health and wellbeing, as hypothesised in CMO-C 4. However, there appear to be notable differences in terms of which tenants exhibit significant correlations between health and wellbeing and each of these two aspects of the wider environment around housing. Understanding the needs and aspirations of different groups of tenants, including how these might align with demographic and other characteristics, are important in further analysis of the qualitative data from this study. This is particularly the case given the markedly different opportunities that Letting Agents and Community-Based Housing Associations have to enable choice of area for tenants, or to make changes to the area in which their properties are located. Table  14 summarises these findings, illustrating how CMO-C 4 has been refined.

The complex patterns revealed in this analysis and the number of factors which potentially underlie the independent variables relating to neighbourhood quality and social support suggest that more evidence is required to draw firm conclusions regarding this possible causal pathway. Indeed, it would be reasonable to suggest that CMO-C 4 might be more accurately conceptualised as at least two separate pathways, since there appears to be something of a divergence in the data patterns related to neighbourhood quality and social support between different groups of tenants. Hence, whilst the experience of a good service from a housing provider may be important for all tenants to gain health and wellbeing benefits, other aspects of the housing experience and its connection to a sense of home, such as the connection between the dwelling and personal relationships [ 13 ] may be more varied between individuals.

Strengths and limitations

The key strength of this research lies in the longitudinal approach, offering an insight into change within individual respondents and the causal dynamics at play. Combining the longitudinal aspect of the study with a realist approach has enabled us to develop a nuanced picture of the health and wellbeing impacts of less tangible aspects of the housing experience.

Limitations of the study include the relatively small sample size and the possibility that the longitudinal approach may have excluded those tenants with less stable housing pathways, although comparison of the participant sample with the wider tenant group suggests minimal difference and therefore limited selection bias. A larger sample size at Wave 3 would also have helped to explore whether the patterns visible at Wave 2 continue over a longer timescale. Further study with a larger group of tenants would be of value in exploring these issues further.

The use of self-rated measures of health and wellbeing could also be seen as a limitation, although using more objective measures of health would likely require a longer timescale, potentially exacerbating participant retention issues. The research was also conducted in one geographical area, so the findings need to be interpreted in the context of the specific housing policy and market context of west central Scotland. Moreover, whilst this study deliberately utilised general outcome measures to capture impact, further research would be of value using a range of more specific outcomes measures to examine differential effects within the broad concept of health and wellbeing.

The basic human need for a home that provides more than simply shelter from the elements [ 12 ] underpins the need to understand the relationships between housing, health and wellbeing in ways that go beyond obvious problems such as damp and cold. Our analysis provides an important addition to the theoretical understanding of at least three potential causal pathways through which housing may affect health and wellbeing. Firstly, a positive tenancy experience, shaped at least in part by relationships with the housing provider is strongly correlated with health and wellbeing for all tenants, regardless of demographic characteristics or background. Secondly, aspects of the tenant experience of housing quality in addition to the basics of weatherproofing seem to be important for some tenants, in ways that are likely to be influenced by previous housing experience and current expectations. Thirdly, elements of neighbourhood quality and social support in the local area may have impacts on health and wellbeing, although with considerable variation between different groups of tenants. It may also be the case that affordability has an effect on health and wellbeing, but interestingly it appears to be relatively marginal within the particular housing market context for this study. Whilst some caution needs to be exercised in interpreting these refined CMO-Cs, given the relatively small sample size on which they are based, the longitudinal nature of the data does provide a significant insight into the patterns of change over the first year of participants’ tenancies and the potential causes for the notable improvements in health and wellbeing. The refined CMO-Cs are summarised in Fig.  3 . The original CMO-C relating to affordability is included with dotted lines, to indicate its potential applicability in other housing markets.

Summary of refined CMO-Cs. Note: Dotted line indicates that this CMOC is not evidenced here, but may be applicable in other housing markets

Taken together, these CMO-Cs offer an empirically-informed realist theoretical framework for causal pathways connecting housing to health and wellbeing. This framework provides a lens through which to examine and potentially improve practice within housing organisations and housing policy, highlighting the ways in which aspects of housing service can operate as a public health intervention in the lives of tenants. Moreover, the framework offers a basis for more research to further refine and test these causal pathways. As Pawson [ 31 , 32 , 53 ] has consistently argued, realist evaluation and research needs to operate in a cyclical fashion, continually examining and improving theoretical models on the basis of empirical evidence to enrich our understanding of causal mechanisms, rather than developing spurious generalisations [ 54 ]. Analysis of the qualitative data from this study (forthcoming) will help to delineate the mechanisms within the framework more accurately and to examine the contextual factors in more detail, whilst other studies may also explore the role of these causal pathways in different contexts.

Availability of data and materials

The datasets generated and analysed during the current study are available in the University of Stirling’s DataSTORRE repository, http://hdl.handle.net/11667/142

‘Significant’ change in the WHO-5 scale is considered to be 10 points when the raw score is scaled to create an index of 0–100 (Topp et al., 2015).

Additional chi-square tests were conducted to check against these correlations. Again, the results need to be interpreted tentatively given the sample size, but these tests suggest a similar pattern.

Note that the research took place before the introduction of the new Private Residential Tenancy in Scotland, which removes the time limit on PRS tenancies.

Local Housing Allowance is the name given to Housing Benefit for tenants in the PRS. It is limited to the 30th percentile of local rents.

Abbreviations

Context-Mechanism-Outcome configuration

Private Rented Sector

Rent Deposit Scheme(s)

Realist Evaluation

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Acknowledgements

The authors would like to thank all of the tenants and staff of the participant organisations who participated in the study and/or helped with the research.

This work was supported by the Economic and Social Research Council and the Medical Research Council under Programme Grant Number MR/L0032827/1. The funder agreed the outline for the study as part of the larger programme, but had no direct involvement the detailed design of the research, or in collection, analysis and interpretation of data, or in writing the manuscript.

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SR analysed the data and was the primary author of the manuscript. LG was a major contributor in writing the manuscript. JG contributed to the analysis and assisted with writing the findings. IA, PS and CD were all involved in planning the project and overseeing the research. All authors read and approved the final manuscript.

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Rolfe, S., Garnham, L., Godwin, J. et al. Housing as a social determinant of health and wellbeing: developing an empirically-informed realist theoretical framework. BMC Public Health 20 , 1138 (2020). https://doi.org/10.1186/s12889-020-09224-0

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Affordable housing for low-income households is still a serious social problem, and social housing can support the achievement of the objectives of economic feasibility, fairness, and social sustainability.

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An interdisciplinary debate on project perspectives

• Research article
• Open access
• Published: 07 December 2020

Sustainable housing development: role and significance of satisfaction aspect

• Iman Abdelshahid Ibrahim 1  

City, Territory and Architecture volume  7 , Article number:  21 ( 2020 ) Cite this article

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Providing quality public housing is one of the main goals of the United Arab Emirates (UAE) government. This paper assesses the level of satisfaction with public housing offered by the UAE government to its citizens based on the physical characteristics and traditional social aspects of the housing unit, urban design, and social environment in the residential area, whereas also their contribution to the residents' life quality under overall satisfaction with the place of living. At the same time, the study provides access to sustainability measurements applied at both the environmental and social levels within the Estidama accredited national rating system. The survey results of two residential complexes in Abu Dhabi show that the majority of residents are mostly satisfied, although the overall level of satisfaction with the functionality of the building and public facilities provided was generally higher than that related to the social environment in the residential district. The research focused on the application of new technologies that increase the level of sustainability in future housing projects.

Introduction

Housing improvement is one of the most important sectors of the economy, which ensures the prosperity of urban development and sustainability (Rahman et al. 2018 ). The variety of design solutions and innovative technologies incited a lot of challenges in the quality of accommodation and satisfaction of residents. Often, designers strive to maintain the aesthetics of housing appearances and neglect the actual needs of clients (Lopez 2010 ). Compared to commercial buildings, the residential design must correspond to day-to-day concerns of people's lives and address problems related to their life experience and ambience (Anderson 2016 ). Besides, due to excessive energy consumption, housing construction must be sustained (Roufechaei et al. 2014 ). Thus, for successful sustainable housing development, an optimal balance between sustainable housing and customer satisfaction is required (Chan and Adabre 2019 ).

In the Middle East, the United Arab Emirates (UAE) strives to consistently develop the urban construction industry through the creation of sustainable cities using innovative technologies that would be consistent with overall state expansion and growth over the years. To this effect, green building norms and regulations have been introduced in Abu Dhabi and Dubai, such as the national Estidama Pearl program, which was launched in 2010 by the Department of Urban Planning and Municipalities in Abu Dhabi (Awadh 2017 ). This program includes a Pearl Rating System (PRS), which ensures the sustainability of housing throughout its life cycle from design to construction and operation (Alobaidi et al. 2015 ). The rating system with a scale from 1 to 5 Pearl focuses on the construction of residential buildings and villas to the different individual requirements to improve the sustainability of the built-up environment. The developed requirements should contribute to minimizing water and energy consumption, improving waste recycling, and using local environmentally friendly materials for construction. The design of buildings must meet a minimum rating of 1 (Pearl 1) and, for public housing, this minimum is 2 (Pearl 2).

In the UAE, much attention and funding are given to the development of public or social housing. At present, the Ministry of Public Works and Housing and Sheikh Zayed's Housing Program, as well as local social housing agencies, are dealing with the problems of providing state accommodation (Ahmed 2017 ). The goal of these federal organizations is to provide decent housing with a large number of subsidies that meets the requirements of all citizens and is aimed at building entire neighbourhoods following the principles of traditional, functional, and autonomous models of urban sub districts (Patricios 2002 ). In Abu Dhabi, such projects as Ain Al Faydah, Watani, Jebel Hafeet, Al Falah, and others have been developed and implemented through support from government investments.

These complexes are residential neighbourhoods consisting of villas and houses and related administrative and commercial buildings, mosques, schools, and parks. These properties have been designed following the traditional planning of sub districts and villages in mind. The main task in the design was to combine conventional architecture and innovative technologies through an optimal balance. The results of a study on sustainable social housing in the city of Al Ain (Ahmed 2017 ) showed that traditional principles of neighbourhood planning and design are less effective for residents as local communities may have different cultural and social development needs. According to the author of the article, it is community residents who can regulate the sustainability of urban forms by giving preference to one tendency over another.

The purpose of this study was to assess the level of satisfaction with public accommodation facilities offered by the UAE government to citizens based on the physical characteristics and traditional social aspects of the housing unit, urban design, and social environment in the residential area, whereas also their contribution to residents' life based on general social and cultural satisfaction with housing. For this purpose, the following research objectives should be fulfilled:

To assess the level of satisfaction of UAE citizens and sustainability parameters in residential models and housing complexes in the state housing stock;

To evaluate the application of environmental, social, and economic sustainability in public housing construction and its compatibility with the social needs of citizens considering the culture of the Emirates;

To determine the sustainability assessment system for public housing construction, Estidama, and how it fits the nature of the project;

To evaluate the community's ability to apply the post-settlement evaluation to housing estates and the extent to which the program interacts with the evaluation to achieve the best possible outcome.

The analytical assessment of residential complexes in terms of environmental, social, and economic sustainability can enable setting particular standards in design that should be followed in new projects to ensure increased sustainability. Besides, it allows developing recommendations for future projects to be followed for a higher level of residential conditions in the state housing stock through sustainability evaluation.

Literature review

As stated above, in projecting housing complexes, the housing design should represent social, aesthetic, and environmental concepts and include all elements for creating an interior space that would satisfy the lifestyle of people or community (Dohr and Portillo 2011 ). Satisfaction with residency is one of the most important aspects that affect the quality of life (Walton et al. 2008 ) and the very behaviour of people in living spaces (Sakip et al. 2012 ). The satisfaction of residents is based on personal qualities (cognitive, emotional, or behavioural characteristics) and social characteristics of the living environment (Mohit and Nazyddah 2011 ). Thus, social, economic, and environmental aspects of housing design should be considered in order to achieve maximum effect (Ali 2010 ; Karji et al. 2019 ). It can be achieved by respecting the cultural, psychological, physiological, financial, and historical characteristics and preferences of residents or the community.

However, along with satisfying these basic needs of residents, other aspects such as security and social status are also highly relevant. According to Shach-Pinsly ( 2019 ), in urban areas that are free from crimes and strife, people feel safer when interacting with others, resulting in increased trust and reciprocity among residents and enhanced feelings of community and belonging. Besides, these social interactions in a community build good relations between residents (Hussein 2019 ) and a sense of pride in belonging to that community (Kohon 2018 ). Another important aspects are the identity and comfort of urban life through environmental design and developed infrastructure (Shawket 2018 ).

Nowadays, in addressing the issue of upgrading the life quality, a healthy environment is given more priority by improving socio-economic and environmental conditions for present and future generations (Dizdaroglu and Yigitcanlar 2016 ). Sustainable development is about meeting human needs and improving their quality of life by minimizing the negative impact on the environment (Ingrao et al. 2018 ; Ioppolo et al. 2019 ). Since public places in neighbourhoods are designed for communication and recreation, the well-being of their residents can also serve as an indicator of satisfaction with the urban surrounding and a better quality of life (Van Kamp et al. 2003 ). These places include playgrounds for children, parks, walking trails, monuments, and architectural structures. According to Saiedlue et al. ( 2015 ), the presence of water elements (lakes, fountains) and the abundance of green spaces are fundamental to increasing satisfaction through refreshing and purifying the environment and, thus, providing significant health benefits to residents.

In addition to the environmental and social components of living satisfaction, the development of infrastructure and economic factors are also of high importance. A sense of identity, belonging, and comfortable city life arises from such elements in urban design as points of key services used by residents regularly (Dempsey et al. 2011 ). The latter include doctors and post offices, banks, supermarkets or stores on the corner, schools, preschool facilities, libraries, sport and entertainment complexes, restaurants and cafes, community centers, and others. All of these elements preferably must be located in places equally accessible to residents and guests. Besides, the transport interchange should meet the needs of all participants (pedestrians, cyclists, and car drivers), whereas also the availability of entrances for people with physical disabilities and various types of municipal transport should be on a high level.

Thus, to study the impact of various aspects on the residency comfort is necessary for a better understanding of what initiatives to be taken to improve the sustainability parameters in residential models and complexes of the state housing stock. The paper (Liu 2003 ) presents the results of assessing the quality of housing projects by estimating the level of satisfaction of residents. It was shown that despite the observance of technical and engineering aspects in the development of large housing complexes, more success of the project is expected with the cooperation and coordination between designers and other parties involved (Liu 2003 ; Lee and Park 2010 ; Mohit and Nazyddah 2011 ). Ultimately, each residential project is implemented for accommodation, and, therefore, a dialogue between the parties is important in the design process as it allows for a proper understanding of the political and social responsibility of the state (Liu et al. 2011 ; Lichtenstein et al. 2013 ).

Besides, the assessment of the final housing option provides important information on the degree of satisfaction with the needs, demands, and expectations of residents (Wongbumru and Dewancker 2016 ). Also, the study (Teck-Hong 2012 ) demonstrates how demographic and socio-economic factors influence the level of satisfaction. For example, older people are usually more enjoy their household than young ones (Wagner et al. 2010 ), homeowners are more gratified than apartment owners (Al‐Momani 2000 ), and also the fact ownership and rent can affect the level of satisfaction (Riazi and Emami 2018 ). All of the above-mentioned factors and characteristics are accounted for in developing a conceptual model for satisfaction assessment, and some aspects are taken as units of measure. The following section discusses the elements that will be used to measure the satisfaction degree. They also form the basis for the development of a data collection tool.

Materials and methods

Case study area.

This research is devoted to studying the level of satisfaction with the principles of sustainable urban development on the example of two public housing districts of the UAE, located in the Emirate of Abu Dhabi. The first site of Al Ain Faydah is located in Al Ain city near mount Jebel Hafeet. It covers an area of 4.12 million m 2 and contains 2000 villas with entertainment, educational, and cultural facilities integrated into the development (Fig.  1 ).

A master plan depiction (on the top) (Plan Al Ain… 2015 ) and a picture from GoogleMaps of the implemented project (on the bottom) of Al Ain Faydah, Al Ain, Abu Dhabi

This project is aimed at recreating the community of Faridj (traditional region of the Emirates), where villas are grouped around a common open space. The architectural design of the facades applied to the Spanish and Mediterranean style (Fig.  2 ). Each villa with a total area of 382 m 2 contains five bedrooms, a maid's room, a living and dining room, a Majlis, a kitchen, a laundry room, and bathrooms. More than 12,000 residents can reside in this complex. The first phase of construction according to the general plan (Fig.  1 ) was fully implemented and the project was introduced into operation in 2015 (Plan Al Ain… 2015 ).

Al Ain Faydah district of the UAE Public Housing Fund

The Al Watani housing complex located in Khalifa City A in the Emirate of Abu Dhabi was chosen as the next object for research (Fig.  3 ). It covers a total area of 1.85 million square meters and offers 1.390 villas and 50 houses with 2.500 apartments to satisfy local housing needs. The project represents a complex configuration of public facilities supported by an appropriate infrastructure that includes schools, stores, and public open spaces to establish communication centers and local meetings.

A masterplan depiction (on the left) (Watani Housing Project 2015 ) and Google Maps picture of the implemented part of the project Al Watani, Khalifa City A, Abu Dhabi (on the rights)

As follows from Fig.  3 , only the first stage of this project has been completed, and 400 villas were commissioned in 2015. The design of each villa is in the style of traditional architecture, which perfectly matches modern design tendencies through modern materials and technology (Fig.  4 ).

The Al Watani district of the UAE public housing fund

The total area of each villa is 405 m 2 , which includes four or five bedrooms, a Majlis, a kitchen, bathrooms, garages, maids’ facilities, and other necessities for the average Emirati family (Watani Housing Project 2015 ).

Concept model of measuring the satisfaction level

Figure  5 presents a schematic representation of the conceptual model for assessing the level of satisfaction in residents, which includes four different influencing factors and parameters. According to Ogu ( 2002 ), it implies the satisfaction with the design and architecture of the house (1), the functionality of the house (2), the level of accessibility (3), and the district location and community (4). These parameters include expectations, socio-economic dynamics, and demographic data.

Schematic representation of the residency satisfaction measurement model

Each factor has a particular designation. For example, the first factor includes the degree of satisfaction with the physical attributes of the house, such as the architecture of the building, the selected design, and interior content, i.e., the layout, number, and size of rooms, the presence of terraces, gardens, or green areas, etc. The second factor (functionality of the house) is the degree of satisfaction with the performance of the house components like windows, doors, roof, floor, wall thickness, noise insulation, the location of water and air conditioning communications, ventilation and air filtration, etc. Thus, these two factors are attributed to the satisfaction of the basic physiological and emotional needs of residents. The remaining factors are related to socio-economic aspects.

Also, the accessibility factor in a broader sense refers to the level of satisfaction with the availability of necessary services, namely, school, garden, clinic, stores, sports grounds or health centers, public places and mosques, etc. This factor may also include traffic interchange and the availability of municipal transport. The last satisfaction factor refers to the affiliation to a particular location and community, as well as the level of technical service. Attributes here are public places, street conditions, lighting levels, roads and sidewalks, population density and traffic congestion, etc. All these designations were used in the development of questionnaires to fully measure and comprehensively analyze the level of satisfaction with residency in public housing, and identify negative factors that can be addressed in future projects.

Questionnaire development and data collection

Based on the conceptual model of satisfaction measures described above, a comprehensive questionnaire was developed to determine socio-economic and physical characteristics, environmental parameters, and other key variables. A total of 26 variables were selected, and 26 questions were compiled, which included open questions and those to be assessed on a five-point Likert scale or the Guttman scale. The open question assumes a free answer for the respondent to identify their attitude towards the problem at hand and to collect their opinions on the project, suggestions for improving the current conditions to increase the number of variables in future questionnaires, whereas also new parameters and problems related to housing. Since the satisfaction level was measured using these scales, descriptors were developed for the Likert scale to consider extreme, moderate, and neutral responses such as ‘very dissatisfied’, ‘dissatisfied’, ‘neutral’, ‘satisfied’, and ‘very satisfied’.

Questionnaires were developed and polled via social media networks in special groups created for residents in particular applications. The survey was also sent to email addresses of those respondents, who were not registered in any of the social media networks. The proposed questionnaire is presented in Appendix A . In total, the survey was attended by 746 participants, of which 544 were residents of Al Ain Faydah and 202 of Al Watani residential complexes. Since in these housing areas include a total of 17,000 residents, a population sample of 10% was sufficient to obtain an adequate estimate for the survey (Higley 2008 ). The responses were collected over 2 months (2019 October–November).

Data processing techniques

The survey results were entered into the database and processed using the SPSS Statistics software package. The Likert scale values for each factor were used to calculate the Z-point index following the formula:

where n is the value of the factor from 1 to 4 points, j is the ordinal number of the respondent (from 1 to 746), Y i is the observed evaluation of each house for n factor, ỹ n is the average distribution for n factor, and S n is the standard deviation of n factor for all residents. When calculating the Z index, residents were grouped into satisfaction categories based on standard deviation (SD). The Z-values for each home represents the degree of satisfaction relative to all residents participating in the survey (Table 1 ).

The data presented in the table demonstrate that tenants with negative Z-values are classified as unsatisfied, while those with positive Z-values are considered satisfied. The Z-values in the middle of the distribution is classified as moderately satisfactory and associated with some uncertainty. Thus, the value can turn negative if the housing conditions worsen, otherwise, the Z-value remains positive. In addition to (Z) indicator, a satisfaction index (IS) was introduced, which is expressed as a percentage of the maximum score given by the resident for each factor.

These factors, in turn, were subdivided into satisfaction categories. As with Z-index, the IS-index has five categories: very low (20–34%), low (35–49%), medium (50–64%), high (65–79%), and very high (80–100%). In calculations, each point on the Likert scale was multiplied by 20 (Watani Housing Project 2015 ). As illustrated, the satisfaction index varies between 20 and 100%, where the average value corresponds to 60%. Thus, scores above 60% suggest an area of medium/high satisfaction level, and the level below 60% indicates an area of medium/low satisfaction. Percentage ranges of satisfaction will be used in the analysis. The second indicator of satisfaction efficiency was the variable index ( I v ), which determines the extent to which each variable affects the level of satisfaction among residents and is calculated as follows (Watani Housing Project 2015 ):

where y t is an estimate for variable t for n factor. Four classification types of satisfaction levels were chosen for I v , which correspond to the following ranges: positive (70–100%), moderately positive (60–69%), moderately negative (50–59%), and negative (20–49%).

Given the fact that overall satisfaction is not considered a simple variable, the combination of satisfaction index variables corresponding to factors 1–4 (Fig.  5 ) is assumed to provide a more reliable assessment of overall satisfaction. Thus, the overall satisfaction index will be calculated as an average of four factors. A comparative and qualitative analysis was performed for these two projects. Also, the values of the Estidama Pearl rating system and the satisfaction level accepted for this project were compared with the data obtained for the described projects.

Building ratings according to Estidama Pearl Rating System are assigned as follows: 1 Pearl (20 mandatory conditions), 2 Pearls (20 mandatory conditions + 60 credit points), 3 Pearls (20 mandatory conditions + 85 credit points), 4 Pearls (20 mandatory conditions + 115 credit points), and 5 Pearls (20 mandatory conditions + 140 credit points). In the Pearl Building Rating System (PBRS) v1.0, eight credit categories with a maximum of 180 points (Abu Dhabi and urban planning council 2010 ) are available, which are depicted in Fig.  6 .

Maximum credit points and mandatory conditions for each category in Estidama PBRS V1.0 program (Abu Dhabi and urban planning council 2010 )

Mandatory loans must be fulfilled by each project applying for Pearl 1 rating. As follows from above, all state-funded projects should be rated with 2 Pearl, and, therefore, 60 additional points should be added to the mandatory requirements. These points can be achieved through the use of innovative technologies, circular water supply systems, renewable energy, waste minimization, etc. Therefore, tracking the impact of the rating program used on the level of satisfaction in residents and the quality of their life is of high importance.

Results and discussion

Survey processing results showed that 85% of the respondents were working people. Besides, statistical analysis of the demographic situation in the surveyed areas has good dynamics towards increasing the number of residents (Fig.  7 ).

Results of a demographic study of the Al-Ain Faydah residential area

As follows from Fig.  7 , the average number of family members living in a villa is 5–6 people, including 2–3 children on average, which is quite suitable for the living area of the villa. According to the analysis results, the average age of children living in these complexes was 5–7 years, which indicates that the surveyed tenants are quite young. Analysis of demographic data for the Watani complex showed similar results. Thus, these results indicate an emerging need for public places and educational institutions for children within the complex. The overall level of satisfaction per capita is shown in Fig.  8 .

The overall level of satisfaction in residents of Al Ain Faydah and Al Watani housing complexes measured based on the total number of surveyed residents

Hence, 41.8% of Al Ain Faydah complex residents consider their overall satisfaction to be high and medium. Nearly similar indicators were obtained in the survey of the Al Watani residential complex, where 40% of residents estimate their level of satisfaction to be medium and high. Besides, indicators of the low and very high levels of satisfaction are almost the same, which indicates the same percentage of the very satisfied and dissatisfied population (10–12%). However, the lowest level of extreme dissatisfaction was the most surprising amounting to less than 5%. These results show positive feedback as satisfaction with living conditions in state complexes, which indicates the right direction of state housing programs development and the application of the Estidama rating system. The results of the variable index analysis for each factor are shown in Fig.  9 .

Satisfaction variables for factors 1–4 per capita in public housing complexes of Al Ain Faydah and Al Watani

The analysis results show that the satisfaction levels relative to the variables for each factor correspond to moderate positive and negative levels in equal degrees. The maximum number of residents of Al Ain Faydah (61%) consider the functionality of the house as a moderately positive, i.e., the layout, choice of materials, water supply, and comfortable location of internal communications. Also, 38–47% of residents refer to other factors that influence satisfaction. Thus, almost half of the interrogated residents of the Al Ain Faydah are moderately satisfied with their living conditions (60–69% satisfaction index), which is in good agreement with indicators of overall satisfaction level (Fig.  8 ).

Slightly less of the interrogated residents (26–35%) have a moderately negative attitude to living in this complex, which corresponds to the average satisfaction level presented in Fig.  7 . Besides, the same percentage of residents (11–12%) have an extremely negative attitude towards the location and community. Based on the data obtained for the Al Ain Faydah project, the satisfaction level is more influenced by the factors of functionality and design of the house, i.e., meeting the physiological needs and environmental parameters, as compared to socio-economic parameters, which correspond to higher levels of unsatisfaction. This may be due to the location of villas relative to each other and the territorial location of public and entertainment places. Also, some residents noted their dissatisfaction with the noise and the resulting garbage near their homes due to the renovation works of nearby villas, which is a significant issue in new areas.

The analysis results of the Al Watani residents' poll showed that they estimate this complex as moderately negative and moderately positive depending on the factor. The maximum number of residents (41.4%) expressed moderately negative satisfaction (50–59%) in terms of the district location and community. Such high values of dissatisfaction may be due to the incompletion of the project, where most of the territory is still under construction. Besides, many priority service delivery points specified in the project have not been completed yet. However, 37–39% of residents are quite satisfied with the design, functionality, accessibility, and location of the houses.

It may also be noted that 18% of the population is 70–100% satisfied with the functionality of the houses, which plays a key role as in the case of Al Ain Faydah complex. Among negative indicators, 17–18% of residents are not satisfied with the design of houses and the availability of public spaces. As mentioned earlier, this complex has been maintained in a traditional style and has a smaller open space area, and the curvature of the streets may contribute to some sense of discomfort and constraint individual space. The assessment results obtained for the Al Watani complex show that the developed housing project is moderately satisfactory for living from the point of view of residents, which is a positive characteristic for further construction.

As for the analysis of how each factor and variable affects the level of satisfaction individually, most of the interviewed population were more satisfied (> 70%) with the design and layout and level of security, as well as the presence of spacious rooms that give a sense of comfort and privacy. A larger number of respondents gave high scores on questions about feeling of comfort and time in their home, indicating a high degree of satisfaction with physiological and psychological needs. These factors are mandatory requirements in the Estidama program, which fully meet the expectations of residents. In terms of architecture and functionality of houses, the study showed that 49–60% of residents are highly satisfied with the overall condition of their house. The majority of respondents (80%) answered negatively to the question about the modification of the house, which indicates a multifaceted approach to the physiological and aesthetic characteristics of living. Besides, residents gave more positive answers to the rational design of the roof and windows, which led to the rare use of tight curtains and the ability to air the room naturally in good weather.

The factor of accessibility corresponded to a moderate level of satisfaction according to the opinion of 40–42% of residents. This level is associated with complicated access to medical facilities and safety in public places. Most respondents gave low scores to these questions. However, other variables that relate to green areas, children's playgrounds, and sports grounds were estimated with high scores. Given the presence of 2–3 children in each home, this need for separation and the physical health of children was met to a high degree. In terms of access to schools, the respondents' opinions differed greatly, which disabled the determination of the satisfaction tendency.

Most respondents indicated that they were generally satisfied with the quality of life in these complexes. Residents appreciated the location and layout of their villas, as well as the large area of parks and green spaces. Poor salt isolation in some buildings in the Al Watani and a road junction in the settlement were mentioned as negative aspects. Concerning the Al Ain Faydah, respondents noted the distance from the city's business center, which takes time to travel to work, and the lack of entertainment and recreational areas. Residents also pointed out that they were very satisfied with their neighbors in terms of their relations, sympathy, and confidentiality.

The results of a survey of residents' satisfaction showed that government housing projects can be considered an acceptable place for a comfortable life with a high and average level of satisfaction, which fully meets the needs in terms of physiological, social, economic, and environmental characteristics. Assessment scales from Abu Dhabi and urban planning council ( 2010 ) were used to calculate the approximate Estidama rating indicators for these housing complexes. The results of a rough estimation on the proposed scales in the Estidama PBRS V1.0 program showed that both complexes are gaining enough additional credits (above 60) to obtain the Pearl 2 rating. The percentage of points on the proposed categories is shown in Fig.  10 .

The percentage ratio of credit points according to Estidama PBRS V1.0 for the studied state housing complexes

The figure depicts how categories of residential buildings, resource energy, materials management including application of environmentally friendly substances in construction and internal works, and the use of energy-efficient technologies with lower emissions of harmful substances influence the rating level. Besides, another important aspect is the use of local, secondary, and biodegradable materials in construction and decoration, as well as waste management and its sorting. Valuable water management greatly contributes to the rating points as well.

According to the master plan, these complexes are equipped with systems to reduce water consumption and sensors on internal and external facilities to control water flow and leakages. Thus, roughly assessing housing against the rating system, it can be characterized as a fairly accurate complex for sustainable housing development. However, this assessment does not guarantee that all conditions at all stages of construction will be met, as it depends on many factors, including the choice of contractors and technological solutions. Nevertheless, for the complexes under study where people live, this system has fully met its expectations, which affects the level of satisfaction of residents with public housing.

Findings obtained in the course of research agree with the results of other works. Thus, the paper (Howley et al. 2009 ; Buys and Miller 2012 ) modeled and quantitatively and qualitatively evaluated the relationship between residence density and satisfaction with the neighbourhood in central city districts. The study shows that a high density of residents has a negative impact on the level of satisfaction and is also related to the quality of the environment, noise level, traffic density, as well as the lack of public participation and necessary services and facilities. All these negative factors were considered when designing facilities studied in this paper.

Examination of the impact caused by socio-environmental factors on community satisfaction in different districts of Delhi (Karuppannan and Sivam 2011 ) showed that it becomes higher when houses are placed around a public place or common open space. The provision of well-located open spaces and good access to public infrastructure play a crucial role in increasing urban sustainability, which is taken into account in the Estidama rating system. Similar results were obtained in the works (Winston 2017 ; Al Shawabke et al. 2020 ).

Conclusions

This study assesses the level of satisfaction with public housing offered by the UAE government to citizens, by the physical characteristics and traditional social aspects of the housing unit, urban design, and social environment in the residential area, whereas also their contribution to overall satisfaction, on the example of two completed government projects in Abu Dhabi, namely, Al Faydah and Al Watani.

According to the research results, the following conclusions can be drawn:

The overall level of satisfaction of residents in these complexes was estimated as high and average. A study of various influencing factors shows that the satisfaction level of 40–60% of residents is most affected by the good performance of the housing, its layout, and interior decoration. The lowest satisfaction rate of 11–12% was established for the factor of accessibility and the location of the building in the complex.

The state housing projects in the UAE can be considered as acceptable for the comfortable life of residents with a high and average level of satisfaction, which fully meets the needs in terms of physiological, social, economic, and environmental characteristics.

The application of the Estidama rating system for public housing construction fully meets the requirements and the expectations of residents although it requires control over each stage of work.

The results obtained are of great scientific significance and can be used in future research efforts.

Availability of data and materials

Data will be available on request.

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Housing interventions for emerging adults experiencing homelessness: A scoping review

Sara semborski.

1 University of Southern California

Brian Redline

Danielle madden, theresa granger, benjamin henwood.

Sara Semborski: Conceptualization; Methodology; Formal analysis; Visualization; Writing – Review & Editing

Brian Redline: Conceptualization; Methodology; Software; Formal analysis; Visualization; Writing – Review & Editing; Project administration

Danielle Madden: Methodology; Formal analysis; Data curation; Writing – Review & Editing

Theresa Granger: Conceptualization; Methodology; Formal analysis; Validation; Supervision; Writing – Review & Editing

Benjamin Henwood: Conceptualization; Methodology; Formal analysis; Supervision; Funding acquisition; Writing – Review & Editing

Associated Data

Introduction..

This review aims to identify and synthesize literature focused on housing interventions for young adults experiencing homelessness.

Following a five-stage approach to scoping reviews, a computerized search was conducted between February 4–8, 2019 to include peer-reviewed articles from a total of eight electronic databases: PsychINFO, Google Scholar, PubMed, Web of Science, Social Work Abstracts, Cochrane, Clinicaltrials.gov , and CINAHL. The search was limited to include literature published between January 1, 1987 and December 31, 2018. Search parameters included three domains: homelessness, housing intervention, and age.

Of the initial 7,344 sources identified, 29 articles met the search criteria and were included in the final sample. Housing models discussed in the reviewed literature include Permanent Supportive Housing, Transitional and Independent Housing and Living Programs, the Foyer model, Housing First, and general Supportive Housing. Housing models were discussed in the context of outcome domains including quality of life, education, employment, housing tenure, cost of intervention, systems and service use, HIV, and social network and relationships.

Discussion.

Housing interventions for young adults experiencing homelessness remains a relatively new intervention to combat homelessness among younger demographics. While the evidence base continues to grow, there remains a need for quality research to generate empirical evidence in this area, though studies included in this review showed promise for the development of best housing practices with this population.

1. Introduction

In 2010, the United States government identified immediate access to housing accompanied by supportive services, also known as permanent supportive housing (PSH), as the “clear solution” to homelessness for adults who have a disabling condition and have experienced longer term homelessness (USICH, 2010). This was based on nearly two decades of research that included studies of PSH using either a randomized control trial or quasi-experimental design that showed high housing retention and reduced cost for this population of adults considered to be “chronically homeless” ( Padgett et al., 2016 ). While some studies of PSH have included young adults aged 18–25 in their sample ( Kozloff, Adair, et al., 2016 ), the chronically homeless population (i.e., those with lasting or recurring episodes of homelessness) tends to be older with an average age in the United States approaching 60 years old ( Culhane et al., 2013 ). Currently, there is no clear consensus on what type of housing intervention works best for young adults ( Semborski et al., 2020 ; Tabol et al., 2010 ) who are in a unique developmental stage also known as “emerging” adulthood that is characterized by shifting roles and identities ( Arnett, 2000 ).

Recent estimates suggest that as many as one-in-ten young adults aged 18–25 experience some form of homelessness over the course of one year ( Morton et al., 2018 ). In addition to the immediate need for shelter, housing unstable young adults face multiple challenges that make them particularly vulnerable. Evidence shows that those who experience homelessness during emerging adulthood often face a number of physical and mental health problems ( Hodgson et al., 2013 ; Medlow et al., 2014 ; Perlman et al., 2014 ), exacerbated by violence and victimization ( Heerde et al., 2014 ) that often result in increased substance use ( Greene et al., 1997 ; Greene & Ringwalt, 1998 ; Nyamathi et al., 2010 ; Thompson et al., 2015 ), unplanned and early pregnancy ( Greene & Ringwalt, 1998 ; Thrane & Chen, 2012 ), and early death ( Auerswald et al., 2016 ). Beyond the adversity associated with homelessness, emerging adulthood is a critical period that often can set a trajectory for the remainder of the life course ( Franke & Anda, 2013 ).

Age appropriate, evidence-based housing interventions appear critical, for homeless young adults who represent a heterogenous group ( Semborski et al., 2020 ). Some housing models being implemented for young adults include: PSH, or time-unlimited housing paired with comprehensive wrap-around services; Transitional Living Programs – sometimes referred to as Independent Living Programs or Foyers ( Levin et al., 2015 ). Transitional models are time-limited, may or may not come with comprehensive wrap-around services, and typically have a large focus on education, training, and employment ( Gaetz, 2014 ). Finally, Rapid Rehousing, which typically provides time-limited housing support in community-based settings with fewer in-house supportive services ( Di Felice, 2014 ). In addition to differences in the structure of these models, some researchers have emphasized the importance of an underlying program philosophy such as whether young adults should be required to seek treatment (e.g., for mental health and/or substance abuse) or participate in employment in exchange for housing, or, on the other hand, should program participants have choice in the types of activities they engage in without requirements tied to housing ( Gaetz, 2014 ). The idea that adequate housing ought to be available to all, and not just those who satisfy “housing-ready” conditions, such as drug use treatment, is known as Housing First ( Padgett et al., 2016 ). Further philosophies that underlie work with youth, adolescents, and young adults include Positive Youth Development, a developmentally appropriate practice approach that focuses on identifying and strengthening protective factors in both the individual lives of young people and their broader environment ( Waid & Uhrich, 2020 ).

Given the range of practice approaches with young people ( Waid & Uhrich, 2020 ), the lack of consensus for a “clear solution” to young adult homelessness, and more recent emphasis by the U.S. federal government to expand housing programs to meet the diverse needs of unstably housed young adults ( USICH, 2017 ; USICH, 2012 ), this scoping review aims to identify and synthesize literature focused on housing interventions for young adults. The questions to be addressed were defined as follows:

• What types of housing programs for young adults experiencing homelessness have been evaluated?
• What domains have studies of housing programs for young adults experiencing homelessness reported on (e.g., housing outcomes, health outcomes, employment, etc.)?
• What outcomes or common experiences are reported in housing programs for young adults experiencing homelessness?

2.1. The scoping review

A scoping review seeks to map the key concepts underpinning an area of research, highlighting the main sources and types of evidence available ( Arksey & O’Malley, 2005 ; Mays et al., 2001 ). This type of review is appropriate when there is complexity such that the research area has not been clearly defined or comprehensively reviewed ( Mays et al., 2001 ). Following the five-stage framework put forth by Arksey and O’Malley (2005) that has been further outlined by the Joanna Briggs Institute (JBI) ( Peters et al., 2019 ), we developed an a priori method to search and identify literature relevant to our research questions.

2.2. Identifying relevant studies

A computerized search was conducted between February 4–8, 2019 to include peer-reviewed articles from a total of eight electronic databases: PsychINFO, Google Scholar, PubMed, Web of Science, Social Work Abstracts, Cochrane, Clinicaltrials.gov , and CINAHL. The search was limited to include literature published between January 1, 1987 and December 31, 2018. Search parameters included three domains based on study aims: homelessness, housing intervention, and age. Search terms across these domains were developed out of an initial literature review and reviewed by several researchers and providers in the field. See Table 1 for a complete list of search terms. A health science research librarian familiar with scoping reviews conducted the initial search.

Specific search terms used.

2.3. Study selection

In total, 7,344, sources were cataloged including articles, book chapters, reports, dissertations, and abstracts. After removing duplicated items, a total of 5,044 records were retrieved. All titles and abstracts generated by the search were reviewed in adherence to the inclusion/exclusion criteria set forth by the authors, shown in Table 2 . Each record was screened for appropriate population and intervention by two independent reviewers to find consensus. Sources were marked ‘include’, ‘exclude’, or ‘uncertain.’ Any discrepancies were discussed as a review team. At the completion of this screening process, articles were imported for further screening into Covidence, a web-based software platform that supports the production of systematic reviews. Once in Covidence, titles and abstracts were screened a third time and 17 additional records were deemed irrelevant. The remaining 166 full texts were assessed for eligibility by two independent reviewers allowing for the exclusion of an additional 137 records, leaving a total of 29 articles that met final inclusion criteria. Figure 1 displays the inclusion and exclusion assessment process of the initial sources located by the search strategy.

Scoping Review of Research on Housing Interventions for Homeless Young Adults: PRISMA Diagram

Inclusion and exclusion criteria.

2.4. Data extraction

Important information regarding each of the included articles was organized and charted in Microsoft Excel per the categories recommended by Arksey and O’Malley (2005) , adapted by the authors to best fit the subject of this scoping review. Categories used to organize the data were: study population, study aims, overview of methods, outcome measures, and main findings. Charting the data allowed for data to be organized by type of study (i.e., qualitative, descriptive or case study, non-experimental, and quasi-experimental or experimental) and then housing model.

2.5. Collating, summarizing, and reporting the results

In order to present the overall results from the included sources, the results were organized using two strategies. First, articles were organized by study design: qualitative, case study and/or descriptive, non-experimental, and quasi-experimental or experimental. Within each design type, articles were then collated by intervention (i.e., model of housing program). Findings across study design were then reported by outcome in order to distill the breadth and scope of the state of the evidence on housing programs for emerging adults.

3.1. Search results

Of the original 5,044 unique sources identified, 166 were considered eligible for inclusion. Sources at this stage were excluded (n=4,878) for the following reasons: wrong population, wrong intervention, wrong population and intervention, or non-research.

3.2. Inclusion of evidence sources by study design

The results comprised 29 papers after full-text review allowed the exclusion of 137 out of the 166 articles considered eligible for inclusion using the same exclusion reasons during the screening phase. Full details of the included 29 articles may be found in the Tables of Included Source Evidence Characteristics in Appendices 1 – 4 . The majority (n=11) were either of qualitative design (see Appendix 1 ) or could be qualified as case studies and/or descriptive in nature (n=11) (see Appendix 2 ), four were non-experimental (see Appendix 3 ), and three were quasi-experimental or experimental designs (see Appendix 4 ). Studies that employed a qualitative design recorded findings primarily focused on the experiences and impacts of housing programs, including impacts on social networks and service utilization, from the perspective of young adult residents. Among the eleven articles that were descriptive and/or utilized a case study design, results discussed housing tenure, employment, service use, and quality of the youth service setting. Non-experimental studies examined outcomes such as employment, education, housing tenure, and HIV, as well as costs and quality of service settings. Quasi-experimental studies focused on service use. Finally, the included experimental studies produced evidence on self-reported quality of life, employment, housing tenure, and overall characteristics of young adult residents. See Table 3 for a complete list of outcomes by study design that corresponds with the numbered articles listed in the Appendices .

Outcome by Study Design

Note: numbers correspond with article number listed in Appendices 1 – 4 .

3.3. Review of findings

Following data extraction, included articles were reviewed to catalogue the study aims, measures, outcomes, results, and limitations to distill necessary information to answer the research questions. First, we describe the interventions (i.e., housing program model) as described in the included articles, followed by an examination into the breadth and scope of the literature by outcome domain.

3.3.1. Review of featured housing models

A review of the housing models featured in the sources of evidence are shown in Table 4 . Across the 29 included articles, authors describe housing programs in terms of three models and/or housing philosophies: 1) Transitional Housing Programs, referred to as Transitional Living Programs (TLP), Independent Living Programs (ILP), and Foyers; 2) Supportive Housing (SH); and 3) Housing First (HF). Most articles (n=20) featured TLPs, ILPs, or Foyers. Seven papers described their model as SH, and two described their model as HF.

Housing models featured in sources of evidence

TLPs, ILPs, and Foyer Models were described as providing structured, time-limited housing of up to 24 months, but sometimes shorter. The focus of these models is to support independence across key domains of life skill development, education and employment, physical and mental health, and stable housing post-housing program. While TLPs and ILPs offer both scatter-site, community-based apartments and/or congregate-style living, Foyers were all congregate-style. Although one of the Foyers was located in New York, USA, Foyers otherwise were found to be more popular in the UK and Australia. Likewise, apart from the one Ethnographic Case Study of a TLP in Ontario, Canada, all examinations into TLPs or ILPS occurred in the United States.

Supportive Housing, on the other hand, was characterized as non-time limited, subsidized, permanent housing with wrap-around services. Coupled with housing, wrap-around services were offered by a multidisciplinary team, either through an Intensive Case Management model or a treatment team approach that offers a semi-independent structure with residential supervision and in-home counseling and support. SH, based on studies with programs located in the United States, Nova Scotia, Ontario, and British Columbia, Canada, was described by authors as housing paired with supportive services. Authors described SH as having a focus on rehabilitation and recovery for homeless or at-risk individuals with serious mental illness. SH was offered in both scatter- and congregate-site contexts. SH, at times is referred to as Permanent Supportive Housing (PSH). The three articles that examined PSH for young adults included programs that were all located in the United States.

Like SH, Housing First (HF), was described as non-time limited, pairing housing and supportive services, characterized by consumer choice and a harm reduction approach ( Tsemberis et al., 2004 ). Offering a low-barrier housing option, HF was described in the included sources as scatter-site housing paired with off-site Assertive Community Treatment (ACT) or Intensive Case Management (ICM), depending on client need. Additionally, HF may be viewed as a framework or philosophy, rather than a distinct housing model ( Gaetz, 2014 ). The two articles that focused on HF in this review came out of a study located across five Canadian Provinces: British Columbia, Manitoba, Ontario, Quebec, and New Brunswick.

3.3.2. Review of content by outcome

Housing tenure..

Table 4 discusses the specifics of each housing model and/or philosophy covered in the 29 sources, as numbered in Appendices 1 – 4 that provide an overview of all included sources. Authors suggested that transitional models (i.e., Transitional Housing Programs (TLPs), Independent Living Programs (ILPs), or Foyers) tend to be time-limited to a maximum of 24 months, with some being less; while Supportive Housing (SH) and Housing First (HF) are generally characterized as being non-time limited. Despite these characterizations, the samples included in the source materials may report on different tenures, based off their data. The three studies that reported on housing tenure were cross-sectional, relying on administrative data to provide length of housing tenure. Studies most often captured housing tenure categorically, exploring outcomes for those housed over a year, compared to those with less time in housing ( Duncan et al., 2008 ; Nolan, 2006 ; Pierce et al., 2018 ). One experimental study of a HF program operationalized housing tenure of study participants as the proportion of days housed for which residence data were available ( Kozloff, Adair, et al., 2016 ). In all four studies, the range of housing tenure of study participants was 18 months or less. These studies suggest that longer housing tenure is correlated with better outcomes among young adult residents ( Duncan et al., 2008 ; Kozloff, Adair, et al., 2016 ; Nolan, 2006 ; Pierce et al., 2018 ) and that HF, specifically, produced longer housing tenure, with a housing tenure over twice that of those housed in the treatment as usual group, with an adjusted mean difference of 34% (p<0.001) ( Kozloff, Adair, et al., 2016 ). The other two articles that address housing tenure were from transitional housing programs. Among TLP residents, those who stayed in the program for 12 months or longer were found to have achieved more desired program outcomes (i.e., education, employment, and wages [all p<0.001]) than those who were in the program for less than 12 months ( Pierce et al., 2018 ). Nolan (2006) stated reasons for discharge from TLP included the following: (listed in order from most to least) violations (17/40), program completion (13/40), voluntarily to pursue other opportunities (7/40), or without other plans (3/40). Nearly half of these exits were to a private residence where the previous TLP resident was not the primary renter (47%) ( Nolan, 2006 ). Twenty percent of participants in these studies exited to independent living and other exits were a return to the street (5%), college (5%), military (5%), or unknown situations (18%) ( Nolan, 2006 ). Another case study of homeless, single mothers aged 18–21 found high attrition as a result of inadequate interventions (15% stayed in the program < 1 month and 58% stayed < 6 months), attributed to a need for higher acuity services for their young, parenting residents beyond the case management and life skills services that was paired with their transitional housing model ( Duncan et al., 2008 ).

Quality of service setting and cost.

Two studies discussed the quality and cost of housing for homeless young adults. One assessed quality of service settings across 29 different organizations that serve homeless young adults using the Youth Program Quality Assessment. Findings suggest that higher quality programs (i.e., those with greater alignment to Positive Youth Development) were associated with engaging in work or educational training (p<0.01), less involvement in the street economy (p<0.01), settings that helped manage or avoid substance use (p=0.01), and settings that improved perceived resilience (p=0.03) ( Gwadz et al., 2017 ). Additionally, PSH was estimated by Dodd et al. (2018) to cost $6,750 less per year, per person than emergency shelter without factoring in any costs related to improved health care (e.g., increased income, decreased hospitalizations, or psychological benefits), yielding a 1.32 return on investment.

Service use.

Thirteen articles reported on service utilization and service-related needs, the majority of which focused on transitional housing models. However, and perhaps most notably, evidence from a randomized control trial focused on HF suggests that young adults that experience homelessness have unique trajectories and service needs that are distinct from adult homeless populations. Findings show that compared to adults housed through a housing first program, young adults residing in housing first were more likely to have not completed high school, have been assaulted in the past 6 months, and have a drug use disorder (all p<0.05). Additionally, of the 164 young adults in this sample, only 49% had a regular doctor, half reported unmet health care needs, and 61% has visited an emergency department in the past 6 months ( Kozloff, Stergiopoulos, et al., 2016 ). A qualitative inquiry into what young adults want from housing programs further illuminates the distinct needs of young adults compared to adults experiencing homelessness. Findings suggest that young adults desired individualized support and increased support through housing environments with peers, noting the importance of social ties as distinct from those among older, homeless adults ( Henwood, Redline, & Rice, 2018 ).

In transitional housing environments, the Family and Youth Services Bureau reported the proportion of clients that receive ten types of services. The types of services common to TLP environments include basic support (including housing) (68%), life skills training (64%), planned aftercare (66%), counseling/therapy (61%), employment (54%), education (54%), program connection (48%), recreational activities (41%), physical health care (30%), and community service learning (29%) ( Mares & Jordan, 2012 ). Successful service delivery and goal achievement in these areas has been linked to the use of outcome assessment tools and interdisciplinary case management ( Giffords et al., 2007 ), as well as programs that closely align with the tenants of Positive Youth Development, most notably the development of strong relationships between staff and young adult residents, a consumer-driven philosophy ( Leonard et al., 2017 ), and even the involvement of young adult residents in program design and development ( Bridgman, 2001 ).

Despite the many positives in the literature regarding service delivery and utilization in SH environments for young adults, there remains a fair amount of critique. An ethnographic study examined SH as a form of social control. Through qualitative inquiry, authors found consensus among young adults residing in SH regarding “feeling trapped in the margins” even after moving into housing. Five specific young adults surveyed felt they had “disappeared into supportive housing” because they were no longer “allowed to be visibly homeless on the streets” ( Fast & Cunningham, 2018 ). While these findings report that some young people feel trapped in the structures of SH, other findings suggest vast inadequacies in funding to keep pace with the growing demand of homelessness among 18–25-year-olds, suggesting a need for more SH opportunities for this population ( Dworsky, 2010 ). However, increases in available housing must be coupled with better matching of individual residents with the appropriate level of care ( Steen & MacKenzie, 2017 ). To meet immediate housing needs without proper funding, researchers recommended partnerships between organizations that can offer housing and organizations that can offer supportive services instead of comprehensive service provision by a single provider ( Dworsky, 2010 ). This finding was also supported by young adults experiencing homelessness who perceived a resource deficit. In qualitative interviews young adults brought up the idea of “personal responsibility and deservedness” when considering who should receive support if enough resources are not available for everyone, suggesting that the work they put in to secure their own housing ought to be considered when prioritizing who gets placed in SH ( Henwood, Redline, & Rice, 2018 ).

The focus of two final studies regarding service deficits center on LGBTQ-specific services within SH environments. One study surveyed 124 service agencies offering TLP for young adults regarding their services and the LGBTQ-inclusivity of those services. Fewer than half of the 124 participating agencies (43.5%) reported offering LGBTQ-specific services and information regarding these services was minimally present on the agency’s websites (20.2%) or Facebook pages (5.3%). Programs offering LGBTQ-specific services were more likely to be located on the West Coast or in the Northeast region, and more likely to offer counseling, support groups, and recreation or youth development activities ( Prock & Kennedy, 2017 ). Additional needs regarding LGBTQ-specific services were noted by Maccio and Ferguson (2016) , highlighting both immediate and long-term housing service needs for LGBTQ homeless young adults. Due to discrimination, harassment, and violence in shelter environments, many LGBTQ homeless young adults desire to remain on the street or in precarious housing. Thus, authors recommend crisis beds and SH, transitional or permanent, specifically dedicated to LGBTQ young adults. Additionally, older LGBTQ young adults experiencing homelessness (i.e., ages 21–24) were identified as particularly vulnerable because many programs are limited to youth under 21, and staff identified a need for more “life-after-housing services” (i.e., educational, employment, mental health, and social services) for this sub-population ( Maccio & Ferguson, 2016 ).

Experience and impacts of housing programs.

Fifteen articles discussed the experience and impacts of supportive housing on young adults, across all supportive housing models and philosophies discussed in this paper (i.e., TLP/ILP/Foyer, SH, HF). Through engagement in supportive services coupled with housing, tenants of TLPs have been reported exiting transitional housing with educational and employment gains, including wages ( Gwadz et al., 2017 ; Pierce et al., 2018 ; Rashid, 2004 ); money saved; and stable housing ( Rashid, 2004 ). Likewise, residents of the Foyer model, another type of transitional housing, had lower rates of incarceration ( Raithel et al., 2015 ). Results of applying transitional housing to families yield a slightly more nuanced finding. The work shows that while many families were able to effect notable positive changes in their lives during and after taking part in the housing program. For some the recovery from homelessness was extremely difficult. For even the most successful formerly homeless families-those that secured employment, housing, and other social supports-the escape from welfare dependence and poverty proved very difficult ( Fischer, 2000 ).

Further, decreased viral load and increased CD4 count was discovered among HIV positive young adults residing in SH ( Dodd et al., 2018 ). Evidence from a randomized control trial found no major demographic differences between those residing in HF and the control group, aside from the number of years of schooling, which was greater among those in housing. Evidence from this trial also found those in SH to self-report better health and lower rates of substance abuse than controls without stable housing ( Kisely et al., 2008 ), as well as improvements in overall quality of life and leisure two years post move-in ( Kozloff, Adair, et al., 2016 ).

Eight articles qualitatively explored the experience and impact of SH from the young adult perspective. Generally, young adults had been positively impacted by their participation in SH. Through the program they reported experiencing changing perspectives (attitudes and priorities) that involved letting go to move forward, regaining personal control over their life through newfound independence, learning new independent living skills and feeling pride in self-reliance ( Curry & Abrams, 2015 ). The presence of markers of ontological security (e.g., constancy, routine, control) positively affected participants’ mental health and well-being, which helped with positive identity construction. Most regarded living in PSH as “a chance to start my life” and considered the question of “What’s next?” within a normative developmental trajectory. An increase in ontological security related to residents’ social environment and participants’ ability to improve on social relationships, which supported improved mental health and sense of self ( Henwood, Redline, Semborski, et al., 2018 ). SH provided the structure for needed social support, bringing together young people who became like family and created a sense of belonging ( Holtschneider, 2016a ). Social cohesion within the SH environment often was facilitated by common experiences, such as utilization of an in-house music studio that facilitated relationships between residents, increased collaboration, and translated into improved intra- and interpersonal skills ( Kelly, 2017 ). It is clear on many occasions SH facilitated the development of necessary skills to flourish as an independent adult ( Holtschneider, 2016a ).

Conversely, despite transitioning out of homelessness into housing, young adult residents continued to describe their lives in terms of fragility and instability, according to one study. While housing in itself did not shape these young people’s sense of stability, it did influence increased feelings of health, happiness, and security ( Karabanow et al., 2016 ). Further, young adult residents discussed barriers to their progress, including difficulty balancing work and school. Public transportation was mentioned as a barrier to work or educational goals. Youth expressed wanting to move forward, beyond the housing program, but feeling unprepared to live independently and a need for ongoing support ( Curry & Abrams, 2015 ). Within the housing environment, some residents perceived that they were overly monitored by programmatic rules and regulations, and that mistakes and/or transgressions by others affect those who are abiding by the rules and regulations. Thus, tensions arose between residents who were viewed as “handling their business” and those who are viewed as “just hanging out” ( Curry & Petering, 2017 ). Some experiences of social isolation were noted ( Henwood, Redline, Semborski, et al., 2018 ), including concerns about safety housing programs where they were unfamiliar with other residents or where housed with older adults compared with feeling safer on the streets surrounded by friend groups, reinforcing the importance of peer relationships ( Ryan & Thompson, 2013 ). Finally, struggles with mental health were associated with less positive orientations toward “what’s next” in their lives after SH ( Henwood, Redline, Semborski, et al., 2018 ). To this degree, the focus on independence and self-sufficiency in SH programming may not produce the intended results. Instead, programs may want to focus on strengthening community integration and supports which may better set a young person up for success in life after SH ( Holtschneider, 2016b ).

4. Discussion

This scoping review builds upon recent work that examined interventions intended to prevent or address youth homelessness ( Morton et al., 2020 ) by focusing specifically on housing interventions for young people experiencing homelessness. Unlike with the adult population experiencing chronic homelessness that tends to be older and has identified a single model as the best practice, we found studies over the past 20 years that focus on several models of housing for young adults (i.e., Transitional Housing Programs, including Foyers and Independent Living Programs; Supportive Housing; and Housing First). Although we found some differences regarding the structure of these programs (see Table 4 ), there remains a sense of confusion around how best to classify housing models and what they are implemented in practice ( Semborski et al., 2020 ). Additionally, findings of this review do not feature a more recent model of supportive housing being applied to young adults, Rapid Rehousing, though some evidence has been produced after 2018 (e.g., Hsu et al., 2019 ), a limitation of the current review, that underscores the ongoing experimentation to find appropriate housing interventions for young adults. Likewise, this review did not cover more untraditional models of housing for displaced young people, such as host homes (Petering, 2019), that are increasing in popularity and deserving of attention.

Overall findings suggest a relatively recent focus on housing programs for youth and young adults as a sub-population that experiences homelessness. Though some work was completed prior to 2012 ( Bridgman, 2001 ; Duncan et al., 2008 ; Dworsky, 2010 ; Fischer, 2000 ; Giffords et al., 2007 ; Kisely et al., 2008 ; Nolan, 2006 ; Rashid, 2004 ), the vast majority of inquiries into housing programs for young adult homelessness occurred after 2012 when youth and young adult homelessness was listed as a specific concern by the U.S. Interagency Council on Homelessness ( USICH, 2012 ; USICH, 2017 ). Therefore, it is fitting that the majority of studies utilized descriptive or qualitative approaches, as researchers and policymakers begin to understand the experience of homelessness among young adults. It is clear more evidence is needed, including use of more diverse methodologies. However, utilizing experimental or even quasi-experimental designs to understand housing environments proves to be quite difficult as it often requires manipulating the environment in which one is housed, often raising questions regarding ethics. Perhaps a comparative effectiveness design would probably be best rather than using something like a TAY triage tool to assign people to different housing resources when we don’t even know what model works best for whom

Prior to diversifying methods to understand age-appropriate housing interventions, there may be a need to further examine what age-appropriate housing interventions look like. Previous work has identified that housing interventions for this population have been borrowed from adult homelessness or foster care ( Semborski et al., 2020 ), as young adults experiencing homelessness are of college age and could be living in dorms. However, the extent which these studies framed or considered the issue of age-appropriateness in their evaluations is unclear and deserving of future attention.

It is increasingly clear that young adults who experience homelessness are unique, with service needs distinct from adults experiencing homelessness. Young adults in a study included in this review noted their desire for individualized support with flexibility and a supportive environment that contains support from peers ( Henwood, Redline, & Rice, 2018 ). It is clear from this review that a longer tenure in a housing environment with built-in support yields better outcomes at program exit ( Duncan et al., 2008 ; Kozloff, Adair, et al., 2016 ; Nolan, 2006 ; Pierce et al., 2018 ). Additionally, longer housing tenure has been associated with the application of HF in supportive housing settings ( Kozloff, Adair, et al., 2016 ), as well as other evidence-based practices, such as Positive Youth Development ( Gwadz et al., 2017 ; Leonard et al., 2017 ). Thus, we believe the most successful housing programs for young adults experiencing homelessness will likely be those that continually look to the evidence and adopt practices and policies with known and proven benefits specifically for at-risk and marginalized young adults.

Financial benefits of housing with built-in support services are well documented among adults consumers ( National Academies of Sciences et al., 2018 ) and has also been found among young adults ( Dodd et al., 2018 ). This review highlighted the vast array of services offered via the built-in supports in these housing environments ( Mares & Jordan, 2012 ), suggesting that interdisciplinary case management is likely to yield better results ( Giffords et al., 2007 ), compared to interventions that utilize a single case manager or consist of a mono-disciplinary team. Not only is housing tenure associated with increased positive outcomes at discharge, but engagement in the services offered in conjunction with housing has been proven to increase outcomes across a number of domains, including educational attainment, employment, life skills, and quality of life ( Gwadz et al., 2017 ; Pierce et al., 2018 ; Raithel et al., 2015 ; Rashid, 2004 ). However, in order to assess the effectiveness of services, it is recommended organizations use an outcome assessment tool ( Giffords et al., 2007 ) to systematically track progress and impact of their service delivery.

Despite the positives of these housing models, our review points to several inadequacies in the current housing climate. First, many communities have struggled with the funding to keep pace with service delivery due to the growing demands of young adult homelessness, including matching young adults with the appropriate level of care ( Steen & MacKenzie, 2017 ). This indicates that more housing with built-in supportive services is needed, but currently unobtainable due to funding deficiencies ( Dworsky, 2010 ). One recommendation for this issue offered by Dworsky (2010) is to form organizational partnerships between housing providers and other service providers. This would allow for comprehensive service provision from multiple providers, rather than a single provider required to offer both housing and supportive services. Triaging services in this way may reduce costs associated with these models of housing, increase flexibility of housing across a range of levels of need, as well as create separation between housing and services, further aligning with the HF philosophy which has been proven to increase housing tenure ( Kozloff, Adair, et al., 2016 ).

The articles reviewed also included discussion of subpopulations and their unique housing needs, which may not be adequately addressed by current models, namely young adults who identify as LGBTQ and parenting young adults. Though we note the array of services offered across housing models for young adults, there is a lack of LGBTQ-specific services and spaces ( Maccio & Ferguson, 2016 ; Prock & Kennedy, 2017 ), which is a colossal issue given that LGBTQ young people are at a heightened risk of experiencing homelessness, compared to their heterosexual and cisgender peers ( Morton et al., 2018 ). Likewise, outcomes among parenting young adults residing in housing with built-in support yielded mixed results, struggling more than non-parenting youth to achieve the same outcomes at discharge ( Fischer, 2000 ). Taken altogether, this evidence suggests that while housing programs for young people experiencing homelessness generally support improved outcomes, we also see age-specific service needs that are not being met by current service provision in these housing environments.

4.1. Limitations of our review.

The exhaustive scope of this review is both a strength and a limitation. While this scoping review covers decades of research, not many studies included in the final sample are within the last five years, posing a challenge as we seek to understand the current state of the literature. The process of reviewing housing interventions for homeless young adults seems to parallel the difficulty of defining “homelessness” among young adults. Thus, it has proven difficult to review housing programs because the target population has not been well defined or is fluid in definition. We chose to focus on studies of housing interventions for young adults experiencing homelessness, but may have incorrectly excluded sources because 1) defining the population has not been clear-cut, and 2) there may have been studies of other populations (e.g., foster care) that could be applied to and inform the questions explored in this study. Federal definitions of homelessness are generally focused on distinct aspects of the homeless episode, namely defining homelessness by sleeping location. Popular locations for young adults include unsheltered (e.g., sleeping in spaces not meant for human habitation), sheltered (e.g., emergency shelter or transitional housing), or staying with others (e.g., couch surfing/hopping or doubling up). Moreover, other definitions, such as the Runaway and Homeless Youth Act (RHYA), do not distinguish between different sleeping locations described here in their definition of homelessness. Instead the RHYA defines homelessness exclusively by the assessment of the situation, when “it is not possible to live in a safe environment with a relative, and who has no other safe alternative living arrangement” ( US Administration for Children & Families, 2009 ).

Beyond the discrepancies of what sleeping locations count as a homelessness episode, there is generally a lack of clarity regarding which young adults are included in the scope of homelessness. Specifically, youth exiting foster care are in an unique place with aging-out of transitional services and as many as 46% of former foster youth experience at least one episode of homelessness before the age of 26 ( Dworsky et al., 2013 ). Thus, Independent Living Programs for former foster youth may be strikingly similar to Transitional Housing Programs that have been applied as interventions for homeless young people, and at times they are one and the same, as some offer housing to both homeless and former foster youth simultaneously. The decision to narrow our focus to studies with majority homeless samples allowed for us to glean information on supportive housing specifically for homeless young adults, but may have also allowed for important information to be missed, specifically since some housing programs house both former foster youth and young people experiencing homeless, and at times these two populations are one and the same. Additionally, we may have missed relevant material due to a) only conducting our search in English, b) utilizing search terms common to experiences of homelessness in the United States, and c) the decision to exclude gray literature, and perhaps most notably. It is also important to note that there are several important studies that have been published since the end of our search period at the end of 2018. These findings highlight the importance of generating empirical evidence when possible to advance the field, inform direct service providers, and advise policymakers. Finally, despite the relative comprehensiveness of this review with two people reviewing each article at multiple steps, it is still possible that a study was mis-identified and not included.

Future directions

Through this review it is clear that young adults who experience homelessness are vulnerable, with higher rates of victimization and substance abuse and less education that older, adult homeless persons ( Kozloff, Stergiopoulos, et al., 2016 ); and though this review is international, all inquiries occur within metropolitan contexts. Thus, the generalizability of these findings to non-urban contexts is unknown and deserving of attention of future research. Additionally, the review of the included sources did not offer information about how the young adults got into housing, requirements for entry, or prioritization. While some communities have begun to implement a “best fit” approach (i.e., serving different youth with different program models), this review is unable to speak to this point. Debate around the specifics of acuity-based prioritization remains ( Rice et al., 2018 ). Understanding this information would increase the effectiveness of this review and the application of its findings. Future work should seek increase use of experimental designs, and perhaps more importantly comparative effectiveness designs, since we are not clear what type of housing works best and for whom ( Rice et al., 2018 ; Semborski et al., 2020 ); look at longer term outcomes; and work to establish clear recommendation for specific subpopulations of young adults experiencing homelessness.

5. Conclusion

Housing interventions for young adults experiencing homelessness remains a relatively new intervention to combat homelessness among younger demographics. While the evidence base continues to grow, there remains a need for quality research to generate empirical evidence in this area. Overall, studies included in this review showed promise for the development of best housing practices with this population. The findings from a small number of quasi-experimental and experimental studies point to the effectiveness of supportive housing interventions, but we conclude that the field lacks rigorous evaluative evidence to effectively establish a best practice, leaving a sense of confusion around multiple, somewhat specific, and at times competing, models of housing for young adults. However, prior to conducting rigorous research to prove and improve housing interventions for young adults, perhaps the first step is to gain clarity on the goal(s) of housing interventions for this population. While the broad goals of supportive housing may be independence and self-sufficiency of young adult residents ( Semborski et al., 2020 ), specific goals have yet to be put forth. Thus, an actionable first step may be to decide on what we ideally hope to be achieved through housing as an intervention for homelessness among young adults before future research agendas set out to prove it as a viable solution.

Despite the gaps in empirical evidence, we support previous conclusions urging us to not wait for an evidence-based best practice to fully guide policy and program design regarding housing homeless young people and instead recognizing access to housing as a fundamental human right ( Morton et al., 2020 ). Young adults with lived experience of homelessness have immediate needs for safe and adequate shelter that cannot wait and the experience to provide needed input to advance the field through informing both SH policy and program development. Evidence-based supportive housing for young adults will require the collaboration of community stakeholders, service providers, advocates, policymakers, and most importantly, young adults with lived experience.

Highlights:

• Across the 29 included articles, authors describe housing programs in terms of three models and/or housing philosophies: 1) Transitional Living Programs (TLP), Independent Living Programs (ILP), or Foyers; 2) Supportive Housing (SH); and 3) Housing First (HF). Most articles (n=20) featured TLPs, ILPs, or Foyers. Seven papers described their model as SH, and two described their model as HF.
• The majority of articles (n=11) were either of qualitative design or could be qualified as case studies and/or descriptive in nature (n=11), four were non-experimental, and three were quasi-experimental or experimental designs.
• Evidence from this review suggests that while housing environments for young people experiencing homelessness generally support improved outcomes, we also see age-specific service needs that are not being met by current service provision in these housing environments, particularly among LGBTQ and parenting young adults.
• Recommendations for providers: Continually seek evidence and adopt practices and policies with known and proven benefits specifically for at-risk and marginalized young adults, also known as evidence-based practices; and use outcome assessment tools to track progress and impacts of those practices.
• Recommendations for administrators, policymakers, and evaluators: Form organizational partnerships between housing providers and other service providers. This would allow for comprehensive service provision from multiple providers, rather than a single provider required to offer both housing and supportive services. Triaging services in this way may reduce costs associated with these models of housing, increase flexibility of housing across a range of levels of need, as well as create separation between housing and services, further aligning with the HF philosophy which has been proven to increase housing tenure

Supplementary Material

Appendix tables.

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Privacy and housing: research perspectives based on a systematic literature review

• Published: 18 March 2022
• Volume 37 , pages 653–683, ( 2022 )

Cite this article

• Priscila Ferreira de Macedo   ORCID: orcid.org/0000-0002-6623-469X 1 ,
• Sheila Walbe Ornstein   ORCID: orcid.org/0000-0002-5684-921X 1 &
• Gleice Azambuja Elali   ORCID: orcid.org/0000-0001-5270-4868 2  

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Grounded in psychological and social constructs, the need for privacy is reflected in human socio-spatial behaviour and in our own home. To discuss housing privacy, this article presents a systematic literature review (SLR) that identified theoretical and methodological aspects relevant to the topic. The research was based on consolidated protocols to identify, select and evaluate articles published between 2000 and 2021 in three databases (Web of Science, Google Scholar and Scielo), with 71 eligible articles identified for synthesis. The results showed a concentration of studies in the American, European and Islamic context, and the increase in this production since 2018. This was guided by the inadequacy of architectural and urban planning projects, by new forms of social interaction and, recently, by the COVID-19 pandemic. From a theoretical point of view, the SLR demonstrated the importance of investigating privacy in housing from a comprehensive perspective, observing its different dimensions (physical, social and psychological) and characterizing the issues involved and the context under analysis. Methodologically, the main instruments identified were: (i) to behavioural analysis, questionnaires, interviews and observations; (ii) to built environment evaluation, in addition to the previous ones, space syntax analysis, architectural design and photographs analysis; (iii) for the general characterization of users, the data collection regarding the socio-demographic and cultural context and the meanings attributed to spatial organizations; (iv) to characterize the participants of the investigations, the analysis of personality traits, the ways to personalize the space, user satisfaction/preferences and the influence of social interactions on these perceptions.

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1 Introduction

Understanding privacy, as a basic human need inserted in a psychological and social concept, implies delving into discussions related to different fields of knowledge, especially in studies related to behaviour and its forms of expression in the built environment. In this field, since the separation of public and private, started in the seventeenth century and consolidated in the beginning of the twentieth century, the house has been understood as the core of private life, offering the prospect of family interaction and guaranteeing privacy for the individual.

In view of this, several studies have emerged to conceptualize and identify the factors associated with privacy as a phenomenon to be carefully investigated, whether about the theories that support the concept (Altman, 1975 ; Hall, 2005 ; Warren & Brandeis, 1890 ; Westin, 1967 ), or the current reviews on the topic (Burgoon, 1982 ; Dienlin, 2013 ; Leino-Kilpi et al., 2001 ; Magi, 2011 ; Margulis, 2003a , 2003b , 2011 ; Solove, 2006 ; Westin, 2003 ). However, there is still a small number of specific studies on the problem regarding the privacy needs of users in their homes, although various studies have drawn attention to the users' dissatisfaction in terms of home related privacy issues, such as those carried out in Brazil by Kowaltowski et al. ( 2006 ), Mendonça ( 2015 ), Reis and Lay ( 2003 ), Villa ( 2008 ) and Zago and Villa ( 2017 ).

Such problems became even more evident at the start of the coronavirus pandemic (Coronavirus Disease—COVID-19), especially in small sized apartments, which due to the available space, have restricted carrying out daily activities, particularly in relation to larger families occupying this space. The increase of the severe acute respiratory syndrome of the coronavirus 2 (SARS-CoV-2) required adopting measures to prevent and control the spread of the virus (Dietz et al., 2020 ), such as the known “quarantines”, advocated by the World Health Organization (WHO), which emphasized the importance of social distancing between individuals. Different countries have adhered to these measures by suspending classes and face-to-face work (replaced by remote activities) and restricting access to non-essential activities (such as bars, restaurants, beaches and shopping malls.)

The sudden use of full-time housing (or almost) has prompted the mainstream media and the real estate market to address the impacts of the built environment on housing and on people's quality of life, many of which have emphasized aspects related to mental health and environmental comfort, including issues related to privacy and different forms of sociability (Fragoso, 2020 ; Garber, 2020 ; Garcia, 2020 ; Hipwood, 2020 ; Jornal Nacional, 2020; Kornhaber, 2020 ; Lampert, 2020 ; Moraes, 2020 ). In the academic context, discussions about the relationship between the pandemic and the built environment also increased, with arguments regarding, among others, urban insertion, densities, presence of green areas, housing dimensions and spatial organization (Avetisyan, 2020 ; Barbosa & Neis, 2020 ; Cunha, 2020 ; Dietz et al., 2020 ; Elali, 2020a , b ; Grupo [MORA], 2020; Hosseini, Fouladi-Far & Aali, 2020; Keenan, 2020 ; Megahed & Ghoneim, 2020 ; Tendais & Ribeiro, 2020 ).

In the domestic space, the new reality has changed the forms of sociability inside and outside the home (Nguyen, 2020 ), indicating greater contact between members of the house/family and interaction through non-face-to-face means with those who are outside (neighbourhood/society). As a result, the problems of privacy in the daily lives of families have become even more evident, especially those associated with the lack of space (Merino et al., 2021 ), the ways of negotiating the use of spaces and the division of time (Mcneilly & Reece, 2020 ; Pasala et al. 2021 ) in new domestic activities, such as: work, education and physical activity (Bezerra et al., 2020 ; Goldberg, McCormick & Virginia, 2021 ; Silva et al., 2020 ) and the perceptions of stress, anxiety and solitude (Benke et al., 2020 ; Buecker et al., 2020 ; Gaeta & Bridges, 2020 ; Losada-Baltar et al., 2020 ; Soga et al., 2020 ; Takashima et al., 2020 ).

In view of the dissatisfactions and the worsening of domestic problems due to the pandemic context and starting from a broad notion of privacy that involves human socio-spatial behaviour Footnote 1 (especially aspects related to territoriality, Footnote 2 personal space, Footnote 3 crowding Footnote 4 and solitude, Footnote 5 the theoretical and methodological aspects of the environment and behaviour, which are relevant to the assessments of the housing space, were investigated. To this end, a Systematic Literature Review (SLR), using bibliometric techniques was carried out on the subject. To present this work, this article begins with a return to the concept of privacy in order to support the discussion; then the details of the method used are reported; continuing with the main results obtained by SLR and its brief discussion.

2 Privacy concept: a look at previous reviews

Academic discussions on privacy gained relevance at the end of the nineteenth century, with the publication of the article The Right to Privacy , by jurists Samuel Warren and Louis Brandeis (1890), when privacy came to be understood as a fundamental right to be preserved. Since then, the concept has been discussed by different areas of knowledge and, despite the evolution of the processes, functions and perceptions that involve privacy, the concepts proposed by Alan Westin ( 1967 ) and Irwin Altman ( 1975 ) continue to stand out as the core of contemporary theories on the subject.

Westin ( 1967 ) defined privacy as the right of individuals, groups or institutions to determine when, how and to what extent their information can be communicated to others. In this regard, the author argued that people would continually be involved in a personal adjustment process to balance their desire for privacy with their desire for disclosure and communication with others; these desires vary both in relation to the scale of need (individual, family group or society), as well as the desired state (solitude, intimacy, anonymity and reserve). For him, the adequate regulation of privacy would combine the three scales with the four desired states, allowing the individual to achieve the goals of self-realization and (intra) psychic balance.

As a primary environmental phenomenon, the privacy was also interpreted by different relevant scholars. Simmel ( 1971 ) stated that privacy is associated with the boundaries around ourselves and also by a periodic opening of these boundaries to personal learning and to intimacy. Sommer ( 1973 ) discussed privacy from the concept of the personal space, or the imaginary space bubble area around individuals which communicate desired levels of interaction and protect individual from outside intrusion, which if entered by another person without agreement, implied on a privacy violation. Pedersen ( 1979 , 1997 ) relying on Westin’s states of privacy, identified another two states of privacy and classified it into: solitude, isolation, anonymity, reserve, intimacy with friends and intimacy with family. Wolfe ( 1978 ) linked privacy to choice and control, and defined it as the ability to choose how, under what circumstances, and to what degree an individual relates or does not relate to another. Sundstorm et al. ( 1996 ) found that privacy regulation theory, which included spatial behaviour, crowding and territoriality, suggests a human tendency to seek social interaction partly through use of the physical environment, as many coping behaviour relies on the physical setting (boundaries demarcation).

From the perspective of Environmental Psychology, according to Gifford et al. ( 2011 ), researchers work at three levels of analysis: (i) fundamental psychological processes, like perception of the environment, spatial cognition and personality, as they filter and structure human experience and behaviour, (ii) the management of social space, as personal space, territoriality, crowding, privacy and the physical setting, and (iii) human interactions. From this perspective, Altman ( 1975 ) defined privacy as a dialectical process of regulating interpersonal barriers, varying in relation to time, context, length of contact, and the receiver of the interaction (groups or individuals), with a desired ideal level. For the author, the definition of the desired levels is based on previous experiences and is part of the cognitive process of individual development, so that the ability to control interactions would be closely related to self-development and vice versa. Through an in-depth study of concepts such as permeability of barriers, territoriality, personal space, crowding and solitude, the author presented the mechanisms and behaviours related to the regulation of privacy and the consequences of failures in this system.

Considering the various contemporary views on social interactions and privacy, several studies have been reviewed, compiled and systematized the issues associated with the theme, with the following emphasized by: Leino-Kilpi et al. ( 2001 ), Margulis ( 2003a , 2003b , 2011 ), Westin ( 2003 ), Solove ( 2006 ), Magi ( 2011 ) and Dienlin ( 2013 ). As they promote updating the concept and create different privacy classifications, some of these reviews are briefly presented below.

Leino-Kilpi et al. ( 2001 ) reviewed the literature on the relationship between privacy and the hospital environment. Based on the seminal concepts, they presented ways of approaching privacy and included other theoretical contributions, as the Burgoon model ( 1982 ), based on how they indicated two viewpoints for investigating the subject: a) the perspectives on the concept—which involves social interactions, the level of privacy desired and obtained, and control over communication and information; and b) the privacy dimensions – physical, psychological, social and information.

Also reflecting what was observed in the literature, the authors highlighted the four dimensions for the phenomenon: i) physical—represents the degree of physical accessibility from one person to another; ii) psychological—addresses the human cognitive and affective process and its capacity to form values (associated with the self); iii) social—skills and efforts to control social interactions with a strong cultural connotation, and related to human socio-spatial behaviour, particularly to proxemics Footnote 6 patterns (Hall, 2005 ), states of privacy (Westin, 1967 ) and their control (Altman, 1975 ); iv) information – the right to determine how, when and to what extent information is available to the other or others (Westin, 1967 ).

Margulis ( 2003a , 2003b , 2011 ) reviewed privacy with regard to the evolution of the concept of Westin's ( 1967 ) and Altman's ( 1975 ) theories. The author presented privacy as being “ an abstract skeleton ” of meanings and functions, which implies the definition of access barriers to the individual or group and social and cultural expressions, including those that are not as obvious, such as social power. Regarding the functions of privacy, he stated they reflect its purposes and benefits, appearing as a basis for personal development (formation of the self) and interpersonal relationships. The author also emphasized the dominance of European and American views, which normally emphasize privacy issues. Finally, he pointed out that studies that intend to use behavioural theories about privacy, must determine whether the existing definitions meet their objectives, warning that they must also include social, environmental, cultural, and social-developmental factors.

Westin ( 2003 ) reviewed the protection of informational privacy, in the light of political-social relations, the evolution of technology and the existing legislation. Regarding the proposed conceptual updates, he reaffirmed privacy as a basic need for human life and an individual right to decide what information should be revealed to others, also ratifying the four privacy states developed by him in the 1960s. Faced with a scenario marked by the excessive use of information technologies, with high data storage capacity, the author emphasized that managing personal states of privacy (from healthy solitude to the intimacy of positive self-disclosure) and balancing democratic forms of access to personal data (in a globalized world with threats coming from encrypted systems) will be the greatest challenges for citizens and governments.

Solove ( 2006 ) reviewed privacy from the perspective of activities that can affect it, identifying what they are, how and why they can cause problems or non-trivial damage to people's lives and well-being. The author validated the concept of privacy as an inherent quality of life in society, and which holds a multiplicity of meanings, varying between individuals and contexts. Based on identifying the problems related to privacy and socially recognized in the legal sphere, the author identified the existing connections and divergences between the different privacy problems, understanding what was essential in people's perceptions of privacy and which, therefore, could not be violated.

Magi ( 2011 ) reviewed the literature on privacy in the social and human sciences, in order to identify its inherent benefits. Based on this review, privacy is relevant to the scale of the individual, interpersonal relationships and society. According to the author, the benefits of privacy are reflected in: i) protection against overreached social interaction, affirming individual autonomy, freedom of choice, ability to control interactions and make judgments; ii) possibility of individual redemption, with the development of self-confidence and preserving interpersonal relationships; iii) support for a more just, democratic and tolerant society. Regarding the concept, she considered that privacy should be used as a general term (umbrella) to describe a set of other concepts that are interrelated with various behaviours and that depend on the culture studied.

Dienlin ( 2013 ) reviewed the concept of privacy associated with communication processes and social network sites. By combining different understandings, he defined privacy as a degree of separation from others (Warren & Brandeis, 1890 ), which can be characterized by different states (Westin, 1967 ), by a continuous adjustment of individual barriers (Altman, 1975 ), which occur in four different dimensions (Burgoon, 1982 ). From this perspective, he proposed that privacy should be analysed in relation to the context, the perception of individuals, the behaviour and the available forms of regulation and control.

The results of the review revealed that studies on privacy must consider: (i) the socio-cultural and political context in which the study population is inserted (Dienlin, 2013 ; Hall, 2005 ; Margulis, 2011 ; Westin, 2003 ), the functions of privacy (Altman, 1975 ; Magi, 2011 ; Westin, 1967 ) and the privacy dimensions (Burgoon, 1982 ; Dienlin, 2013 ; Leino-Kilpi et al., 2001 ); (iii) the definitions and demarcations of territorial boundaries and personal space (Altman, 1975 ; Hall, 2005 ); (iv) the types of privacy violation issues (Altman, 1975 ; Solove, 2006 ; Westin, 2003 ); (v) perceptions of solitude and crowding (Altman, 1975 ; Hall, 2005 ; Westin, 1967 ). The results also reinforce the relevance of the research by Altman ( 1975 ) and Westin ( 1967 ), reaffirming that their ideas have stood the test of time.

Actually, the literature shows that find a closed concept of privacy is still far from being achieved as it involves multiples viewpoints (as seen: nursing, political sciences, law), varied context (social, political, demographical, informational) and complex social interactions. Despite this, the different viewpoint of the literature also revealed some relations on privacy that must be considered in any study of the theme. When addressing privacy, we are probably also talking (directly or indirectly) about interpersonal boundaries and their demarcation, territoriality, personal space, intimacy, proxemics patterns and perceptions of solitude and crowding. In turn, such phenomena are expressed by the physical environment, by the cultural, social, demographics and political context, and by the personality traits and individual behaviours. Having reverberation in problems and invasions of privacy, availability of regulation mechanisms and control, and similar situations, these different facets of the question could be revealed by the dimensions of privacy (to be selected in function of the objectives of each study).

Linking those findings with the environmental point of view, this research focuses privacy in a human socio-spatial behaviour perspective, that must involves: (i) the physical dimension, expressed by the elements of physical space, personal space and territoriality; (ii) the psychological dimension, indicated mainly by personality traits, behaviours and perceptions of individual, especially those related to solitude and crowding; (iii) the social dimension, represented by the management of social space, including proxemics patterns, culture, social, demographics and political context, social interactions, control, coping strategies; (iv) the informational dimension, corresponding to the right to determine how, when and to what extent information is available to the other or others.

Based on this understanding, authors such as Newell ( 1995 ), Petronio ( 2002 ), Margulis ( 2011 ) and Dielin (2013) comment on the emergence of several models for the study and understanding of privacy, some centred on physical space, others centred on people's behaviour and, still, those that prioritize the relationship between the two. In the first perspective, privacy is usually discussed in terms of its visual and physical elements. The second perspective involves a personal and a synesthetic perception (Hall, 2005 ). The third perspective seeks to address privacy in a comprehensive sense since it involves an imbricated relation between physical space, psychological perceptions and social relations and interactions. In this last view, our research chose and adapted the Burgoon model (1982) to our goals, as the model fitted on a socio-spatial behaviour perspective.

To understand the state of the art about the phenomenon of housing privacy, the SLR was carried out, using bibliometric techniques. In order to clarify the selection criteria of articles, the method is based on two references: (i) the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), developed by Moher et al. ( 2009 ); (ii) the Sample, Phenomenon of Interest, Design, Evaluation, Research Type (SPIDER), developed by Cooke et al. ( 2012 ).

The PRISMA diagram quantifies the selected articles and is divided into four stages: 1) identification – selection of databases and initial search of key words; 2) screening – definition of exclusion criteria and selection of article by titles and abstract; 3) eligibility – definition of inclusion criteria and identification of papers of interest by reading full article; 4) included—presents the works chosen for the qualitative and quantitative syntheses (meta-analysis).

The SPIDER tool, in turn, proposes the systematization of qualitative syntheses in the form of a table with information on: the sample, the phenomenon of interest, the research design (methods), the evaluation measures and the research type. Due to the subjective and contextual nature of the research theme, some information was also included, as the: journal that published the paper, the research’s objectives and the geographical location of the sample. Furthermore, in order to align the research with the context of existing reviews, the phenomenon of interest used on the SPIDER tool, have been converted into the four dimensions of privacy from Burgoon model ( 1982 ).

The objective of this SLR (Table 1 ) was to identify the theoretical and methodological aspects relevant to housing privacy, and their relationship with human behaviour and the built environment. In this regard, the questions answered were of a conceptual and methodological nature, namely: (1) Which dimensions are relevant to understand the phenomenon of housing privacy? (2) What aspects of the built environment and human behaviour were used to have privacy in the home? (3) What research methods and approaches were used to investigate housing privacy?

The English and Portuguese languages were defined as search criteria and the main database chosen was the Web of Science. Since it mainly contains publications in the English language and, as a consequence of the specific interest in the Brazilian reality, the search for articles in the Portuguese language was also carried out on the Google Scholar and Scielo platform.

As the nature of the investigation involves the intersection between the themes of housing and privacy, the searches were carried out by combining the keywords related to each theme. For the Web of Science database, the keywords for each theme were searched by the Boolean operator “OR”, with the combination of the terms related to “housing” and “privacy” made by the Boolean operator “AND”. The keywords were searched in the “TOPIC” field, including the search by title, abstract, author's keywords and keyword plus. Searches for articles in Portuguese were carried out by searching the keywords related to “habitação” and “privacidade” ( “housing” and “privacy”) with a Boolean operator “ E ” (AND). In Scielo, the option “All indexes” was used, whereas in Google Scholar, as it is a very comprehensive search engine, the search was restricted by “title” (Table 2 ).

The identification, screening and eligibility stages were executed considering the searches carried out on the Web of Science, and it was decided to include the results of Google Scholar and Scielo searches as manual additions in the included stage. Other publications, from the references cited by the selected articles, of prior knowledge, as well as articles related to COVID-19, were also included in the diagram as manual additions.

In the first search, Footnote 7 carried out on the Web of Science database with the combination of keywords, 40,933 results were identified, which reveals the scope of the theme. To obtain relevant data in the screening stage, results were filtered by related areas, namely: architecture, environmental sciences, environmental studies, behavioural sciences, family studies, psychology (development, multidisciplinary or social), social problems. With this restriction, 1,060 articles were selected and their titles and abstracts were read to screening stage.

After that, the exclusion criteria were defined (Table 3 ), indicating the non-incorporation of papers that the object of study were not related with home environment (such as offices or hospitals) or were not related with our main goal (such as territorial planning, energy efficiency, clinical psychology).

Finally, inclusion criteria (Table 3 ) were defined. Criteria to selected one paper as part for our study were: (i) have been produced since the 2000s; (ii) had samples related to urban housing; (iii) had clear methodological instruments related to the built environment or user behaviour; (iv) had the related themes (privacy, territoriality, personal space, crowding and solitude) as the main objective, and not only as one of the criteria of analysis or evaluation.

After defining the inclusion criteria of the 58 articles listed in the eligibility stage, 50 articles were selected for the included stage, to which the articles in the manual additions were added (Fig.  1 ).

Adapted from: Moher et al. ( 2009 )

PRISMA flow diagram.

The Brazilian articles (7 articles), articles in English related to the COVID-19 pandemic (6 articles) and the others cited in publications (8 articles) were included in the SLR as manual additions, totalling 21 additions. At the end of the full reading, 71 articles were selected for quantitative and qualitative synthesis (Fig.  1 ).

4.1 Qualitative synthesis

To facilitate the data collection and to understand the concepts and variables that involve housing privacy, the articles included were separated into four key themes, namely: privacy, territoriality and personal space, Footnote 8 crowding and solitude.

For the qualitative synthesis, the articles of each theme were systematized in tables, originated by the SPIDER tool, which contained information about the journal, authors, year of publication, title, objective, geographic location of the study, studied sample, privacy dimensions, research design (methods), evaluation measures and type of research, as seen in the example (Table 4 ).

The systematization of articles in the tables revealed a variety of studies in different journals and in geographic regions of the planet. The objectives of the studies addressed different natures, with approaches in different scales of coverage such as: individual perception or internal organization of the house and neighbourhood. The samples were also quite variable depending on the cultural context or subjectivity of the topics covered, including qualitative studies with a sample of two families or quantitative studies with more than a thousand participants.

Although most publications focus on a specific theme, in many cases there was an intersection between them, whether related to privacy and personal space, through the assessment of personal objects, or between the correlations of crowding perceptions and levels of user satisfaction with their privacy, for example.

Regarding the privacy dimensions, the physical dimension was largely identified by discussions about spatial organization, architectural elements, Footnote 9 housing typology, neighbourhood, density and personal objects. The social dimension by social interactions, accessibility hierarchy, culture, control, spatial boundaries and coping strategies. Finally, the psychology dimension was recognized by user satisfaction and preferences, stress, meaning of home, social support and personality traits.

Regarding the methodological instruments, in general, the studies sought to capture the users' perception and the specialists’ technical impressions on the environments. The surveys were mostly qualitative, with the combined use of two or more instruments, such as: document analysis, Footnote 10 direct and indirect observations (with capture or analysis of photographs), questionnaires, interviews, focus group, analysis of architectural designs, space syntax analysis and others.

Finally, as regards the evaluation criteria, the studies sought to identify the residents data (social, demographics or both), user satisfaction or preferences, the layout of the spaces and its implicit social relations, distribution of the architectural elements (doors, windows, green areas, etc.), housing density, domestic activities, visuals, smells, noises and objects perceived as relevant by residents, site plan, territories and physical characteristics of the neighbourhood, social interactions (between family, neighbours, visitors or passers-by) inside and outside the houses, personality traits and the levels of control, stress and solitude.

4.2 Quantitative synthesis

The quantitative synthesis of the selected articles sought to demonstrate the general outlook of empirical studies on the subject of housing privacy from the 2000s to the present period. Considering the key themes of the 71 publications, it is observed that (Fig.  2 and Table 5 ): 27 are about privacy (38%), 14 about territoriality and personal space (20%), 14 about crowding (20%) and 16 about solitude (22%).

Publications (in %) by key theme chart (total articles: 71)

Regarding the periodicity (Fig.  3 ), it was decided to use three-year bands Footnote 11 to visualize the frequency of publications by key theme. Discussions about housing privacy, which declined at the beginning of the period (between 2003 and 2008), started to increase after 2012 and are more pronounced in the current period.

Publications per year on key topics (total articles: 71)

The larger production in the early 2000s coincides with the spread of computers and effects on individual perceptions resulting from their use. The period after 2008, and especially since 2012, is consistent with the consolidation of social networks by cell phones and with the expansion of discussions on the protection of personal data, which, despite dealing particularly with the internet, also resonate in daily activities and, consequently, in the home and in the privacy of users.

In the studies from 2018 onwards, the greatest publication period of articles, the themes about crowding, territoriality and personal space are equivalent or surpass those of privacy, a trend that may indicate greater concern regarding the perceptions and demarcations of individual boundaries. The impact of the COVID-19 pandemic period is emphasized in the 2020 and 2021 studies that focus more on the theme of solitude, revealing that this may have been the main challenge encountered by people at home, the quarantine period—a trend that could be accentuated in 2021.

Regarding the data sources, 51 journals were identified, of which 20 were in the area of psychology and 16 in the area of architecture, urbanism and design. Despite the relevant number of journals, 41 present only one published article, while the other 30 articles were published among 10 journals (Fig.  4 ). Although there is a dominance of publications in two journals in the field of psychology, the theme is increasingly relevant in specific journals in the area of architecture, urbanism and design (Fig. 4 ).

Total articles by relevant journals (total articles: 30)

Total articles by countries and key theme (total articles: 71)

Regarding the geographical context (Fig. 5 ), discussions on privacy were found in 25 different countries and another 5 in cross-cultural contexts. The countries with the most published articles were: USA (18), Brazil Footnote 12 (7), Spain (5); Iran (5), United Kingdom (4), Malaysia (3), Japan (3), Iraq (2), Turkey (2) and China (2). The other countries presented 1 publication each.

Given the diversity of countries, the relationship between the approaches given to each key theme and the region where the studies are inserted are noteworthy. The correlations between countries and themes were drawn by cultural similarity, to the detriment of continental division, given the importance of culture related to privacy issues. In this perspective, the countries that dealt with Islam, were grouped as Islamic countries, while Mexico was incorporated into South and Central America. The regional context was divided into: Latin America, Anglo-Saxon America, Europe, Africa, Islamic Countries, Asia and Oceania.

Islamic and Asian countries focused their discussions on the key theme of privacy, probably due to the religious and social importance the phenomenon can assume in the daily life of this culture. Specifically, in the Asian context, there are also studies on solitude in Japan, which may indicate greater westernization in the country. Anglo-Saxon and European countries focus their discussions on the problems of privacy, highlighting crowding and solitude. In Europe, studies on territoriality and personal space are also relevant. Brazilian studies primarily deal with privacy inside the homes and aspects of territoriality, with current studies addressing solitude, the Nigerian studies mention crowding, and the Australian studies mention solitude. However, the sample is limited to trace cultural trends in the discussions of these situations. Finally, cross-cultural studies deal mainly with differences in perceptions of privacy when nationalities or ethnicities differ.

The dimensions of privacy were also correlated to the key themes (Table 6 ). In the privacy-oriented texts, the social and physical dimensions predominated, with less relevance for the psychological dimensions. In turn, due to the nature of the concept, all texts on territoriality and personal space addressed the physical dimensions, with an emphasis also on the psychological dimension and, finally, the social dimension. The psychological dimension predominated in studies on crowding and solitude, indicating its intrinsic condition to both concepts. The articles about crowding also emphasized the physical dimension, with some emphasis on the social dimension, while those related to solitude emphasized the social dimension, with the physical dimension being less relevant. Finally, the information dimension was not relevant to any of the key themes and was observed in only 2 studies (Cetkovic, 2011 ; Chan, 2000 ).

With regard to the criteria and evaluation measures (Table 7 ), 19 variables were identified with four or more occurrences in the total of studies surveyed: spatial organization, architectural elements, neighbourhood, density, personal objects, housing typology, social interactions, culture, hierarchy of accessibility, domestic activities, control, boundaries demarcations, coping strategies, user satisfaction, user preference, stress, meaning of home, social support and personality traits. The other variables, which appear in three studies or less, were not listed.

The main items evaluated (Fig.  6 ) in the physical dimension were: spatial organization (27%), architectural elements (17%), neighbourhood (14%), density (14%), personal objects (11%), housing typology (6%). In the social dimension they were: social interactions (27%), culture (21%), hierarchy of accessibility (17%), domestic activities (11%), control (11%), boundaries demarcation (6%), coping strategies (6%). In the psychological dimension they were: user satisfaction (24%), stress (15%), user preference (13%), meaning of home (10%), social support (8%) and personality traits (8%).

Main evaluation measures (in%), by privacy dimension (total articles: 71). Note Each article can have more than one measure

Finally, the research instruments used were highlighted to identify the methods and techniques used in the field of research on screen. 27 different instruments were identified (Fig.  7 ), the most relevant being: questionnaire (54%), interview (25%), observations (17%), space syntax analysis (13%), document analysis (11%), analysis of photos (8%) and analysis of architectural design (7%).

Main instruments (in%) used in housing privacy surveys (total articles: 71). Note Each article can have more than one instrument

The use of focus groups (6%) and image cards (4%) were identified but with less relevance, while 18 other instruments (25%) such as walkthrough and DNA collection appeared in only one or two articles.

5 Discussion of results

The SLR carried out showed that the housing privacy studies published between 2000 and 2021 focus mainly on the physical, psychological and social dimensions of the phenomenon, and that the information dimension is not relevant to the discussions found. Regarding the key theme of privacy, the physical and social dimensions stand out, revealing greater influence from aspects beyond the individual and linked to culture. For the key themes of territoriality and personal space, the physical and psychological dimensions predominate, demonstrating greater proximity to the self and the individual needs for personalized spaces and sense of belonging. In the case of crowding, the physical and psychological dimensions were also more relevant, especially focusing on the influence of space on users' satisfaction and stress. Finally, in studies on solitude, the social and psychological dimensions predominated, revealing the influence of domestic activities and social interactions on the perceived social support, user satisfaction and stress.

With regard to aspects relevant to the discussion about housing privacy, the studies raised showed they are related to links between human behaviour and the built environment, and must recognize, among others: the meanings of home and privacy of residents, their cultural and personality traits, relations with the family and neighbours; users preferences, satisfaction and expectations regarding the house where they live and the one they would like, the layout of the design attributes and available control resources; the spatial organizational of the house and domestic activities, the personal spaces and objects, the existing territories and neighbourhood; the type and frequency of privacy invasions and the coping strategies adopted by users to protect it, the level of stress, crowding and solitude that can be perceived in their homes.

Regarding the methods and techniques used to investigate housing privacy, the material analysed emphasized the users' perspective, with higher recurrence of using questionnaires and interviews, followed by in loco observations. The instruments used to assess the built environment were also relevant in the samples analysed and, in addition to those mentioned, consisted of technical analysis of architectural designs and photographs and of space syntax analysis. The other instruments were used for more specific purposes and varied according to the objectives of each study.

On the key theme of privacy, mainly questionnaires, interviews, analysis of architectural designs and space syntax analysis were used. The questionnaires and interviews highlighted topics related to socio-demographic data, user satisfaction and preferences, their concepts of home and privacy, and their perceptions about spatial organization of the house and its architectural elements, the invasions of privacy, available facilities (mechanisms regulation) and associated behaviours, family relationships and daily activities. The analyses of architectural designs, photographs and space syntax analysis, in turn, addressed privacy related to the possibilities of physical or visual access to spaces, expressed by the spatial organization, layout of the design attributes and the existing accessibility hierarchies.

On the topic of territoriality and personal space, the most used instruments were questionnaires, observations and interviews. For territoriality, the studies dealt primarily with the neighbourhood scale, with assessments of demarcation and control of territories and the resulting sense of belonging. The personal space assessments addressed the housing interior design, with questions and observations related to characteristics of the individuals and their ways of personalizing the spaces.

With regard to crowding and solitude, the questionnaires were more frequent, and an interview with open-ended questions for evaluations on these themes was identified in only one study (Ruiz-Casares, 2012 ). Regarding crowding, the questionnaires were related to the level of stress, the size and density of the home or specific rooms, especially addressing the internal characteristics of the dwellings and satisfaction of users. Regarding solitude, the questionnaires presented little association with the physical aspects of the home, containing questions more associated with feelings of solitude and social isolation (stress, anxiety and depression), and with perceptions of social support of the family and the community.

Regarding the geographic location of the studies analysed, the results found reinforced Margulis' point about the European and American predominance in privacy-related research (Margulis, 2003a , 2003b , 2011 ). American studies lead the discussions on all the topics considered, with a total of 18 publications, more than double of the country, in second place, in this case Brazil, with 7 studies, followed by Spain and Iran, both with 5 articles. It should be noted that the relevance of Spain has grown with recent studies on the impacts of the COVID-19 pandemic.

The growing discussion about privacy in the context of Islamic housing should also be highlighted. Over the last decades, intensified globalization inserted the western housing design model in these contexts, causing discrepancies between the desired privacy, based on religious customs, and that obtained, expressed by the organization of the Western house. In other words, the physical dimension of privacy does not reflect the social and psychological dimension desired by users. Also on the privacy dimensions, we saw that studies on housing privacy focus on the physical, psychological and social dimensions, with the need to also include the social and/or economic data of residents (Dienlin, 2013 ; Margulis, 2003a , 2003b (a), (b), 2011; Westin, 2003 ).

In housing studies, the privacy problems were addressed by levels of satisfaction, by questions about the types of privacy issues and inconveniences faced, about where and when invasions took place, or about what the ideal home would be like. Thus, it is observed that Solove's ( 2006 ) legal view that understanding privacy protection includes identifying and characterizing the problem is also valid for discussions on housing privacy. Regarding the relationship between the use of technology and impacts on privacy (Westin, 2003 ), only two studies (Cetkovic, 2011; Stepanikova et al., 2010 ) address the theme of using automation or time spent on the internet for housing-related discussions, revealing a gap in the studies about the relationships between technology, privacy and ways of living.

Regarding behaviours, research on housing privacy reinforces contemporary assumptions (Dienlin, 2013 ; Magi, 2011 ; Solove, 2006 ) that users' behaviours vary according to contexts and perceptions of privacy. This is expressed by variations in the hierarchies of accessibility to the environments, by the different meanings of home and privacy associated with the cultural practices and perceptions of the users, but especially by the variations of thematic approaches by region. In Islamic and Eastern countries, it is important to discuss privacy as an essential concept for the formation of society, and it is important to address the means to keep it protected inside the houses or families. In the European and American contexts, on the other hand, it is relevant to understand it from the perspective of individual needs, discussing the consequences of when it is violated, whether in the sense of feeling crowded or isolated.

The benefits of privacy, raised by Magi ( 2011 ), were considered mainly in the introduction of the studies, but not very relevant as evaluation measures. Only in comparative studies on traditional and modern houses or on the addition of space control items, questions related to the benefits that privacy can provide were evaluated in the application of methodological instruments.

Corroborating previous reviews in this field and reinforcing the subjectivity involved in its study, the results of the SLR carried out reaffirm the need to discuss the topic of housing privacy:

Consider a comprehensive perspective, with aspects that involve the social dynamics of the context where housing is inserted and the residents’ individual perceptions (Altman, 1975 ; Dienlin, 2013 ; Hall, 2005 ; Margulis, 2003a , 2003b (a), (b), 2011; Solove, 2006 ).

Include social and demographic factors (Altman, 1975 ; Dienlin, 2013 ; Hall, 2005 ; Margulis, 2003a , 2003b (a), (b), 2011; Solove, 2006 ; Westin, 1967 ), considered as evaluation criteria in all studies that use questionnaires and interviews.

Highlight the privacy role in the development of culture (Dienlin, 2013 ; Hall, 2005 ; Margulis, 2011 ; Westin, 1967 e 2003) and in the human cognitive and affective processes, especially those associated with individual development and communication modes, perceiving and revealing the social environment in which residents are inserted (Altman, 1975 ; Burgoon, 1982 ; Dienlin, 2013 ; Leino-Kilpi et al., 2001 ; Margulis, 2003a , 2003b , 2011).

In addition to alignment with previous reviews, the findings of this research advance in relation to existing studies, bringing as contributions the discussions on housing privacy:

Identifying the importance of the meanings of home, family, neighbourhood (neighbours, neighbourhood features and social support), spatial organization (including its architectural elements and domestic activities), as well as its hierarchy in terms of accessibility, and the satisfaction and preferences of users.

The ever-expanding concern with issues of social isolation due to the pandemic, an essential dimension to understand contemporary times, especially in view of the current multifunctionality assumed by housing.

Clearly demonstrating the recent increase in the interest on privacy as a research topic.

This is, therefore, an open field for new studies, which may expand understanding privacy in the context of housing and increase the consistency and comprehensiveness of these approaches for the housing context.

6 Conclusion

Due to the research criteria, most studies found by conducting the SLR address the privacy key-theme, with productions on territoriality and personal space, crowding and solitude that have almost equivalent quantities of publications, which demonstrates relevance parity between the themes. Regarding temporal terms, there has been a recent increase in studies on crowding and solitude. On the one hand, the growth of studies on crowding may reflect the low quality of housing spaces, which, due to poorly dimensioned internal spaces, inadequate urban insertions or not being culturally adapted to the context of residents, increase the perceptions of users’ stress and dissatisfaction. On the other hand, the growing interest in the topic of solitude seems to be a consequence of new forms of social interaction, associated with digital media and the pandemic.

Regarding the areas of knowledge in which these articles were published, journals in the field of psychology were the most recurrent, although there is an increasing participation of journals in architecture, urbanism and design, especially in the key themes associated with the physical dimension (privacy, territoriality and personal space). This demonstrates that the issue of housing privacy is an expanding approach for the area – which justifies the interest in SLR.

The results obtained also suggest that although the concepts of privacy, territoriality, personal space, crowding and solitude have been widely discussed and conceptualized in different areas of knowledge. Although they are still far from being exhausted as an object of study in discussions about housing, given the subjective characteristics that surround them and the contextual nature of the application of results, which prevent broad generalizations or design recommendations applicable to different contexts.

The SLR on housing privacy has shown it is vital these types of studies evaluate both the context in its broadest form, raising data on the socio-demographic and cultural context of users, and the social meanings attributed to existing space organizations, as well as on the scale close to the individual, evaluating their personality traits, their forms of personalization, their satisfaction and preferences and the influence of social interactions and physical attributes on these perceptions.

It is also important to highlight the limitations of the study. The first refers to the database chosen, only one for studies in English and two for texts in Portuguese. The inclusion of more databases (in relation to the Brazilian context, for example), can expand discussions on the themes, allowing more consistent conclusions on these fields or on the cultural differences of the approaches by countries. Another limitation concerns the type of publication. In this study, we chose to limit the results to scientific articles published in peer-reviewed journals, so future research may include, in addition to other databases, works published in congresses, theses and dissertations. Finally, as the study evaluated mainly the housing unit and its neighbourhood, issues directed primarily at urbanism and housing policies were excluded, and as observed in a UK (Lindsay, Williams & Dair, 2012 ) and American (Day, 2001) study, they may interfere in housing privacy relationships. Thus, it is recommended that future works in this area should consider the urban context and public policies in their analysis.

Regarding future works, even in studies inserted in the scope of architecture and urbanism, few presented the implications of how the research results could be adapted to the conception of new architectural projects. The architectural design adjustment propositions or guidelines found included: i) descriptions of what an ideal home should be (Day, 2000 ; Willems et al., 2020 ); ii) a proposition for the use of environmental control resources (Pable, 2012 ); iii) explicit design recommendations (Al-Kodmany, 2000 ; Fallah, Khalili & Rasdi, 2015 ). Therefore, future research studies could outline guidelines on how to apply the users' perceptions in the design of new projects, or in reforms of existing spaces. Despite the scarce studies, they are of great value for the context of housing projects, especially in the pandemic or post-pandemic period.

Housing privacy permeates different dimensions, analysis variables, research methods and approaches, with research that addresses both the generic characteristics of the context under study, as well as individual physiological or behavioural responses. Therefore, it is recommended that research in the area could present a clear definition of what should be effectively evaluated and the relationships that can be established.

Human socio-spatial behaviour: a generic term to indicate human behaviour related to the use of space “ as part of the interpersonal communication process and as one of the mediators of person-environment interaction ” (Pinheiro & Elali, 2011 , p. 148).

Territoriality: concept derived from ethology, concerns the feeling related to an area (physically defined) in relation to when the person experiences a feeling of possession, even if it is subjective and transitory (Sommer, 1973 ; Pinheiro & Elali, 2011 ) .

Personal space: " emotionally charged area around each person, sometimes described as a soap bubble or aura, and which helps to regulate the spacing between individuals " (Sommer, 1973 , p. X).

Crowding: “ an experiential state in which the restrictive aspects of spatial limitation are perceived by the individuals exposed to them ” (Stokols, 1976 , p. 50); situation in which the person experiences the need for a larger space than what is actually available to him (Hall, 2005 ); “ Knowing one is observed ” (Tuan, 1983 , p.69).

Solitude: non-reciprocity in search for the other; although the person desires a closer contact (or a relationship), the other does not favour him—it cannot be considered synonymous with isolation (a situation in which the person does not seek contact) – (Altman, 1975 ).

Proxemics: study of the relationships of proximity and distance between people during their interactions, understanding the environment as a fundamental component of this process (Hall, 2005 ).

Search conducted in August/2020. After this first identification, an alert was created on the Web of Science website with the established criteria and restrictions, and the publications that appeared after that date were added to the study as manual additions.

Although territoriality and personal space are different concepts, this joint is justified by two main reasons: (i) in daily life, people seem to see those meanings close together, depending on situations; (ii) specifically about housing studies, both themes deal with personal objects, rooms feature and/or residents’ behaviours associated with primary territories demarcations (Altman, 1975 ).

Although they address the organizational structure of the house, it was decided to distinguish the criteria of spatial organization and the architectural elements, the first related to the spatial distribution of the environments considering the complete composition of the house, while the architectural elements primarily cover isolated items such as doors, windows, curtains.

Document research is inherent in the production of articles and, therefore, was present in all articles. However, in the tables, the item document analysis stood out as an instrument, when the evaluation of the samples was based exclusively on these analyses.

As the period considered is 22 years and this article was produced in the beginning of 2021, it was decided to include the year 2021 in the temporal range from 2018.

The studies identified in Brazil are relevant to the context of researchers and that is why they were treated with special emphasis in the work.

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Acknowledgements

The authors Sheila Walbe Ornstein and Gleice Azambuja Elali express their gratitude to the National Council for Scientific and Technological Development (CNPq), Brazil, for their respective productivity grants.

Two authors are productivity fellows from the National Council for Scientific and Technological Development (CNPq). Sheila Walbe Orstein under the CNPq number 304131/2020-2 and Gleice Azambuja Elali under the CNPq number 308280/2018-0.

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This article integrates the partial results of the thesis under development by the doctoral student Priscila Macedo in the Architecture and Urbanism Postgraduate Program at USP, under the guidance of the doctoral professors Sheila Walbe Ornstein (principal advisor, USP) and Gleice Azambuja Elali (co-advisor, UFRN). Specifically in the preparation of this article, Priscila Macedo was responsible for structuring the contents of the Systematic Literature Review; Sheila Ornstein collaborated with the discussion on contemporary ways of living based on her post-occupancy evaluation research in the housing field (both social and aimed at middle-income social strata); Gleice Elali collaborated with the analysis of topics related to privacy and the relationship between the built environment and human behaviour.

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de Macedo, P.F., Ornstein, S.W. & Elali, G.A. Privacy and housing: research perspectives based on a systematic literature review. J Hous and the Built Environ 37 , 653–683 (2022). https://doi.org/10.1007/s10901-022-09939-z

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Social housing decarbonisation study: views from social housing providers

Findings from a study to explore providers’ attitudes to improved energy performance, barriers to implementing new measures, and funding.

Social Housing Decarbonisation Study: views from social housing providers

Ref: BEIS Research Paper Number 2021/056

PDF , 803 KB , 94 pages

In November 2020, BEIS commissioned IFF Research to conduct research with social housing providers to develop understanding of their ambition for energy performance retrofit, current plans for carrying out retrofit on their stock, the current state of retrofit and key issues associated with working with tenants and leaseholders in mixed-tenure stock. The project took place between November 2020 and May 2021. Primary research data was collected through semi-structured interviews with 39 providers and a survey with 449 providers.

The research found:

• energy efficiency improvements are not often the primary motivator for improving stock, but many providers are seeking to improve energy performance in the future
• social housing tenants do not generally refuse to allow retrofit work in their homes - 52% of social housing providers report tenants never refuse work
• greater effort is required by social housing providers to sufficiently engage with future challenges of retrofitting mixed-tenure housing stock, that is buildings containing both social rented and privately-owned dwellings. Half (49%) of providers who have carried out energy performance improvement work on their stock included mixed-tenure units
• the Social Housing Decarbonisation Fund is perceived positively: 78% of providers were likely to apply, of which 90% would seek assistance from the Technical Assistance Facility (TAF)

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Social Housing in Mauritius_Social Movement and Low Income Housing in Mauritius

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Fact-checking warnings from Democrats about Project 2025 and Donald Trump

This fact check originally appeared on PolitiFact .

Project 2025 has a starring role in this week’s Democratic National Convention.

And it was front and center on Night 1.

WATCH: Hauling large copy of Project 2025, Michigan state Sen. McMorrow speaks at 2024 DNC

“This is Project 2025,” Michigan state Sen. Mallory McMorrow, D-Royal Oak, said as she laid a hardbound copy of the 900-page document on the lectern. “Over the next four nights, you are going to hear a lot about what is in this 900-page document. Why? Because this is the Republican blueprint for a second Trump term.”

Vice President Kamala Harris, the Democratic presidential nominee, has warned Americans about “Trump’s Project 2025” agenda — even though former President Donald Trump doesn’t claim the conservative presidential transition document.

“Donald Trump wants to take our country backward,” Harris said July 23 in Milwaukee. “He and his extreme Project 2025 agenda will weaken the middle class. Like, we know we got to take this seriously, and can you believe they put that thing in writing?”

Minnesota Gov. Tim Walz, Harris’ running mate, has joined in on the talking point.

“Don’t believe (Trump) when he’s playing dumb about this Project 2025. He knows exactly what it’ll do,” Walz said Aug. 9 in Glendale, Arizona.

Trump’s campaign has worked to build distance from the project, which the Heritage Foundation, a conservative think tank, led with contributions from dozens of conservative groups.

Much of the plan calls for extensive executive-branch overhauls and draws on both long-standing conservative principles, such as tax cuts, and more recent culture war issues. It lays out recommendations for disbanding the Commerce and Education departments, eliminating certain climate protections and consolidating more power to the president.

Project 2025 offers a sweeping vision for a Republican-led executive branch, and some of its policies mirror Trump’s 2024 agenda, But Harris and her presidential campaign have at times gone too far in describing what the project calls for and how closely the plans overlap with Trump’s campaign.

PolitiFact researched Harris’ warnings about how the plan would affect reproductive rights, federal entitlement programs and education, just as we did for President Joe Biden’s Project 2025 rhetoric. Here’s what the project does and doesn’t call for, and how it squares with Trump’s positions.

Are Trump and Project 2025 connected?

To distance himself from Project 2025 amid the Democratic attacks, Trump wrote on Truth Social that he “knows nothing” about it and has “no idea” who is in charge of it. (CNN identified at least 140 former advisers from the Trump administration who have been involved.)

The Heritage Foundation sought contributions from more than 100 conservative organizations for its policy vision for the next Republican presidency, which was published in 2023.

Project 2025 is now winding down some of its policy operations, and director Paul Dans, a former Trump administration official, is stepping down, The Washington Post reported July 30. Trump campaign managers Susie Wiles and Chris LaCivita denounced the document.

WATCH: A look at the Project 2025 plan to reshape government and Trump’s links to its authors

However, Project 2025 contributors include a number of high-ranking officials from Trump’s first administration, including former White House adviser Peter Navarro and former Housing and Urban Development Secretary Ben Carson.

A recently released recording of Russell Vought, a Project 2025 author and the former director of Trump’s Office of Management and Budget, showed Vought saying Trump’s “very supportive of what we do.” He said Trump was only distancing himself because Democrats were making a bogeyman out of the document.

Project 2025 wouldn’t ban abortion outright, but would curtail access

The Harris campaign shared a graphic on X that claimed “Trump’s Project 2025 plan for workers” would “go after birth control and ban abortion nationwide.”

The plan doesn’t call to ban abortion nationwide, though its recommendations could curtail some contraceptives and limit abortion access.

What’s known about Trump’s abortion agenda neither lines up with Harris’ description nor Project 2025’s wish list.

Project 2025 says the Department of Health and Human Services Department should “return to being known as the Department of Life by explicitly rejecting the notion that abortion is health care.”

It recommends that the Food and Drug Administration reverse its 2000 approval of mifepristone, the first pill taken in a two-drug regimen for a medication abortion. Medication is the most common form of abortion in the U.S. — accounting for around 63 percent in 2023.

If mifepristone were to remain approved, Project 2025 recommends new rules, such as cutting its use from 10 weeks into pregnancy to seven. It would have to be provided to patients in person — part of the group’s efforts to limit access to the drug by mail. In June, the U.S. Supreme Court rejected a legal challenge to mifepristone’s FDA approval over procedural grounds.

WATCH: Trump’s plans for health care and reproductive rights if he returns to White House The manual also calls for the Justice Department to enforce the 1873 Comstock Act on mifepristone, which bans the mailing of “obscene” materials. Abortion access supporters fear that a strict interpretation of the law could go further to ban mailing the materials used in procedural abortions, such as surgical instruments and equipment.

The plan proposes withholding federal money from states that don’t report to the Centers for Disease Control and Prevention how many abortions take place within their borders. The plan also would prohibit abortion providers, such as Planned Parenthood, from receiving Medicaid funds. It also calls for the Department of Health and Human Services to ensure that the training of medical professionals, including doctors and nurses, omits abortion training.

The document says some forms of emergency contraception — particularly Ella, a pill that can be taken within five days of unprotected sex to prevent pregnancy — should be excluded from no-cost coverage. The Affordable Care Act requires most private health insurers to cover recommended preventive services, which involves a range of birth control methods, including emergency contraception.

Trump has recently said states should decide abortion regulations and that he wouldn’t block access to contraceptives. Trump said during his June 27 debate with Biden that he wouldn’t ban mifepristone after the Supreme Court “approved” it. But the court rejected the lawsuit based on standing, not the case’s merits. He has not weighed in on the Comstock Act or said whether he supports it being used to block abortion medication, or other kinds of abortions.

Project 2025 doesn’t call for cutting Social Security, but proposes some changes to Medicare

“When you read (Project 2025),” Harris told a crowd July 23 in Wisconsin, “you will see, Donald Trump intends to cut Social Security and Medicare.”

The Project 2025 document does not call for Social Security cuts. None of its 10 references to Social Security addresses plans for cutting the program.

Harris also misleads about Trump’s Social Security views.

In his earlier campaigns and before he was a politician, Trump said about a half-dozen times that he’s open to major overhauls of Social Security, including cuts and privatization. More recently, in a March 2024 CNBC interview, Trump said of entitlement programs such as Social Security, “There’s a lot you can do in terms of entitlements, in terms of cutting.” However, he quickly walked that statement back, and his CNBC comment stands at odds with essentially everything else Trump has said during the 2024 presidential campaign.

Trump’s campaign website says that not “a single penny” should be cut from Social Security. We rated Harris’ claim that Trump intends to cut Social Security Mostly False.

Project 2025 does propose changes to Medicare, including making Medicare Advantage, the private insurance offering in Medicare, the “default” enrollment option. Unlike Original Medicare, Medicare Advantage plans have provider networks and can also require prior authorization, meaning that the plan can approve or deny certain services. Original Medicare plans don’t have prior authorization requirements.

The manual also calls for repealing health policies enacted under Biden, such as the Inflation Reduction Act. The law enabled Medicare to negotiate with drugmakers for the first time in history, and recently resulted in an agreement with drug companies to lower the prices of 10 expensive prescriptions for Medicare enrollees.

Trump, however, has said repeatedly during the 2024 presidential campaign that he will not cut Medicare.

Project 2025 would eliminate the Education Department, which Trump supports

The Harris campaign said Project 2025 would “eliminate the U.S. Department of Education” — and that’s accurate. Project 2025 says federal education policy “should be limited and, ultimately, the federal Department of Education should be eliminated.” The plan scales back the federal government’s role in education policy and devolves the functions that remain to other agencies.

Aside from eliminating the department, the project also proposes scrapping the Biden administration’s Title IX revision, which prohibits discrimination based on sexual orientation and gender identity. It also would let states opt out of federal education programs and calls for passing a federal parents’ bill of rights similar to ones passed in some Republican-led state legislatures.

Republicans, including Trump, have pledged to close the department, which gained its status in 1979 within Democratic President Jimmy Carter’s presidential Cabinet.

In one of his Agenda 47 policy videos, Trump promised to close the department and “to send all education work and needs back to the states.” Eliminating the department would have to go through Congress.

What Project 2025, Trump would do on overtime pay

In the graphic, the Harris campaign says Project 2025 allows “employers to stop paying workers for overtime work.”

The plan doesn’t call for banning overtime wages. It recommends changes to some Occupational Safety and Health Administration, or OSHA, regulations and to overtime rules. Some changes, if enacted, could result in some people losing overtime protections, experts told us.

The document proposes that the Labor Department maintain an overtime threshold “that does not punish businesses in lower-cost regions (e.g., the southeast United States).” This threshold is the amount of money executive, administrative or professional employees need to make for an employer to exempt them from overtime pay under the Fair Labor Standards Act.

In 2019, the Trump’s administration finalized a rule that expanded overtime pay eligibility to most salaried workers earning less than about $35,568, which it said made about 1.3 million more workers eligible for overtime pay. The Trump-era threshold is high enough to cover most line workers in lower-cost regions, Project 2025 said.

The Biden administration raised that threshold to $43,888 beginning July 1, and that will rise to $58,656 on Jan. 1, 2025. That would grant overtime eligibility to about 4 million workers, the Labor Department said.

It’s unclear how many workers Project 2025’s proposal to return to the Trump-era overtime threshold in some parts of the country would affect, but experts said some would presumably lose the right to overtime wages.

Other overtime proposals in Project 2025’s plan include allowing some workers to choose to accumulate paid time off instead of overtime pay, or to work more hours in one week and fewer in the next, rather than receive overtime.

Trump’s past with overtime pay is complicated. In 2016, the Obama administration said it would raise the overtime to salaried workers earning less than $47,476 a year, about double the exemption level set in 2004 of $23,660 a year.

But when a judge blocked the Obama rule, the Trump administration didn’t challenge the court ruling. Instead it set its own overtime threshold, which raised the amount, but by less than Obama.

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