Health in the Tenderloin: A Resident-Guided Study of Substance Use, Treatment, and Housing

• In Event: 406 - Section on Alcohol, Drugs, and Tobacco Paper Session. Examining Addiction: Critical Perspectives (co-sponsored with the Section on Sexualities)

Abstract

Understanding the relationship between health and places is critical for the successful delivery of community-based health services. This is particularly true in places that are considered "risky", where the social or physical environments can increase harm, such as the Tenderloin neighborhood of San Francisco, California. It is evident that the social environment of the Tenderloin shapes the health of its residents, but the mechanisms involved in this process are less understood. The purpose of this paper is to qualitatively describe how residents of the Tenderloin neighborhood report the pathways through which the environment shapes their everyday health experiences. I focus on tenants living in the supportive housing hotels who have histories of using drugs and/or alcohol. To examine the relationship between health and place, I developed the docent method, a new qualitative method for exploring health and place. The docent method consists of a participant-led walking interview through the buildings, streets, and other places significant to each participant. Based on docent method interviews with formerly homeless women living in supportive housing, I present three interrelated ways the Tenderloin social environment affects women’s substance use and treatment experiences: 1) the risks of a broader drug market are transferred from other spaces and concentrated in the Tenderloin, 2) policing and surveillance on multiple levels were persistent, inescapable presences, and 3) participants experienced economic, social, and physical stratification in the Tenderloin.

Author

• Jamie Suki Chang, University of California-SF