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Demographic and economic characteristics of residents of four subsidized housing facilities in Nashville, TN, and their preferences for co-located services

Clouse, K.; Kimpel, C.; Chavez, L.; Terrell, T.; Landivar Donato, J.; Hasbrooke, N.; Frenia, M.; Elrod, B.; Ketel, C.

2025-08-26 public and global health
10.1101/2025.08.23.25334285 medRxiv
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IntroductionPermanent supportive housing, which combines stable housing with tailored wraparound services, has emerged as a critical intervention to combat chronic homelessness and promote health equity. This study focuses on Nashville, Tennessee, an area marked by rapid growth, poverty, and housing instability, to better understand the characteristics and service needs of residents in subsidized housing. MethodsA cross-sectional study (2023-2025) recruited 140 residents from four subsidized housing facilities using randomized selection. We administered semi-structured questionnaires assessing demographics, past experiences with homelessness and incarceration, and preferences for health and social services. ResultsMost residents were Black/African American (63.6%) and older adults, with 80% earning under $20,000 annually. Significant experiences with both homelessness (70%) and incarceration (53.6%) were noted. Residents expressed strong interest in on-site services, particularly dental and vision care (over 90%) and adult primary care accepting TennCare/Medicaid (91.4%). ConclusionsOur findings depict a population facing multiple vulnerabilities, including economic instability and social isolation, highlights the importance of combining housing with comprehensive health and social services in addressing inequities. Prioritizing resident feedback in service design can enhance the effectiveness of housing interventions. Effective interventions must be trauma-informed and community-centered, ensuring that housing serves as a foundation for health and well-being. Housing providers and policymakers should foster collaboration across sectors to facilitate sustainable, equitable health outcomes in subsidized housing settings.

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