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Violence and insecurity are often read as totalising narratives of communities in parts of Latin America, flattening the complexity of everyday life and the responses of occupants who suffer from fear. In this article we draw on ethnographic research undertaken in los Altos de Cazucá in Colombia and in San Luis Potosí in Mexico. While both sites are distinct locations with different historic, economic, social and political contexts they share features of communities affected by violence and insecurity: distrust of institutions of the state; rationalisations for managing violence in daily life; and narratives of fear that appear woven through the fabric of conversations. However, fear and violence are not all-encompassing experiences and individuals in both these communities describe practices of navigation of violence that draw on positive communal experiences. This article explores how, in these communities where violence comes to be expected but never normalised, people navigate their everyday lives. KeywordsViolence; social navigation; Colombia; Mexico; insecurity; everyday life. Please cite this article as:

Objectives The aims of the present study were to examine tenants' experiences of a model of integrated health care and supportive housing and to identify whether integrated health care and supportive housing improved self-reported health and healthcare access. Methods The present study used a mixed-method survey design (n=75) and qualitative interviews (n=20) performed between September 2015 and August 2016. Participants were tenants of permanent supportive housing in Brisbane (Qld, Australia). Qualitative data were analysed thematically. Results Integrated health care and supportive housing were resources for tenants to overcome systematic barriers to accessing mainstream health care experienced when homeless. When homeless, people did not have access to resources required to maintain their health. Homelessness meant not having a voice to influence the health care people received; healthcare practitioners treated symptoms of poverty rather than considering how homelessness makes people sick. Integrated healthcare and supportive housing enabled tenants to receive treatment for health problems that were compounded by the barriers to accessing mainstream healthcare that homelessness represented. Conclusions Extending the evidence about housing as a social determinant of health, the present study shows that integrated health care and supportive housing enabled tenants to take control to self-manage their health care. In addition to homelessness directly contributing to ill health, the present study provides evidence of how the experience of homelessness contributes to exclusions from mainstream healthcare. What is known about the topic? People who are homeless experience poor physical and mental health, have unmet health care needs and use disproportionate rates of emergency health services. What does the paper add? The experience of homelessness creates barriers to accessing adequate health care. The provision of onsite multidisciplinary integrated health care in permanent supportive housing enabled illness self-management and greater control over lifestyle, and was associated with self-reported improved health and life satisfaction in formerly homeless tenants. What are the implications for practitioners? Integrated health care and supportive housing for the formerly homeless can improve self-reported health outcomes, enable healthier lifestyle choices and facilitate pathways into more appropriate and effective health care.

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