Health and Homelessness

Homelessness is a growing problem in Canada that affects not only large urban populations but also rural areas alike. Approximately 17 million people in Canada are homeless and/or experience great difficulty coping with the lack of affordable housing, both of which are found to have a direct impact on health. Further, the determinants of health are broadly affected when the access to proper shelter is deficient. Overall, it has an impact on individuals, families, and communities, further emphasizing the need for healthcare providers, including nurses, to embrace a leadership role that addresses and advocates for programs that promote affordable housing and strive to assure health of all.

 

Though there is no concrete definition for homelessness, certain classifications have been established. According to the Registered Nurses Association of Ontario (2004), “There are different ways in which homelessness occurs:

  • Absolute Homelessness: Individuals sleeping outside or using public or private shelters
  • Concealed Homelessness: Individuals who are provisionally lodging with friends or family
  • Risk of Homelessness: Individuals struggling to meet core housing needs of which affordability, suitability and adequacy norms are all elements.”

 

Homelessness exists in many different faces which include families, individuals, and youth. This fact is further supported by an Ottawa-based longitudinal study which found that in 2002 and 2003 « 17% of those interviewed identified themselves as being of Aboriginal descent, compared to their 1% representation in the general Ottawa population » (www.unitedwayottawa.ca). The issue of homelessness has a multiplicity of causes including: eviction, loss of employment, inability to afford the cost of rent, conflicts, as well as mental and physical health problems. Thus, comprehensive assessment may serve as an effective tool to complement the faculty of nursing skills and resources.

 

Homelessness has a direct correlation to health outcomes and the accessibility of health services. Also, individuals who are homeless are found to be at an increased risk for several chronic and/or fatal diseases such as the growing concern of Tuberculosis (TB). Individuals who are homeless are 20-300 times more likely to contract TB.

 

Over the years, housing programs have been decreased or cancelled. From 1984-1993, the federal government cut approximately two billion dollars from the national housing program, and subsequently delivered the biggest hit with the cancellation of the national housing program in 1993. Financial cuts to any programs often cause great losses. In 2000, the federal government held an inter-provincial and inter-territorial housing summit that proclaimed the plan to create affordable housing. However, a concrete national housing strategy has not yet been realized. Rather, announcements regarding new housing were delivered but the materialization of which accounts to fractions. Governments and individuals must act on promises and develop strategies to eliminate homelessness and poverty.

 

There are many initiatives occurring at the activist level. Two such initiatives include the «Make Poverty History Campaign» and the «1% Solution». « The Make Poverty History» campaign wants to improve aid, trade-justice, eliminate the deficit, and end child poverty in Canada» (www.makepovertyhistory.ca). «The Toronto Disaster Relief Committee (TDRC) initiated the 1% Solution to call on all levels of government to double their commitment to housing programs by restoring and renewing house spending» (www.tdrc.net).

 

CNSA believes that nurses as well as nursing students have many roles and responsibilities in assisting with the abolishment of homelessness. Nursing practice will be impacted by homelessness and by the lack of affordable housing due to the emotional, mental, physical, and physiological toll that it has on the health of individuals who are battling housing issues. We have the responsibility to educate and advocate all levels of government, health care professionals, and the public. We must endorse, support and become involved in initiatives that call on all levels of government and policy to acknowledge and respond to the crisis of homelessness and the lack of affordable housing in Canada.

 

References:

Make Poverty History (2005). Retrieved November 30, 2005 from http. www.makepovertyhistory.ca

Registered Nurses Association of Ontario (2004). Policy Statement: Homelessness. Retrieved August 1, 2005 from http://www.rnao.org/html/PDF/RNAO_Policy_Statement_Homelessness.pdf

Stamler & Yui (2005). Community Health Nursing a Canadian Perspective: Poverty and Homelessness. Prentice Hall: Toronto, ON: pp.283-297.

Toronto Disaster Relief Committee (2005). National Housing and Homelessness 2005 - Promises made, Promises betrayed: National report card grades federal housing effort as a failure. Retrieved November 30, 2005 from http://www.tdrc.net Toronto Disaster Relief Committee (2000). An Open Letter Canadians Housing Ministers: Canada's nation-wide housing crisis demands a nation-wide solution: $2 billion in new funding for social housing. Retrieved August 1, 2005 from http://www.tdrc.net

Toronto Disaster Relief Committee. One Percent Solution. Retrieved August 1, 2005 from http://www.tdrc.net

Tuberculosis Action Group (2003). TB or not TB? There is no question. Retrieved August 1, 2005 from http://www.tdrc.net

United Way of Ottawa (2005). Experiencing Homelessness – The first report card on Homelessness in Ottawa 2005. Retrieved August 1, 2005 from http://www.unitedwayottawa.ca