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Homelessness and Health in Canada: Research Lessons and Priorities

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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.

Résumé

Cet article a été rédigé en vue d’une conférence de réflexion internationale sur la réduction des disparités en matière de santé et la promotion de l’équité dans les populations vulnérables. Son but était de donner un aperçu de la recherche sur le phénomène des sans abri et de stimuler la discussion sur les orientations stratégiques dans ce domaine. Nous avons retracé les recherches sur l’itinérance, avec un accent particulier sur celles qui ont été menées au Canada. Les études ont été regroupées selon leur sujet et leur cadre dans les catégories suivantes: ampleur du phénomène des sans abri, état de santé de ces personnes, interventions pour réduire le phénomène et améliorer la santé des individus, et orientations stratégiques pour la recherche future. Parmi les principaux problèmes étudiés, mentionnons la définition du phénomène des sans abri et son ampleur, son hétérogénéité et les explications contradictoires de la problématique. Les sans abris présentent un niveau élevé de maladie et le cheminement qui les amène à se retrouver sans-logis et en mauvaise santé est complexe. Parmi les efforts pour réduire le phénomène et améliorer la santé des individus, notons les stratégies de nature biomédicale, éducative, environnementale et politique, tous des domaines caractérisés par de nombreuses carences et possibilités en ce qui concerne la recherche. La recherche stratégique doit s’appuyer sur l’engagement des partenaires et de la collectivité et sur des méthodes plus rigoureuses. Les priorités doivent, entre autres choses, porter sur la création d’un consensus quant à la façon de mesurer le phénomène, l’état de santé des sans abri, le développement de l’infrastructure de recherche, et la volonté de s’assurer que l’on puisse mesurer l’efficacité des futures initiatives.

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Authors and Affiliations

  1. Institute of Health Promotion Research, Room 425, Library Processing Centre, 2206 East Mall, Vancouver, BC V6T 1Z3, Canada

    C. James Frankish PhD (Associate Director) & Darryl Quantz MSc

  2. Centre for Research on Inner City Health, St. Michael’s Hospital; Faculty of Medicine, University of Toronto, Canada

    Stephen W. Hwang MD, MPH

Authors
  1. C. James Frankish PhD
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  2. Stephen W. Hwang MD, MPH
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  3. Darryl Quantz MSc
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Corresponding author

Correspondence to C. James Frankish PhD.

Additional information

Acknowledgements and Sources of Support: This article is based on a paper prepared for the International Think-Tank on Reducing Health Disparities and Promoting Equity for Vulnerable Populations held in Ottawa on September 21–23, 2003. This work was supported by the Canadian Institutes of Health Research, the National Homelessness Initiative, and Human Resources & Skills Development Canada. Production of this article was made possible in part through the support of the National Secretariat on Homelessness. Dr. Frankish holds a Senior Scholar Award from the Michael Smith Foundation for Health Research. Dr. Hwang holds a New Investigator Award from the Canadian Institutes of Health Research. The Centre for Research on Inner City Health is supported in part by a grant from the Ontario Ministry of Health and Long-Term Care. The results and conclusions are those of the authors, and no official endorsement by any organization is intended or should be inferred.

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Frankish, C.J., Hwang, S.W. & Quantz, D. Homelessness and Health in Canada: Research Lessons and Priorities. Can J Public Health 96 (Suppl 2), S23–S29 (2005). https://doi.org/10.1007/BF03403700

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