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An Intersectional Perspective on Digital Health: Longitudinal Narratives and Observations With Older and Middle-Aged Women Experiencing Homelessness

Gaber, Sophie Nadia; Mattsson, Elisabet; Klarare, Anna; Dawes, Joanna; Rapaport, Penny; (2025) An Intersectional Perspective on Digital Health: Longitudinal Narratives and Observations With Older and Middle-Aged Women Experiencing Homelessness. The Gerontologist , 65 (4) , Article gnaf021. 10.1093/geront/gnaf021. Green open access

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Abstract

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.

Type: Article
Title: An Intersectional Perspective on Digital Health: Longitudinal Narratives and Observations With Older and Middle-Aged Women Experiencing Homelessness
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1093/geront/gnaf021
Publisher version: https://doi.org/10.1093/geront/gnaf021
Language: English
Additional information: © The Author(s) 2025. Published by Oxford University Press on behalf of the Gerontological Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Science & Technology, Life Sciences & Biomedicine, Gerontology, Geriatrics & Gerontology, digital divide, eHealth, homeless, qualitative research, Women's health
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry > Mental Health of Older People
URI: https://discovery.ucl.ac.uk/id/eprint/10216794
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