Homelessness and Health in Canada: Research Lessons and Priorities

Abstract

This article was for prepared for an international think-tank on reducing health disparities and promoting equity for vulnerable populations. Its purposes are to provide an overview of homelessness research and to stimulate discussion on strategic directions for research. We identified studies on homelessness, with an emphasis on Canadian research. Studies were grouped by focus and design under the following topics: the scope of homelessness, the health status of homeless persons, interventions to reduce homelessness and improve health, and strategic directions for future research. Key issues include the definition of homelessness, the scope of homelessness, its heterogeneity, and competing explanations of homelessness. Homeless people suffer from higher levels of disease and the causal pathways linking homelessness and poor health are complex. Efforts to reduce homelessness and improve health have included biomedical, educational, environmental, and policy strategies. Significant research gaps and opportunities exist in these areas. Strategic research will require stakeholder and community engagement, and more rigorous methods. Priorities include achievement of consensus on measuring homelessness, health status of the homeless, development of research infrastructure, and ensuring that future initiatives can be evaluated for effectiveness. MeSH terms: Homeless persons; vulnerable populations; poverty; health status; health behaviour; health services La traduction du résumé se trouve à la fin de l'article.

Homeless Women's Voices on Incorporating Companion Animals into Shelter Services

“…Additionally, they are faced with a lack of affordable housing, including inadequate housing for Aboriginal peoples and other specific populations such as the elderly, disabled, those with mental health disabilities, youth, immigrants, and women. In addition, as per the Canadian Federal government's fiduciary responsibility, and Federal social policies such as the National Child Benefit Supplement and the Employment Insurance policy, women are left with inadequate support (Lenon 2000;Hulchanski 2001;Callaghan et al 2002;Frankish, Hwang and Quantz 2005;Graham, Walsh and Sandalack 2008).…”

“…Research supports that homeless individuals are at a greater risk of poor health outcomes (O' Grady and Gaetz 2004;Frankish, Hwang and Quantz 2005) and increased utilization of mental health and addictions services (Caton et al 1995;Grimm and Maldonado 1995;Bogard et al 1999;Burt, Laudan and Edgar 2001;Taylor, Williams and Gray 2004) than their housed counterparts. Women who are homeless are less likely to have substance abuse disorders, have higher rates of mental illness (Fischer and Breakey 1991), and are at greater risk of death than homeless men (Roy et al 1998;Cheung and Hwang 2004).…”

Clarifying the link between traumatic brain injury and homelessness: Workshop proceedings

“…In 2011, on average 3669 beds were occupied nightly in the Toronto shelter system alone and the projected 2012 operating budget for these shelters was $62.26 million [6]. People who are homeless spend 4 more days on average in hospital each year, suffer from more mental health and substance abuse problems and have a higher mortality rate than those in the general population [7][8][9][10][11][12][13]. The potential to reduce the rate of homelessness and the incidence of injury and illness among homeless people has significant financial, societal and individual implications.…”

Development of IMAGINE: A three-pillar student initiative to promote social accountability and interprofessional education

“…Compared to men in the general population, homeless men living in shelters in Toronto have a 2-8 times higher mortality rate (Hwang, 2000), with higher rates of chronic disease conditions, infectious diseases, mental health disorders, and substance use. Furthermore, members of the homeless population face barriers that prevent them from accessing health care services, including a lack of identification documents and inadequate housing (Frankish, Hwang, & Quantz, 2005;Hwang et al, 2010).…”