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An Intersectional Perspective on Digital Health: Longitudinal Narratives and Observations With Older and Middle-Aged Women Experiencing Homelessness
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, CIRCLE – Complex Intervention Research in Health and Care. UCL, Fac Brain Sci, Div Psychiat, London, England..ORCID iD: 0000-0001-5804-0433
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. Marie Cederschiold Univ Coll, Dept Healthcare Sci, Stockholm, Sweden..ORCID iD: 0000-0001-5104-1281
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health, Participatory eHealth and Health Data Research Group. Marie Cederschiold Univ Coll, Dept Healthcare Sci, Stockholm, Sweden..ORCID iD: 0000-0001-7935-3260
UCL, Inst Epidemiol & Hlth Care, UCL Collaborat Ctr Inclus Hlth, London, England..
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2025 (English)In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 65, no 4, article id gnaf021Article in journal (Refereed) Published
Abstract [en]

Background and Objectives: People experiencing homelessness and older people encounter barriers as health and social care services are increasingly delivered online, however, there is limited knowledge about how this relates to older and middle-aged women experiencing homelessness, especially those from minoritized and/or migrant communities. We aimed to explore how technology, including digital health, can help or hinder older and middle-aged women to navigate paths through and out of homelessness.

Research Design and Methods: This 16-month qualitative longitudinal study utilized narrative interviews and participant observations with seven older and two middle-aged women experiencing homelessness, in London, England. Additionally, we observed interactions between the women experiencing homelessness and 2 information and communications technology class facilitators. We collected and analyzed data using a narrative, interpretative approach. An advisory board of women with lived experiences of homelessness supported the interpretation of findings and development of practice and policy recommendations.

Results: We present our findings as 3 composite narrative vignettes co-constructed with the participants: (1) "No, I'm not taking this telephone appointment"; (2) "Technology doesn't judge you"; and (3) "You have to be a digital person now." The findings illuminate determinants of digital health equity related to aging, gender, and migration status among older and middle-aged women experiencing homelessness.

Discussion and Implications: Using an intersectional lens, we provide recommendations about how to better align digital health to the needs of older and middle-aged women experiencing homelessness. The findings will inform intervention development.

Place, publisher, year, edition, pages
Oxford University Press, 2025. Vol. 65, no 4, article id gnaf021
Keywords [en]
digital divide, eHealth, homeless, qualitative research, Women's health
National Category
Social Work Nursing
Identifiers
URN: urn:nbn:se:uu:diva-554890DOI: 10.1093/geront/gnaf021ISI: 001460320300001PubMedID: 39869439Scopus ID: 2-s2.0-105002758555OAI: oai:DiVA.org:uu-554890DiVA, id: diva2:1954274
Available from: 2025-04-24 Created: 2025-04-24 Last updated: 2025-04-24Bibliographically approved

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Gaber, SophieMattsson, ElisabetKlarare, Anna
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CIRCLE – Complex Intervention Research in Health and CareDepartment of Women's and Children's HealthParticipatory eHealth and Health Data Research Group
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