Beyond individual factors: a critical ethnographic account of urban residential fire risks, experiences, and responses in single-room occupancy (SRO) housing.
Burn injuries
Ethnographic design
Fire risks
Inadequate housing
Inequities
Participant observation
Single-room occupancy
Structural factors
Underserved communities
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
28 Aug 2024
28 Aug 2024
Historique:
received:
30
05
2024
accepted:
23
08
2024
medline:
31
8
2024
pubmed:
31
8
2024
entrez:
28
8
2024
Statut:
epublish
Résumé
Burn injuries are a significant public health concern, closely linked to housing conditions and socioeconomic status. Residents in socioeconomically deprived neighbourhoods are at increased risk of exposure to hazards due to older and poorer housing conditions and limited access to fire protection measures. Individual behaviours such as substance use, smoking, and hoarding are often highlighted as primary causes of residential fires, overshadowing the broader socioeconomic and structural factors that also play a significant role in housing safety. This paper explores the correlation between inadequate housing conditions and heightened fire risks leading to burn injuries, focusing on the contextual factors shaping everyday urban fire risks, experiences, and responses of residents living in Single-Room Occupancy (SRO) housing in Vancouver's Downtown East Side (DTES) and staff working in the fire, health, housing (social and private), and non-profit sectors. As part of an ongoing ethnographic study, we partnered with the Vancouver Fire Rescue Services (VFRS) to conduct participant observations in private, non-profit, and government-owned SROs, modular homes, and a temporary shelter. This paper synthesizes insights from participant observations from the first author's self-reflexive journals, including informal conversations with approximately fifty-nine individuals such as SRO tenants, SRO managers/caretakers, health workers, burn survivors, municipal staff, not-for-profit staff, and firefighters. Urgent housing-related issues contributing to inequitable everyday urban fire risks were identified, such as structural deficiencies in SRO buildings and systems, inadequate waste management and storage, and inequitable approaches to addressing hoarding. Additionally, disparities in access to information and the interaction between interpersonal and structural stigmas were significant factors, underscoring the pressing need for intervention. Communities like DTES, facing precarious housing conditions, disadvantaged neighbourhoods, and complex health and social challenges, necessitate a comprehensive and holistic approach to fire prevention and safety. Recognizing the interplay between housing instability, mental and physical health issues, unregulated toxic drug supply, drug criminalization, and structural inequities allows practitioners from various sectors to develop contextually driven fire prevention strategies. This multifaceted approach transcends individual-level behaviour change and is crucial for addressing the complex issues contributing to fire risks in underserved communities.
Sections du résumé
BACKGROUND
BACKGROUND
Burn injuries are a significant public health concern, closely linked to housing conditions and socioeconomic status. Residents in socioeconomically deprived neighbourhoods are at increased risk of exposure to hazards due to older and poorer housing conditions and limited access to fire protection measures. Individual behaviours such as substance use, smoking, and hoarding are often highlighted as primary causes of residential fires, overshadowing the broader socioeconomic and structural factors that also play a significant role in housing safety. This paper explores the correlation between inadequate housing conditions and heightened fire risks leading to burn injuries, focusing on the contextual factors shaping everyday urban fire risks, experiences, and responses of residents living in Single-Room Occupancy (SRO) housing in Vancouver's Downtown East Side (DTES) and staff working in the fire, health, housing (social and private), and non-profit sectors.
METHODS
METHODS
As part of an ongoing ethnographic study, we partnered with the Vancouver Fire Rescue Services (VFRS) to conduct participant observations in private, non-profit, and government-owned SROs, modular homes, and a temporary shelter. This paper synthesizes insights from participant observations from the first author's self-reflexive journals, including informal conversations with approximately fifty-nine individuals such as SRO tenants, SRO managers/caretakers, health workers, burn survivors, municipal staff, not-for-profit staff, and firefighters.
RESULTS
RESULTS
Urgent housing-related issues contributing to inequitable everyday urban fire risks were identified, such as structural deficiencies in SRO buildings and systems, inadequate waste management and storage, and inequitable approaches to addressing hoarding. Additionally, disparities in access to information and the interaction between interpersonal and structural stigmas were significant factors, underscoring the pressing need for intervention.
CONCLUSION
CONCLUSIONS
Communities like DTES, facing precarious housing conditions, disadvantaged neighbourhoods, and complex health and social challenges, necessitate a comprehensive and holistic approach to fire prevention and safety. Recognizing the interplay between housing instability, mental and physical health issues, unregulated toxic drug supply, drug criminalization, and structural inequities allows practitioners from various sectors to develop contextually driven fire prevention strategies. This multifaceted approach transcends individual-level behaviour change and is crucial for addressing the complex issues contributing to fire risks in underserved communities.
Identifiants
pubmed: 39198806
doi: 10.1186/s12889-024-19866-z
pii: 10.1186/s12889-024-19866-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2343Informations de copyright
© 2024. The Author(s).
Références
Butler SM. Optimizing investment in housing as a social determinant of health. JAMA Health Forum. 2022;3(9):1–3.
doi: 10.1001/jamahealthforum.2022.3626
Moran-McCabe K, Burris S. Eviction and the necessary conditions for health. N Engl J Med. 2021;385(16):1443–5.
pubmed: 34623786
doi: 10.1056/NEJMp2031947
Nyamathi A, Salem B. The impact of unstable housing on health. Lancet Public Health. 2021;6:265–6.
doi: 10.1016/S2468-2667(21)00035-9
United Nations High Commissioner for Human Rights. The right to adequate housing. https://www.ohchr.org/sites/default/files/Documents/Publications/FS21_rev_1_Housing_en.pdf . Accessed 20 April 2024.
United Nations. The 17 Sustainable Development Goals. United Nations. 2024. https://sdgs.un.org/goals . Accessed 20 April 2024.
United Nations Digital Library. Committee on Economic, Social and Cultural Rights: report on the 5th session, 26 November-14 December 1990. Available from: https://digitallibrary.un.org/record/114868?ln=en&v=pdf . Accessed 20 April 2024.
Keall M, Baker M, Howden-Chapman P, Cunningham M, Ormandy D. Assessing housing quality and its impact on health, safety and sustainability. J Epidemiol Community Health. 2010;64:765–71.
pubmed: 20515890
doi: 10.1136/jech.2009.100701
Howden-Chapman P, Bennett J, Edwards R, Jacobs D, Nathan K, Ormandy D. Review of the impacts of housing quality on inequalities in health and well-being. Annual Rev Public Health. 2023;44:233–54.
doi: 10.1146/annurev-publhealth-071521-111836
Krieger J, Higgins D. Housing and health: Time again for public health action. Am J Public Health. 2002;92(5):758–68.
pubmed: 11988443
pmcid: 1447157
doi: 10.2105/AJPH.92.5.758
Easthope H. A place called home. Hous Theory Soc. 2004;21(3):128–38.
doi: 10.1080/14036090410021360
Speer J. It’s not like your home: homeless encampments, Housing projects, and the struggle over domestic space. Antipode. 2017;49(2):517–35.
doi: 10.1111/anti.12275
Sommerville P. The Social Construction of Home. J Architectural Plann Res. 1997;14(3):226–45.
Rolfe S, Gamham L, Godwin J et al. Housing as a social determinant of health and wellbeing: developing an empirically informed realist theoretical framework. BMC Public Health. 2020; 1138(2020).
Sommerville P. Understanding homelessness. Hous Theory Soc. 2013;30(4):384–415.
doi: 10.1080/14036096.2012.756096
Mistry R, Pasisi L, Chong S, et al. Socioeconomic deprivation and burns. Burns. 2010;36(3):403–8.
pubmed: 20006447
doi: 10.1016/j.burns.2009.05.021
Purcell L, Bartley C, Purcell M, et al. The effect of neighbourhood area deprivation index on residential burn injury severity. Burns. 2021;47(2):447–54.
pubmed: 32830002
doi: 10.1016/j.burns.2020.07.014
Snelling S, Challoner T, Lewis D. Burns and socioeconomic deprivation: the experience of an adult burns centre. Burns. 2021;47(8):1890–5.
pubmed: 33722449
doi: 10.1016/j.burns.2021.02.019
Heng J, Atkins J, Clancy O, et al. Geographical analysis of socioeconomic factors in risk of domestic burn injury in London 2007–2013. Burns. 2015;41(3):437–45.
pubmed: 25554260
doi: 10.1016/j.burns.2014.12.001
Rajabali F, Zheng A, Turcotte K, et al. The association of material deprivation component measures with injury hospital separations in British Columbia, Canada. Inj Epidemiol. 2019;6(20):1–9.
Swope C, Hernández D. Housing as a determinant of health equity: a conceptual model. Soc Sci Med. 2019;243(2019):1–13.
Turner S, Johnson R, Weightman A, et al. Risk factors associated with unintentional house fire incidents, injuries and deaths in high-income countries: a systematic review. Inj Prev. 2017;23(2):131–7.
pubmed: 28119340
doi: 10.1136/injuryprev-2016-042174
Grineski S, Hernández A. Landlords, fear, and children’s respiratory health: an untold story of environmental injustice in central city. Int J Justice Sustain. 2010;15(3):199–216.
Vrouwe S, Johnson M, Pham C, et al. The homelessness crisis and burn injuries: a cohort study. J Burn Care Res. 2020;41(4):820–7.
pubmed: 32619013
doi: 10.1093/jbcr/iraa023
Kramer B, Gibran N, Helmbach D, et al. Assault and substance abuse characterise burn injuries in homeless patients. J Burn Care Res. 2008;29(3):461–7.
pubmed: 18388565
doi: 10.1097/BCR.0b013e31817112b0
Friesinger J, Topor A, Bøe TD et al. The ambiguous influences of fire safety on people with mental health problems in supported housing. Humanities & Social Sciences Communication. 2019; 22(2019).
Shokouhi M, Nasiriani K, Cheraghi Z, et al. Preventive measures for fire-related injuries and their risk factors in residential buildings: a systematic review. J Inj Violence Res. 2019;11(1):1–14.
pubmed: 30416192
pmcid: 6420922
Beaulieu E, Smith J, Zheng A, et al. The geographic and demographic distribution of residential fires, related injuries and deaths in four Canadian provinces. Can J Public Health. 2020;111:107–16.
pubmed: 31598873
doi: 10.17269/s41997-019-00256-7
Papp A, Haythornthwaite J. Ethnicity and etiology in burn trauma. J Burn Care Res. 2014;35(2):99–105.
doi: 10.1097/BCR.0b013e3182a223ec
Gilbert S, Butry D. Identifying vulnerable populations to death and injuries from residential fires. Inj Prev. 2018;24(5):358–64.
pubmed: 28774896
doi: 10.1136/injuryprev-2017-042343
Danewid I. The fire this time: Grenfell, racial capitalism and the urbanization of empire. Eur J Int Relat. 2020;26(1):289–313.
doi: 10.1177/1354066119858388
Grenfell United. [Internet]. https://grenfellunited.org.uk/ . Accessed 28 July 2024.
The Tyee. [Internet]. Video shows how rapidly the deadly Winters Hotel fire spread. Accessed 28 July 2024. https://thetyee.ca/News/2024/01/30/Video-Winters-Hotel-Fire/
Shildrick T. Lessons from Grenfell: poverty propaganda, stigma and class power. Sociol Rev Monogr. 2018;66(4):783–98.
doi: 10.1177/0038026118777424
Krupa J, Boggess A, Chamberlain A, et al. Noxious housing: the influence of single room occupancy (SRO) facilities on neighbourhood crime. Crime Delinquency. 2021;67(9):1404–28.
doi: 10.1177/0011128719875701
Evans L, Strathdee S. A roof is not enough: unstable housing, vulnerability to HIV infection and the plight of SRO. Int J Drug Policy. 2006;17(2006):115–7.
doi: 10.1016/j.drugpo.2005.10.003
BC Housing Research Centre. 2018 Summary report: SRO renewal initiative series. https://www.bchousing.org/publications/BK-SRO-Renewal-Initiative-Public-Private-Partnerships.pdf . Accessed 30 April 2024.
City of Vancouver. Council Report 2023 [Internet]. https://council.vancouver.ca/20230530/documents/r4.pdf . Accessed 30 April 2024.
City of Vancouver. Single Room Occupancy (SRO) Revitalization Action Plan. 2017. https://vancouver.ca/files/cov/sro-revitalization-action-plan.pdf . Accessed 30 April 2024.
Lazarus L, Deering C, Nabess R, et al. Risky health environments: women sex workers’ struggles to find safe, secure and non-exploitative housing in Canada’s poorest postal code. Soc Sci Med. 2011;73(2011):1600–7.
pubmed: 22018526
pmcid: 3355978
doi: 10.1016/j.socscimed.2011.09.015
Masuda J. Abandoning the SRO: public health withdrawal from sanitary enforcement in Vancouver’s downtown Eastside. J Urban History. 2023;49(4):821–43.
doi: 10.1177/00961442211018795
Barbic S, Jones A, Woodward M, et al. Clinical and functional characteristics of young adults living in single room occupancy housing: preliminary findings from a 10-year longitudinal study. Can J Public Health. 2018;109(2):2014–214.
doi: 10.17269/s41997-018-0087-9
Mifflin E, Wilton E. No place like home: rooming houses in contemporary urban context. Environ Plann. 2005;37(3):403–21.
doi: 10.1068/a36119
City of Vancouver. Vancouver Fire Rescue Services Annual Report 2023 [Internet]. https://vancouver.ca/files/cov/vfrs-annual-report-2023.pdf
Newham J. An overview of Vancouver’s Downtown Eastside for UBC learning exchange Trek program participants]. https://www.learningexchange.ubc.ca/files/2010/11/overviewdtes2016.pdf . Accessed 28 April 2024.
Statistics Canada. Visible Minority of Person. https://www23.statcan.gc.ca/imdb/p3Var.pl?Function=DEC&Id=45152 . Accessed 24 May 2024.
City of Vancouver. Downtown Eastside [Internet]. https://vancouver.ca/news-calendar/downtown-eastside.aspx . Accessed 28 April 2024.
Somers J, Moniruzzaman A, Rezansoff S. Migration to the downtown Eastside neighbourhood of Vancouver and changes in service use in a cohort of mentally ill homeless adults: a 10-year retrospective study. BMJ Open. 2015;6(1):1–9.
Hammersly M, Atkinson P. Ethnography: principles in practice. 4th ed. London: Routledge; 2019.
doi: 10.4324/9781315146027
Hammersly M. Reading Ethnographic Research. 2nd ed. Essex, UK: Addison Wesley Longman Limited; 1998.
Madison DS. Critical ethnography: methods, ethics, and performance. 3rd ed. London: Sage; 2019.
Lee L, Zarowsky C. Foundational values for public health. Public Health Rev. 2015;36(2):1–9.
Thorne S. Interpretive description. 2nd ed. New York: Routledge; 2016.
doi: 10.4324/9781315426259
Atkinson P, Coffey A, Delamont S, et al. Handbook of Ethnography. 2nd ed. London: Sage; 2007.
doi: 10.4324/9780203944769
Braun V, Clarke V. Thematic analysis: a practical guide. London: Sage; 2022.
doi: 10.1007/978-3-319-69909-7_3470-2
Polit D, Beck C. Nursing research: generating and assessing evidence for nursing practice. 11th ed. Wolters Kluwer; 2021.
McCradden MD, Vasilva D, Orchanian-Cheff A, et al. Ambiguous identities of drugs and people: a scoping review of opioid-related stigma. Int J Drug Policy. 2019;74:295–215.
doi: 10.1016/j.drugpo.2019.10.005
Link B, Phelan JC. Conceptualizing Stigma. Annual Review of Sociology. 2001. 27(2001): 363–385.
Government of Canada. Naloxone. https://www.canada.ca/en/health-canada/services/opioids/naloxone.html . Accessed 25 July 2024.
British Columbia Government. Public Safety and Solicitor General. News Release. https://news.gov.bc.ca/releases/2024PSSG0001-000069 . Accessed 1 August 2024.
Office of the Auditor General of British Columbia. BC’s Toxic Drug Crisis: Implementation of Harm Reduction Programs. https://www.bcauditor.com/sites/default/files/publications/reports/OAGBC-BCsToxicDrugCrisis-Report-March2024.pdf . Accessed 1 August 2024.
Bingham B, Moniruzzaman A, Patterson M et al. Indigenous and non-indigenous people experiencing homelessness and mental health in two Canadian cities: a retrospective analysis and implications for culturally informed action. BMJ Open. 2019. 1–10.
Patrick C. Aboriginal homelessness in Canada: A literature review. The Homeless Hub. 2014. https://www.homelesshub.ca/sites/default/files/AboriginalLiteratureReview.pdf . Accessed 4 May 2024.
The Tyee. Atira overhauls board acknowledges oversight failures. 2023. https://thetyee.ca/News/2023/12/22/Atira-Overhauls-Board-Acknowledges-Oversight-Failures/ . Accessed 19 May 2024.
City of Vancouver. Hoarding Clutter Image Rating Scale. https://vancouver.ca/files/cov/hoarding-clutter-image-rating-scale.pdf . Accessed 11 April 2024.
Coquitlam Archives. Riverview Hospital Historical Society Collection. https://searcharchives.coquitlam.ca/index.php/riverview-hospital-historical-society-collection . Accessed 15 March 2024.
Kerman N, Kidd SA, Mutschler C, et al. Managing high-risk behaviours and challenges to prevent housing loss in permanent supportive housing: a rapid review. Harm Reduct J. 2023;20:40.
doi: 10.1186/s12954-023-00873-z
Snowdon J, Pertusa A, Mataix-Cols D. On hoarding and squalor: a few considerations for DSM-5. Depress Anxiety. 2012;29:417–24.
pubmed: 22553007
doi: 10.1002/da.21943
Ayers C, Iqbal Y, Strickland K. Medical conditions in geriatric hoarding disorder patients. Aging Ment Health. 2014;18(2):148–51.
pubmed: 23863040
doi: 10.1080/13607863.2013.814105
Bodryzlova Y, O’Connor K, Vallée V, et al. Community partnership in response to hoarding disorder in Montreal. Psychiatric Serv. 2020;71:631–4.
doi: 10.1176/appi.ps.201900485
Wacquant L. Punishing the poor. The neoliberal government of Social Insecurity. Durham: Duke University Press; 2009.
doi: 10.2307/j.ctv11smrv3
Rose N. Governing risks individuals: the role of psychiatry in new regimes of control. Psychiatry Psychol Law. 1998;5(2):177–95.
doi: 10.1080/13218719809524933
Kysow K, Bratiotis C, Lauster N. How can cities tackle hoarding? Examining an intervention program bringing together fire and health authorities in Vancouver. Health Soc Care Community. 2020;28:1160–9.
pubmed: 31984612
doi: 10.1111/hsc.12948
Wacquant L, Slater T, Pereira VB. Territorial stigmatization in action. Environ Plann. 2014;46(6):1270–80.
doi: 10.1068/a4606ge
Runefors M, Andersson R, Delin M, et al. Residential fire safety: an interdisciplinary approach. Springer Cham; 2023.
Government of Canada. Truth and Reconciliation Commission of Canada. https://www.rcaanc-cirnac.gc.ca/eng/1450124405592/1529106060525 . Accessed 15 March 2024.
British, Columbia, Declaration on the Rights of Indigenous Peoples Act. https://www2.gov.bc.ca/gov/content/governments/indigenous-people/new-relationship/united-nations-declaration-on-the-rights-of-indigenous-peoples . Accessed 25 May 2024.
United Nations Declaration on the Rights of Indigenous Peoples. 2018. https://www.un.org/development/desa/indigenouspeoples/wp-content/uploads/sites/19/2018/11/UNDRIP_E_web.pdf . Accessed 25 May 2024.
Benoit C, Carroll D, Chaudhry M. In search of a healing place: Aboriginal women in Vancouver’s downtown Eastside. Soc Sci Med. 2003;56(2003):821–33.
pubmed: 12560015
doi: 10.1016/S0277-9536(02)00081-3
Ivsins A. From risky places to safe spaces: re-assembling spaces and places in Vancouver’s downtown Eastside. Health Place. 2019;58(2019):1–8.
Varcoe C, Browne AJ. Integrating understanding of structural and systemic violence into TVIC. In: Wathen CN, Varcoe C, editors. Implementing trauma- and violence-informed care: a Handbook for Health and Social Services. University of Toronto; 2023. pp. 25–38.
Wathen N, Varcoe C. Implementing trauma – and violence informed care: a handbook. Toronto. University of Toronto; 2023.
Browne AJ, Varcoe C, Ford-Gilboe M et al. Disruption as opportunity: impacts of an organizational health equity intervention in primary care clinics. Int J Equity Health. 2018; 17(154).