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Housing Vulnerability and Health: Canada’s Hidden Emergency. A report on the Reach3 Health and Housing in Transition Study, November 2010.
In Canada, healthcare is something that we generally take for granted.
Few of us are concerned that we would not be able to see a doctor if we needed, if we would be able to rest and recover from a case of the flu, or whether or not buying medicine would mean we couldn’t pay the rent. Yet for the homeless and those so severely disenfranchised that they are at risk for becoming homeless, these are very real concerns. Housing Vulnerability and Health: Canada’s Hidden Emergency examines these issues. It draws upon a data set collected by surveying 1200 people in homeless shelters, meal programs, single occupancy hotels and rooming houses in 3 Canadian cities. The results are a fascinating, if disturbing, glimpse of both the medical concerns of this group, the barriers they face in getting the care they need, and the role housing plays in their struggle.
The report emphasizes the fact that the health issues of the homeless and vulnerably housed are considerably different from that of the typical Canadian. The group surveyed suffered from a list of diseases and chronic conditions that are as alarming as they were frequent; Hepatitis B & C (30%), Asthma (23%), HIV (6%), arthritis (33%). Over one quarter are missing a limb or have other issues with mobility. Mental illness was also common, with over half the group having been diagnosed with a mental health problem, and over 60% having suffered a traumatic brain injury. Hospital visits among the homeless and vulnerably housed are alarmingly frequent. Over half of the group surveyed had visited an emergency department in the past year, and one in four required an overnight hospital stay.
Even more revealing were the factors the group reported as preventing them from getting treatment for their conditions. As many as 38% indicated that they were unable to access healthcare in the past year, and 23% had unmet mental healthcare needs. When asked the specific factors that prevented them from accessing healthcare they needed, 8% were unable to wait for an appointment, 10% reported actually being refused service, and 9% simply didn’t have a healthcare card. Furthermore, one in five people suffering from mental illness did not even know where to seek treatment. These factors combined have resulted in a group of people with a lifespan 7 to 10 years shorter than the average Canadian, with suicide rates for women six times higher than those in the general population.
The study urges the need for improvements in the quality and accessibility of housing for this group. Through such improvements, both the length and quality of their lives can be improved. The authors argue that quality housing is a basic foundation for maintaining mental and physical health. The federal government, as part of its obligations in the Canada Health Act, needs to play a role in ensuring all Canadians have access to safe housing of reasonable quality, affording protection from the weather, and a degree of security. Such housing provides a place to recover from illness and would ease many of their difficulties in maintaining a healthy and appropriate diet. It must also be stable, in the sense that the is rent affordable.
Those surveyed indicated that they spent 52% of their income on housing. The study argues that when rent costs more than 30% of a household’s income, there is little money left for medicine, food or other unexpected expenses. Furthermore, without residual income to save, loss of a job or inability to work due to sickness would place individuals at extreme risk for homelessness. The report suggests that housing subsidized by charities or government programs could ease this burden considerably. Furthermore, housing must be appropriate to the individual, particularly in the case of individuals with mental illness. A supportive living situation is badly needed, with access to appropriate social and medical services. Such services would help residents from returning to a life on the street, finding themselves in a hospital, or as the report indicates, ending up in jail.
Review by Ben Wilkie
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Thursday, 17 May 2012 
