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Alcohol & Other Drugs

Homelessness

What are we talking about and what do we know

Bernie Pauly

Reprinted from "Housing" issue of Visions Journal, 2013, 8 (1), pp. 5-6

Homelessness is a societal problem impacting many Canadian communities. In urban centres, like Victoria and Vancouver, homelessness is and continues to be a priority concern.1 Although less visible, we know homelessness in rural communities exists too.2 Homelessness affects women, families, youth and seniors, and disproportionately impacts Aboriginal peoples.

People who experience homelessness have more physical, mental health and substance use problems than the general population.3 Worst of all, we know that people who are homeless or at risk of homelessness die prematurely.4 We also know that housing people costs less than managing homelessness.5 Clearly, homelessness is a problem we need to solve to prevent deaths, improve health and save money.

Homelessness in Canada

The word “homelessness” gets tossed around; people say it often. So, when we start to ask what we can do to solve homelessness, we need to start with an understanding of what we mean.

The Canadian Definition of Homelessness, drafted by the Canadian Homelessness Research Network, defines four different categories of homelessness. These include being:

  1. unsheltered and living in the streets or places not meant for human habitation
  2. emergency sheltered, which refers to those who are in emergency overnight shelters for the homeless
  3. provisionally sheltered, which includes those who have temporary accommodation
  4. at risk of homelessness because rent is consuming too much of their income or housing does not meet public health and safety standards6

Defining homelessness in this way highlights the society-wide problems that have contributed to homelessness and recognizes that housing is a human right. Ending homelessness means that everyone will have a fixed address that is affordable, safe, adequately maintained and suitable in size, and if needed, a system of services that support housing stability.6

Canada has been party to two international treaties that commit Canada to housing as a human right. In both the Universal Declaration of Human Rights and the International Covenant on Social, Cultural and Economic Rights, adequate housing is part of the right to adequate standard of living.7 The United Nations (UN) has criticized Canada several times for not meeting our commitments to these treaties, especially for Aboriginal peoples.8

In BC, a Victoria legal case established that preventing people from erecting shelter is a threat to health and human rights.9 However, allowing someone to erect shelter is not the same as ensuring that everyone has a right to a safe affordable home, sufficient income to afford housing, adequate food to eat, and a sense of belonging to a community.

Canada does not have a national housing strategy. The UN has recommended that Canada develop a national strategy for addressing issues of homelessness.

Roots of Homelessness

The causes of homelessness are not necessarily what we see on our streets. David Hulchanski, a prominent Canadian researcher, describes how a series of ‘dehousing policies’ have created homelessness.10 These dehousing policies include shifts to a more privatized housing market, with little non-profit housing being built over the last 20 years.11,12 It’s no surprise that, as these policy changes were unfolding, homelessness started to emerge as a concern. These policies, combined with a series of other new and long-standing policies, have fueled the problem. For Aboriginal peoples in Canada, a history of decolonization has limited their access to land and resources, and has contributed to high rates of poor health and homelessness.13

In BC, changes to welfare rates and the failure of welfare rates to match increases in cost of living have contributed to growing levels of poverty and increasing homelessness for many.14,15 For example, the current shelter rate in BC is $375 per month, and in Victoria, the average cost of rental market bachelor suite is $676.16 While public or social housing costs less, there are approximately 1,545 people on the housing registry for subsidized housing in Victoria.

People on all forms of social assistance, or working for minimum wages, simply do not have enough income to afford market rents, feed and clothe themselves, and have no money for emergencies or savings.16 These are fundamental issues, or root determinants, that impact and contribute to homelessness for many people.

Some people become homeless because of job loss, injury, illness, violence or family conflict. In particular, family conflict and violence impact and contribute to homelessness for youth and women.

Closing mental institutions meant that people with mental illness were discharged into the community without access to affordable housing options. Many did not have incomes or opportunities for employment sufficient to afford the high cost of housing in our cities. At the same time, being homeless contributes to worsening mental health. Similarly, substance use often begins with, or is made worse by, homelessness.

Mental illness and substance use are not necessarily root causes of homelessness, but they are part of the pathways into and out of homelessness. In the United States, large-scale analysis has shown that it is housing and income conditions that are more likely to determine rates of homelessness.17,18 Factors such as poverty, mental illness and substance use determine who will become homeless in such conditions.

Solutions to Homelessness

Clearly, the solutions to homelessness rest in at least four areas:

  • an adequate supply of housing
  • an adequate income
  • prevention of homelessness among at-risk groups
  • evidence-based interventions that end homelessness

When seeking solutions, it is crucial to remember that homelessness affects real people. The experience is accompanied by trauma and difficulties that many bear and will bear for generations.

If homelessness is a systemic problem, then we need to listen to, and hear, the voices of people whose choices in life have been compromised by the system—a system that often disadvantages those who are poor and/or because of their gender, sexual orientation or ethnic background. It is difficult to know how to solve a situation if you don’t understand something about the experiences and needs of people who have lived that situation.

In my work, I am very aware of the multitude of policies and programs that fail people who are homeless. They fail precisely because the policy makers haven’t listened to, and included, the voices of people who have experienced homelessness. My colleague and I  have been working to identify promising practices for social inclusion19 of people experiencing homelessness. We are taking next steps to incorporate these learnings—and the voices of people who are impacted by homelessness—in the development of solutions to end homelessness.

 
About the author

Dr. Pauly is an Associate Professor in the School of Nursing at the University of Victoria, Scientist with the Centre for Addictions Research of BC, and member of the Core Public Health Functions Research Initiative. Her primary research focus is the promotion of health equity in public health and reduction of health inequities associated with substance use and homelessness. She is a research collaborator with the Greater Victoria Coalition to End Homelessness and co-author of Quiet Crisis, a report on housing and supports in Greater Victoria

Footnotes:
  1. Victoria Foundation. (2012). Victoria’s vital signs: Greater Victoria’s 2012 annual check-up. Victoria, BC: Victoria Foundation.
  2. National Coalition for the Homeless. (2009, July). Rural homelessness. Retrieved from: www.nationalhomeless.org
  3. Frankish, C.J., Hwang, S.W., & Quantz, D. (2005). Homelessness and health in Canada: Research lessons and priorities. Canadian Journal of Public Health, 96(Suppl 2), S23-29.
  4. Hwang, S.W., Wilkins, R., Tjepkema, M., et al. (2009). Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 year follow-up study. British Medical Journal, 339, b4036.
  5. Patterson, M., Somers, J., MacIntosh, K., et al. (2007). Housing and supports for adults with severe addictions and mental illness in British Columbia. Vancouver: Centre for Applied Research in Mental Illness and Addiction, Simon Fraser University.
  6. Canadian Homelessness Research Network. (2012). Canadian definition of homelessness. Toronto: Canadian Homelessness Research Network.
  7. Office of the United Nations High Commissioner for Human Rights. (2009). The right to adequate housing: Fact Sheet No. 21 (Rev.1). Geneva, Switzerland: UN Habitat.
  8. Kothari, M. (2007). United Nations special rapporteur on adequate housing, Miloon Kothari: Mission to Canada. Ottawa: Main Ottawa Public Library.
  9. Victoria (City) v. Adams, 563 (BCCA 2009).
  10. Hulchanski, J.D. (2009, February 18). Homelessness in Canada: Past, present, future. In Growing home: Housing and homelessness in Canada. Symposium conducted at the meeting of the University of Calgary, Calgary, AB. Retrieved from www.cprn.org/documents/51110_EN.pdf
  11. Shapcott, M. (2009). Housing. In D. Raphael (Ed.), Social determinants of health: Canadian perspectives (pp. 201-215). Toronto: Canadian Scholar's Press.
  12. Gaetz, S. (2010). The struggle to end homelessness in Canada: How we created the crisis, and how we can end it. The Open Health Services and Policy Journal, 3, 21-26.
  13. Loppie Reading, C. & Wein, F. (2009). Health inequities and social determinants of Aboriginal Peoples’ health. Prince George, BC: National Collaborating Centre for Aboriginal Health.
  14. Wallace, B., Klein, S. & Reitsma-Street, M. (2006). Denied assistance: Closing the front door on welfare in BC. Vancouver: Canadian Centre for Policy Alternatives & Vancouver Island Public Interest Research Group.
  15. Eggleton, A. & Segal, H. (2009). In from the margins: A call to action on poverty, housing and homelessness: Report of the subcommittee on cities. Ottawa: Standing Senate Committee on Social Affairs.
  16. Pauly, B. M., Jackson, N., Wynn-Williams, A. et al. (2012). Quiet crisis: Homelessness and at risk in Victoria. Victoria, BC: Greater Victoria Coalition to End Homelessness.
  17. Quigley, J., & Raphael, S. (2001). The economics of homelessness:  The evidence from North America. European Journal of Housing Policy, 1(3), 323-336.
  18. Quigley, J., Raphael, S., & Smolensky, E. (2001). Homeless in America; Homeless in California. The Review of Economics and Statistics, 83(1), 37-51.
  19. Norman, T., & Pauly, B. (2013). Including people who experience homelessness:  A scoping review of the literature. International Journal of Sociology and Social Policy, 33(3/4).

 

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