Characterizing people experiencing homelessness and trends in homelessness using population-level emergency department visit data in Ontario, Canada

Strobel, Stephenson; Burcul, Ivana; Dai, Jai Hong; Ma, Zechen; Jamani, Shaila; Hossain, Rahat

doi:10.25318/82-003-x202100100002-eng

Cited by 15 publications

(16 citation statements)

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“…There may not be a clear distinction between correlates, predictors and consequences of homelessness in this complex system. Data about people experiencing homelessness may be prone to less completeness than other population groups because of the challenges associated with identifying individuals with frequently changing residential addresses over time and between datasets [ 59 – 61 ]. There were challenges comparing between studies because of the different definitions of exposures, outcomes, analytical methods and reporting completeness.…”

Section: Discussionmentioning

confidence: 99%

Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review

Mitchell,

Waring,

Ahern

et al. 2023

BMC Public Health

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Background Homelessness is a complex societal and public health challenge. Limited information exists about the population-level health and social care-related predictors and consequences of persons with lived experience of homelessness (PEH). Studies that focus on population subgroups or ad hoc questionnaires to gather data are of relatively limited generalisability to whole-population health surveillance and planning. The aim of this study was to find and synthesise information about the risk factors for, and consequences of, experiencing homelessness in whole-population studies that used routine administrative data. Method We performed a systematic search using EMBASE, MEDLINE, the Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and PsycINFO research databases for English-language studies published from inception until February 2023 that reported analyses of administrative data about homelessness and health and social care-related predictors and consequences. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Results Of the 1224 articles reviewed, 30 publications met the inclusion criteria. The included studies examined a wide range of topic areas, and the homelessness definitions used in each varied considerably. Studies were categorised into several topic areas: Mortality, morbidity and COVID-19; health care usage and hospital re-admission; care home admission and shelter stay; and other (e.g. employment, crime victimisation). The studies reported that that the physical and mental health of people who experience homelessness was worse than that of the general population. Homeless individuals were more likely to have higher risk of hospitalisation, more likely to use emergency departments, have higher mortality rates and were at greater risk of needing intensive care or of dying from COVID-19 compared with general population. Additionally, homeless individuals were more likely to be incarcerated or unemployed. The effects were strongest for those who experienced being homeless as a child compared to those who experienced being homeless later on in life. Conclusions This is the first systematic review of whole-population observational studies that used administrative data to identify causes and consequences associated with individuals who are experiencing homelessness. While the scientific literature provides evidence on some of the possible risk factors associated with being homeless, research into this research topic has been limited and gaps still remain. There is a need for more standardised best practice approaches to understand better the causes and consequences associated with being homeless.

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Section: Discussionmentioning

confidence: 99%

Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review

Mitchell,

Waring,

Ahern

et al. 2023

BMC Public Health

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“…Since the development of this algorithm, various studies have leveraged this method to measure or describe homelessness in Ontario and Canada (Hossain et al 2021;Richard et al 2021;Strobel et al 2021;Wang et al 2020). There are obvious advantages to the use of this tool, which explains its immediate uptake.…”

Section: Using Health Administrative Data To Measure Homelessnessmentioning

confidence: 99%

“…People experiencing homelessness (PEH) face significant social stigma and numerous structural inequities and are at increased risk for a variety of poor health outcomes (Bowen et al 2019). This population is highly heterogeneous, with many subgroups, such as Indigenous People and veterans, who are disproportionately represented; these subgroups experience contextdependent challenges that require specific types and intensities of support (Findlay et al 2018;Kidd et al 2017;Kneebone et al 2015;Pomeroy 2020;Schiff et al 2016;Strobel et al 2021). Despite this, our ability to respond effectively to homelessness is hindered by difficulties in counting PEH (CAEH 2018).…”

Section: Introductionmentioning

confidence: 99%

Utility, Limitations and Opportunities for Using Linked Health Administrative Data to Study Homelessness in Ontario

Booth¹,

Richard²,

Forchuk³

et al. 2022

hcq

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Homelessness is a significant social issue within Canada but is difficult to quantify at the population level. In this paper, we discuss the development and use of a case ascertainment algorithm that identifies people experiencing homelessness through health administrative data. We highlight the appropriateness of various uses of this method given its key strengths and limitations. Finally, we discuss plans to improve this methodology and broaden its use through the addition of linkable administrative data from non-health sectors, such as emergency shelters and social services organizations.

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“…In Canada, homelessness has been on the rise between 2010-2017 [44], with 1% of the total population visibly homeless, that is, sleeping rough or using shelters, and 8% of the population experiencing 'hidden' homelessness such as sleeping in their car, with friends, 'couch surfing', or in a tent [45]. Canada also has the highest income to house price ratio in the world [46], which means that the average price of a house costs more for Canadians relative to income than anyone else in the world.…”

Section: The Housing Crisis In Canadamentioning

confidence: 99%

Capital Sequestration: Degrowth through Investing in Community-Led Transformations of Provisioning Systems

Sellers¹

2022

CiS

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Investing in different futures is an existential challenge that much research within and adjacent to Ecological Economics engages with, yet organizations that recognize this social ecological imperative have few options for funding and implementing radical transformations to the needs and well-being provisioning systems that currently exist. Ecological macroeconomic ideas and EE principles of long term well being and justice on a livable planet will be explored in the context of the housing crisis in Canada, and a rural Ontario community organization attempting to find transformative solutions to the lived, local experience of this crisis. Provisioning systems for housing, when tied to real estate markets, debt money creation, land enclosures, and financialized supply chains, contribute to capital accumulation cycles; it is hardly possible to meet our housing needs, in aggregate, without also perpetuating the form of this provisioning system. The idea presented here, that of Capital Sequestration, proposes to remove capital from markets and 'invests' this capital in land trusts as an intentional transformation of financial capital into social and ecological values. Through land and housing trusts as well as non-market funding pathways, Capital Sequestration is a method of investing in the transformation of provisioning systems through the sustained and collective boundary management of financial markets and incommensurable values. This practice offers significant promise as it applies ecological macroeconomic theory work, is grounded in the normative goals of and emerges from empirical research of EE, and meets a pressing need within society for imagining alternative economies.

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Characterizing people experiencing homelessness and trends in homelessness using population-level emergency department visit data in Ontario, Canada

Cited by 15 publications

References 0 publications

Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review

Predictors and consequences of homelessness in whole-population observational studies that used administrative data: a systematic review

Utility, Limitations and Opportunities for Using Linked Health Administrative Data to Study Homelessness in Ontario

Capital Sequestration: Degrowth through Investing in Community-Led Transformations of Provisioning Systems

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