Supporting Women Exit Sex Work: A Contribution Analysis of the Exit Doors Here Integrated Care Program in Toronto, Canada.

Introduction: Exiting sex work is a complex process which can be facilitated by integrated action on health and its social determinants such as housing and employment. Few programs offer such coordinated support, and even fewer have been evaluated. We assessed if and how Exit Doors Here, a program anchored in the Critical Time Intervention (CTI) model, facilitated women's progress towards their goals, and exit from sex work. Description: We performed a contribution analysis by combining pre-post questionnaire and administrative data from 55 women enrolled in the program (2018-2021), yearly interviews with program staff and peer mentors, and literature reviews to assess program outcomes and mechanisms as described in the theory of change. Discussion: We found evidence that the program contributed to participants progressing on their pre-employment, housing, income, and sex work exiting goals. We identified four "key ingredients" facilitating success: trust building, collaborative goal setting, connecting with community supports and weekly drop-in sessions. Conclusion: This rigorous theory-based evaluation provides much needed evidence on the process and effectiveness of an integrated sex work exiting program. Findings regarding key program ingredients can inform other interventions serving similarly marginalized populations.

Equity Promoting Integrated Care: Definition and Future Development.

Over the last three decades, integrated care has emerged as an important health system strategy to improve population health while addressing the unique needs of structurally marginalised communities. However, less attention has been given to the role of integrated care in addressing issues related to inequities in health and health care. In this commentary we introduce the concept of Equity Promoting Integrated Care (EPIC) that situates integrated care in a social justice context to frame the actions necessary to center equity as a priority for integrated care. We suggest that efforts to advance the design and implementation of integrated care should focus on three avenues for future research and practice, namely, the collaborative mobilization of a global network of integrated care stakeholders to advocate for social justice and health equity, investing in equity-focused approaches to implementation science that highlight the importance of social concepts such as colonialism and intersectionality to advance the theory and practice of implementing EPIC models of care, and leveraging innovative approaches to measuring equity-related aspects of integrated care to inform continuous improvement of health systems.

Health Equity Cannot Be Sought Without the Consideration of Racism In Equity-Focused Urban Health Initiatives.

Given that racism is present worldwide, we believe it is imperative to address racism in the pursuit of health equity in cities. Despite the strengths of global urban health efforts in improving health equity, these initiatives can be furthered by explicitly considering systemic racism. Because racism is a major contributor to health issues, utilizing critical race theory (CRT) and taking an anti-racist perspective can help key players understand how racial health differences are initiated and sustained, which will subsequently inform solutions in seeking to address urban health inequities. Applying CRT within policymaking can happen in a variety of ways that are explored in this article. Ultimately, by acknowledging and responding to the effect of racism on groups within cities and the increased difficulties racialized minorities face, international players may use their power to transfer data and resources to cities that could benefit from specialized support.

Disparities in Suicide-Related Behaviors Across Sexual Orientations by Gender: A Retrospective Cohort Study Using Linked Health Administrative Data.

OBJECTIVE: The authors used a population-representative sample and health administrative data to quantify suicide-related behavior leading to acute care or deaths across self-identified heterosexual, gay/lesbian, and bisexual individuals. METHODS: Data from a population-based survey (N=123,995) were linked to health administrative data (2002-2019), and differences in time to suicide-related behavior events across sexual orientations were examined using Cox proportional hazards regression. RESULTS: The crude incidence rates of suicide-related behavior events per 100,000 person-years were 224.7 for heterosexuals, 664.7 for gay/lesbian individuals, and 5,911.9 for bisexual individuals. In fully adjusted (gender-combined) models, bisexual individuals were 2.98 times (95% CI=2.08-4.27) more likely to have an event, and gay men and lesbians 2.10 times (95% CI=1.18-3.71) more likely, compared with heterosexual individuals. CONCLUSIONS: In a large population-based sample of Ontario residents, using clinically relevant outcomes, the study found gay/lesbian and bisexual individuals to be at elevated risk of suicide-related behavior events. Increased education among psychiatric professionals is needed to improve awareness of and sensitivity to the elevated risk of suicide-related behavior among sexual minority individuals, and further research on interventions is needed to reduce such behaviors.

Disparities in cannabis-related emergency department visits across depressed and non-depressed individuals and the impact of recreational cannabis policy in Ontario, Canada.

BACKGROUND: Recreational cannabis policies are being considered in many jurisdictions internationally. Given that cannabis use is more prevalent among people with depression, legalisation may lead to more adverse events in this population. Cannabis legalisation in Canada included the legalisation of flower and herbs (phase 1) in October 2018, and the deregulation of cannabis edibles one year later (phase 2). This study investigated disparities in cannabis-related emergency department (ED) visits in depressed and non-depressed individuals in each phase. METHODS: Using administrative data, we identified all adults diagnosed with depression 60 months prior to legalisation (n = 929 844). A non-depressed comparison group was identified using propensity score matching. We compared the pre-post policy differences in cannabis-related ED-visits in depressed individuals v. matched (and unmatched) non-depressed individuals. RESULTS: In the matched sample (i.e. comparison with non-depressed people similar to the depressed group), people with depression had approximately four times higher risk of cannabis-related ED-visits relative to the non-depressed over the entire period. Phases 1 and 2 were not associated with any changes in the matched depressed and non-depressed groups. In the unmatched sample (i.e. comparison with the non-depressed general population), the disparity between individuals with and without depression is greater. While phase 1 was associated with an immediate increase in ED-visits among the general population, phase 2 was not associated with any changes in the unmatched depressed and non-depressed groups. CONCLUSIONS: Depression is a risk factor for cannabis-related ED-visits. Cannabis legalisation did not further elevate the risk among individuals diagnosed with depression.

Experiences of insecurity among non-standard workers across different welfare states: A qualitative cross-country study.

In recent decades, economic crises and political reforms focused on employment flexibilization have increased the use of non-standard employment (NSE). National political and economic contexts determine how employers interact with labour and how the state interacts with labour markets and manages social welfare policies. These factors influence the prevalence of NSE and the level of employment insecurity it creates, but the extent to which a country's policy context mitigates the health influences of NSE is unclear. This study describes how workers experience insecurities created by NSE, and how this influences their health and well-being, in countries with different welfare states: Belgium, Canada, Chile, Spain, Sweden, and the United States. Interviews with 250 workers in NSE were analysed using a multiple-case study approach. Workers in all countries experienced multiple insecurities (e.g., income and employment insecurity) and relational tension with employers/clients, with negative health and well-being influences, in ways that were shaped by social inequalities (e.g., related to family support or immigration status). Welfare state differences were reflected in the level of workers' exclusion from social protections, the time scale of their insecurity (threatening daily survival or longer-term life planning), and their ability to derive a sense of control from NSE. Workers in Belgium, Sweden, and Spain, countries with more generous welfare states, navigated these insecurities with greater success and with less influence on health and well-being. Findings contribute to our understanding of the health and well-being influences of NSE across different welfare regimes and suggest the need in all six countries for stronger state responses to NSE. Increased investment in universal and more equal rights and benefits in NSE could reduce the widening gap between standard and NSE.

Tools for local health in all policies implementation: evidence from an explanatory case study of Kuopio, Finland.

AIMS: This paper describes the use of three governance tools for health in all policies utilised to facilitate implementation in the municipality of Kuopio, Finland: impact assessments, a city mandate (the Kuopio strategy), and shared budgets. METHODS: An explanatory case study was used. Data sources included semistructured interviews with 10 government employees and scholarly literature. Realist scientific methods were used to reveal mechanisms underlying the use of tools in health in all policies. RESULTS: Strong evidence was found supporting initial and new theory/hypotheses regarding the use of each tool in achieving positive implementation outcomes. Impact assessments facilitated health in all policies by enhancing understanding of health implications. The Kuopio strategy aided in implementation by giving credence to health in all policies work via formal authority. Shared budgets promoted intersectoral discussions and understanding, and a sense of ownership, in addition to allowing time to be spent on health in all policies work and not financial deliberation. CONCLUSIONS: Findings confirm the efficacious use of three governance tools in implementing health in all policies in Kuopio. Knowledge and evidence-based guidelines on local health in all policies implementation are needed as this policy approach continues to be recognised and adopted as a means to promote population health and health equity.

An umbrella review of intersectoral and multisectoral approaches to health policy.

Despite the widespread acceptance of the need for intersectoral and multisectoral approaches, knowledge around how to support, achieve, and sustain multisectoral action is limited. While there have been studies that seek to collate evidence on multisectoral action with a specific focus (e.g., Health in All Policies [HiAP]), we postulated that successes of working cross-sectorally to achieve health goals with one approach can glean insights and perhaps translate to other approaches which work across sectors (i.e., shared insights across HiAP, Healthy Cities, One Health, and other approaches). Thus, the goal of this study is to assemble evidence from systematic approaches to reviewing the literature (e.g., scoping review, systematic review) that collate findings on facilitators/enablers of and barriers to implementing various intersectoral and multisectoral approaches to health, to strengthen understanding of how to best implement health policies that work across sectors, whichever they may be. This umbrella review (i.e., review of reviews) was informed by the PRISMA guidelines for scoping reviews, yielding 10 studies included in this review. Enablers detailed are: (1) systems for liaising and engaged communication; (2) political leadership; (3) shared vision or common goals (win-win strategies); (4) education and access to information; and (5) funding. Barriers detailed were: (1) lack of shared vision across sectors; (2) lack of funding; (3) lack of political leadership; (4) lack of ownership and accountability; and (5) insufficient and unavailable indicators and data. These findings provide a rigorous evidence base for policymakers to inform intersectoral and multisectoral approaches to not only aid in the achievement of goals, such as the Sustainable Development Goals, but to work towards health equity.

Probing key informants' views of health equity within the World Health Organization's Urban HEART initiative.

To date, no studies have assessed how those involved in the World Health Organization's (WHO) work understand the concept of health equity. To fill the gap, this research poses the question, "how do Urban Health Equity Assessment and Response Tool (Urban HEART) key informants understand the concept of health equity?", with Urban HEART being selected given the focus on health equity. To answer this question, this study undertakes synchronous electronic interviews with key informants to assess how they understand health equity within the context of Urban HEART. Key findings demonstrate that: (i) equity is seen as a core value and inequities were understood to be avoidable, systematic, unnecessary, and unfair; (ii) there was a questionable acceptance of need to act, given that political sensitivity arose around acknowledging inequities as "unnecessary"; (iii) despite this broader understanding of the key aspects of health inequity, the concept of health equity was seen as vague; (iv) the recognized vagueness inherent in the concept of health equity may be due to various factors including country differences; (v) how the terms "health inequity" and "health inequality" were used varied drastically; and (vi) when speaking about equity, a wide range of aspects emerged. Moving forward, it would be important to establish a shared understanding across key terms and seek clarification, prior to any global health initiatives, whether explicitly focused on health equity or not.

Breastfeeding Duration Is Inversely Associated with Postpartum Allostatic Load: A Possible Mechanism for Improved Maternal Health.

Background: Allostatic load, a multisystem composite measure of chronic stress reflecting the cumulative wear and tear on the body, has utility in explaining maternal and child health disparities and predicting future health when measured during the peripartum period. Research using cross-sectional data has demonstrated an inverse association between concurrent breastfeeding status and maternal postpartum allostatic load. However, the relationship between breastfeeding duration and postpartum allostatic load has not been determined. Objective: This study aimed to examine the association between breastfeeding duration and postpartum allostatic load using prospective data, and to compare the association by race/ethnicity to better understand etiologies of health inequities. Materials and Methods: A secondary analysis of a data sample of 1,791 postpartum women from the Community Child Health Research Network was conducted. Multiple linear regression tested the association between and breastfeeding duration and allostatic load (range 0-10, calculated from 10 biomarkers) at 6 and 12 months postpartum, adjusting for race/ethnicity, maternal age, education, poverty level, study center, smoking, marital status, and prepregnancy body mass index. Stratified analyses examined differences in associations by race/ethnicity. Results: Breastfeeding duration was inversely associated with maternal allostatic load. In adjusted models, mothers who breastfed ≥6 months had 0.41 points lower allostatic load at 6 months (95% CI: -0.71 to -0.11) and 0.36 points lower allostatic load at 12 months postpartum (95% CI: -0.69 to -0.036) compared with mothers who never breastfed. Effect sizes varied in strength and significance across race/ethnic groups. Conclusions: Study findings suggest that extended breastfeeding for at least 6 months is linked with reduced chronic stress load in mothers during the first year postpartum. The inconsistency of findings across race/ethnic groups signals the importance of adjusting for prepregnancy allostatic load in future studies.

How and why buy-in for health in all policies was facilitated in Ecuador: a realist case study of Plan Nacional para el Buen Vivir.

BACKGROUND: In 2008, Ecuador introduced Plan Nacional para el Buen Vivir (PNBV; National Plan for Good Living), which was widely recognized as a promising example of Health in All Policies (HiAP) due to the integration of policy sectors on health and health equity objectives. PBNV was implemented through three successive plans (2009-2013, 2013-2017, 2017-2021). In a time of widening global health inequities, there is growing interest in understanding how politics and governance shape HiAP implementation. The objective of this study was to test specific hypotheses about how, why, to what extent, and under what circumstances HiAP was implemented in Ecuador. METHODS: An explanatory case study approach (HiAP Analysis using Realist Methods on International Case Studies-HARMONICS) was used to understand the processes that hindered or facilitated HiAP implementation. Realist methods and systems theory were employed to test hypotheses through analysis of empirical and grey literature, and 19 key informant interviews. This case study focused on processes related to buy-in for a HiAP approach by diverse policy sectors, particularly in relation to the strong mandate and transformative governance approach that were introduced by then-President Rafael Correa's administration to support PNBV. RESULTS: The mandate and governance approach of the HiAP approach achieved buy-in for implementation across diverse sectors. Support for the hypotheses was found through direct evidence about buy-in for HiAP implementation by policy sectors; and indirect evidence about allocation of governmental resources for HiAP implementation. Key mechanisms identified included: influence of political elites; challenges in dealing with political opposition and 'siloed' ways of thinking; and the role of strategies and resources in motivating buy-in. CONCLUSION: In Ecuador, political elites were a catalyst for mechanisms that impacted buy-in and government funding for HiAP implementation. They raised awareness among policy sectors initially opposed to PNBV about the rationale for changing governance practices, and they provided financial resources to support efforts related to PNBV. Specific mechanisms help explain these phenomena further. Future studies should examine ways that PNBV may have been an impediment to health equity for some marginalized groups while strengthening HiAP implementation.

Non-Standard Employment and Unemployment during the COVID-19 Crisis: Economic and Health Findings from a Six-Country Survey Study.

The COVID-19 crisis is a global event that has created and amplified social inequalities, including an already existing and steadily increasing problem of employment and income insecurity and erosion of workplace rights, affecting workers globally. The aim of this exploratory study was to review employment-related determinants of health and health protection during the pandemic, or more specifically, to examine several links between non-standard employment, unemployment, economic, health, and safety outcomes during the COVID-19 pandemic in Sweden, Belgium, Spain, Canada, the United States, and Chile, based on an online survey conducted from November 2020 to June 2021. The study focused on both non-standard workers and unemployed workers and examined worker outcomes in the context of current type and duration of employment arrangements, as well as employment transitions triggered by the COVID-19 crisis. The results suggest that COVID-19-related changes in non-standard worker employment arrangements, or unemployment, are related to changes in work hours, income, and benefits, as well as the self-reported prevalence of suffering from severe to extreme anxiety or depression. The results also suggest a link between worker type, duration of employment arrangements, or unemployment, and the ability to cover regular expenses during the pandemic. Additionally, the findings indicate that the type and duration of employment arrangements are related to the provision of personal protective equipment or other COVID-19 protection measures. This study provides additional evidence that workers in non-standard employment and the unemployed have experienced numerous and complex adverse effects of the pandemic and require additional protection through tailored pandemic responses and recovery strategies.

Legislatively Excluded, Medically Uninsured and Structurally Violated: The Social Organization of HIV Healthcare for African, Caribbean and Black Immigrants with Precarious Immigration Status in Toronto, Canada.

African, Caribbean and Black immigrants face persistent legislative barriers to accessing healthcare services in Canada. This Institutional Ethnography examines how structural violence and exclusionary legislative frameworks restrict the right to HIV healthcare access for many Black immigrants. We conducted semi-structured interviews with Black immigrants living with HIV (n = 20) and healthcare workers in Toronto, Canada (n = 15), and analyzed relevant policy texts. Findings revealed that exclusionary immigration and healthcare legislation shaping and regulating immigrants' right to health restricted access to public resources, including health insurance and HIV healthcare and related services, subjecting Black immigrants with precarious status to structural violence. Healthcare providers and administrative staff worked as healthcare gatekeepers. These barriers undermine public health efforts of advancing health equity and ending HIV "while leaving no one behind." We urge continued policy reforms in Canada's immigration and healthcare systems regarding HIV care access for Canada's precarious status immigrants.

Intersectoral and multisectoral approaches to health policy: an umbrella review protocol.

BACKGROUND: It is widely recognized that one's health is influenced by a multitude of nonmedical factors, known as the social determinants of health (SDH). The SDH are defined as "the conditions in which people are born, grow, live, work and age, and which are shaped by the distribution of money, power and resources at global, national and local levels". Despite their influence on health, most of the SDH are targeted through government departments and ministries outside of the traditional health sector (e.g. education, housing). As such, the need for intersectoral and multisectoral approaches arises. Intersectoral and multisectoral approaches are thought to be essential to addressing many global health challenges our world faces today and achieving the Sustainable Development Goals. There are various ways of undertaking intersectoral and multisectoral action, but there are three widely recognized approaches (Health in All Policies [HiAP], Healthy Cities, and One Health) that each have a unique focus. However, despite the widespread acceptance of the need for intersectoral and multisectoral approaches, knowledge around how to support, achieve and sustain multisectoral action is limited. The goal of this study is to assemble evidence from systematic approaches to reviewing the literature (e.g. scoping review, systematic review) that collate findings on facilitators/enablers and barriers to implementing various intersectoral and multisectoral approaches to health, to strengthen understanding of how to best implement health policies that work across sectors, whichever they may be. METHODS: An umbrella review (i.e. review of reviews) is to be undertaken to collate findings from the peer-reviewed literature, specifically from Ovid MEDLINE and Scopus databases. This umbrella review protocol was developed following the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P), and study design informed by the PRISMA guidelines for scoping reviews (PRISMA-ScR). DISCUSSION: Countries that employ multisectoral approaches are better able to identify and address issues around poverty, housing and others, by working collaboratively across sectors, with multisectoral action by governments thought to be required to achieve health equity.

Who loses more? Identifying the relationship between hospitalization and income loss: prediction of hospitalization duration and differences of gender and employment status.

BACKGROUND: The major determinants of health and well-being include wider socio-economic and political responses to poverty alleviation. To data, however, South Korea has no related social protection policies to replace income loss or prevent non-preferable health conditions for workers. In particular, there are several differences in social protection policies by gender or occupational groups. This study aimed to investigate how hospitalization affects income loss among workers in South Korea. METHODS: The study sample included 4876 Korean workers who responded to the Korean Welfare Panel Study (KoWePS) for all eight years from 2009 to 2016. We conducted a receiver operating characteristics (ROC) analysis to determine the cut-off point for the length of hospitalization that corresponded to the greatest loss of income. We used panel multi-linear regression to examine the relationship between hospitalization and income loss by gender and employment arrangement. RESULTS: The greatest income loss for women in non-standard employment and self-employed men was observed when the length of hospitalization was seven days or less. When they were hospitalized for more than 14 days, income loss also occurred among men in non-standard employment. In addition, when workers were hospitalized for more than 14 days, the impact of the loss of income was felt into the subsequent year. CONCLUSION: Non-standard and self-employed workers, and even female standard workers, are typically excluded from public insurance coverage in South Korea, and social security is insufficient when they are injured. To protect workers from the vicious circle of the poverty-health trap, national social protections such as sickness benefits are needed.

Intersectional inequalities in younger women's experiences of physical intimate partner violence across communities in Bangladesh.

BACKGROUND: Physical intimate partner violence (IPV) risk looms large for younger women in Bangladesh. We are, however, yet to know the association between their intersectional social locations and IPV across communities. Drawing on intersectionality theory's tenet that interacting systems of power, oppressions, and privileges work together, we hypothesized that (1) younger, lower educated or poor women's physical IPV experiences will be exacerbated in disadvantaged communities; and conversely, (2) younger, higher educated or nonpoor women's physical IPV experiences will be ameliorated in advantaged communities. METHODS: We applied intercategorical intersectionality analyses using multilevel logistic regression models in 15,421 currently married women across 911 communities from a national, cross-sectional survey in 2015. To test the hypotheses, women's probabilities of currently experiencing physical IPV among intersectional social groups were compared. These comparisons were made, at first, within each type of disadvantaged (e.g., younger or poor) and advantaged (e.g., older or nonpoor) communities; and then, between different types of communities. RESULTS: While our specific hypotheses were not supported, we found significant within community differences, suggesting that younger, lower educated or poor women were bearing the brunt of IPV in almost every community (probabilities ranged from 34.0-37.1%). Younger, poor compared to older, nonpoor women had significantly higher IPV probabilities (the minimum difference = 12.7, 95% CI, 2.8, 22.6) in all communities. Similar trend was observed between younger, lower educated compared to older, higher educated women in all except communities that were poor. Interestingly, younger women's advantage of higher education and material resources compared to their lower educated or poor counterparts was observed only in advantaged communities. However, these within community differences did not vary between disadvantaged and advantaged communities (difference-in-differences ranged from - 0.9%, (95% CI, - 8.5, 6.7) to - 8.6%, (95% CI, - 17.6, 0.5). CONCLUSIONS: Using intersectionality theory made visible the IPV precarity of younger, lower educated or poor women across communities. Future research might examine the structures and processes that put them at these precarious locations to ameliorate their socio-economic-educational inequalities and reduce IPV in all communities. For testing hypotheses using intersectionality theory, this study might advance scholarship on physical IPV in Bangladesh and quantitative intersectionality globally.

Measuring the Burden of Intimate Partner Violence by Sex and Sexual Identity: Results From a Random Sample in Toronto, Canada.

Debates on how sex, gender, and sexual identity relate to intimate partner violence (IPV) are longstanding. Yet the role that measurement plays in how we understand the distribution of IPV has been understudied. We investigated whether people respond differently to IPV items by sex and sexual identity and the implications this has for understanding differences in IPV burdens. Our sample was 2,412 randomly selected residents of Toronto, Canada, from the Neighborhood Effects on Health and Well-being (NEHW) study. IPV was measured using short forms of the Physical and Nonphysical Partner Abuse Scales (20 items). We evaluated the psychometric properties of this measure by sex and sexual identity. We examined whether experiences of IPV differed by sex and sexual identity (accounting for age and neighborhood clustering) and the impacts of accounting for latent structure and measurement variance. We identified differential item functioning by sex for six items, mostly related to nonphysical IPV (e.g., partner jealousy). Males had higher probabilities of reporting five of the six items compared to females with the same latent IPV scores. Being female and identifying as lesbian, gay, or bisexual were positively associated with experiencing IPV. However, the association between female sex and IPV was underestimated when response bias was not accounted for and outcomes were dichotomized as "any IPV." Common practices of assuming measurement invariance and dichotomizing IPV can underestimate the association between sex or gender and IPV. Researchers should continue to attend to gender-based and intersectional differences in IPV but test for measurement invariance prior to comparing groups and analyze scale (as opposed to binary) measures to account for chronicity or intensity.

Classism and Everyday Racism as Experienced by Racialized Health Care Users: A Concept Mapping Study.

In Toronto, Canada, 51.5 % of the population are members of racialized groups. Systemic labor market racism has resulted in an overrepresentation of racialized groups in low-income and precarious jobs, a racialization of poverty, and poor health. Yet, the health care system is structured around a model of service delivery and policies that fail to consider unequal power social relations or racism. This study examines how racialized health care users experience classism and everyday racism in the health care setting and whether these experiences differ within stratifications such as social class, gender, and immigration status. A concept mapping design was used to identify mechanisms of classism and everyday racism. For the rating activity, 41 participants identified as racialized health care users. The data analysis was completed using concept systems software. Racialized health care users reported "race"/ethnic-based discrimination as moderate to high and socioeconomic position-/social class-based discrimination as moderate in importance for the challenges experienced when receiving health care; differences within stratifications were also identified. To improve access to services and quality of care, antiracist policies that focus on unequal power social relations and a broader systems thinking are needed to address institutional racism within the health care system.

A gap in knowledge surrounding urban housing interventions: a call for gender redistribution.

Using gender-sensitive (ensures that resource distribution considers gender) and gender-redistributive (aims to develop balanced gendered relationships through redistributing resources) analytic lenses in urban health interventions is long overdue. The social construction of gender and its impact on the health of marginalized women, especially women who experience homelessness within urban settings is frequently overlooked. Housing research, programs, and policies too often fail to utilize gender redistributive frameworks-perpetuating gendered harm for many. This article provides an update of current practices around consideration of gender in housing interventions and literature while advocating for the necessary incorporation of gender-redistributive practices in housing research and program implementation. Addressing these gaps will address the longstanding neglect that has led to disparities among women who experience homelessness or housing insecurity.