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HE100 Study Guide - Final Guide: Domestic Violence, Unemployment Benefits, Deinstitutionalisation

Health Sciences
Course Code
Renee Mac Phee
Study Guide

of 4
Sleeping in indoor or outdoor public places and/or emergency shelters
Living in illegal or temporary accommodations and/or relying on friends and acquaintances for
Living in housing that is considered unsafe, unhealthy, unaffordable, overcrowded or insecure
Homelessness has emerged from shrouded alleys to a position of prominence
o Not confined to poorest countries
Growth in both absolute homelessness and relative homelessness has occurred in urban and non
urban areas
United Nations (1987) established a distinction between absolute and relative homelessness
Absolute Homelessness
People living on the street and victims of disaster with no homes at all; complete absence of
Those with no fixed address including:
o People living on the streets
o Those using shelters
o In the case of young children, those provided with shelter in conditions bearing little
resemblance to a home, often referred to as welfare motels
Relative Homelessness
People housed in dwelling that fail to meet 5 basic standards set out by the United Nations:
o Adequately protect occupants from the elements
o Be provided with safe water and sanitation
o Provide for secure tenure and personal safety (locks on doors and windows)
o Lie within easy reach of employment, education and health care
o Be affordable
Canadian Distinctions
Chronic homelessness
o 20 - 40% of those using emergency shelters/hotels
o Socially marginal people (psychiatric conditions, substance abuse)
o Many repeat stays in shelters over the course of a person's life
Periodic homelessness/episodic
o Leave home as a result of a crisis: domestic violence/abuse
May or may not return home
o More frequent shelter use with episodes lasting from a few months to a year
Temporary homelessness/transitional
o Lose shelter because of fire or flood, hospitalization, unemployment, eviction or foreclosure
o Brief one-time stay at a shelter
Who is Homeless?
Characteristics of the "stereotypic" homeless person
o Single
o Alcoholic and/or drug using
o Male
o NOTE: policy and program response to homelessness reflects this out dated view
All ages, gender, sexual orientation, race or class
Different socio-economic, educational, ethnic and familial backgrounds
Diverse medical histories
Homeless Canadians include:
o Increasing numbers of women
o Increasing numbers of children
o People marginalized from housing markets
o Increasing numbers of other groups in special circumstances
Persons with mental illness
Aboriginal people
Why Do People Become Homeless
Causes of homelessness include:
o Job loss/increased rates of unemployment
o Health issues
o Psychiatric morbidity and changes in mental health services
o Cuts and restrictions to social assistance
o Cuts and restrictions to employment insurance(aka unemployment insurance)
o Low wages and job insecurity
o Lack of affordable housing
o Discrimination and abuse from landlords
o Spousal abuse
o Violence in relationships
o Neglect
o Family breakdown
Families With Children
Most rapid growth in numbers of homeless women with children
Risk factors for homelessness among women:
o Poverty, family violence, alcoholism, drug abuse, mental and physical health problems, lack
of affordable housing
As a result, more women and their children trapped in vicious cycle - choice between
homelessness and one of the previous stated risk factors
Welfare motels and hostels are available
o Fewer people on the streets
o However, research reveals that children in these environments report increasing
frequencies of acute illness, chronic illness and development of slowing or delay
Street Youth
Over 70% of whom report leaving home because of physical and/or sexual abuse
Health needs similar to homeless adults
o Also include treatment and prevention of diseases arising from commercial sex work
o Often overlooked: resources necessary for their personal development
Persons With Mental Illness
Includes persons with major psychiatric illness
o Trend to de-institutionalize has provided a patchy infrastructure of care
o Debilitated: cannot handle organizational and financial issues to maintain/establish a
permanent place of residence
o An estimated 5-7% homeless individuals with mental illness require institutionalization
o Once homeless lack of services leaves them vulnerable to the morbidity of their
predisposing illness and morbidity associated with being homeless
Homelessness and Health
Increasing numbers of Canadians are homeless
Canada's northern climate makes secure shelter a fundamental prerequisite for health
Fundamental health issue for Canadians
o Whether as a cause or consequence of ill health
o Substantial evidence of health consequences:
Increased mortality
Increased morbidity
Diminished quality of life (QOL)
Homelessness in intimately linked to health status
Link between homelessness and health is twofold
o Ill health predisposes to homelessness
o Homelessness leads to adverse health effects and particular health needs
Homeless leads to:
o Increased rates of illness
Accentuated by the difficulties in providing health care services
o Increased mortality
Freezing deaths
Deaths due to fires
Substance abuse
Illnesses associated with homelessness:
o Tuberculosis (TB)
o Musculoskeletal diseases
Outdoors and on feet
o Sexually transmitted diseases (STDs)
o Depression
o Obesity
o Anemia
o Injuries and burns
o Developmental delays
o Ear infections (otitis media)
o Respiratory tract infections and pneumonia
o GI diseases and conditions
o Skin conditions
o Cancer
Consequences associated with homelessness:
o Substance abuse
o Inadequate nutrition (eg. eat from garbage)
o Sleep problems - cold hard ground with no blankets
o Risky sexual behaviours
o Low self esteem
o Ongoing societal rejection
o High stress
Increased risk of CVD and cancers
o Social isolation
o Unsanitary and precarious living conditions
o Inadequate protection against conception
o Violence