Lecture 21 Flashcards

1
Q

How many people experience homelessness annually in Canada?

A
  • 235000
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2
Q

The average life expectancy in Canada is 82 years old. What is the estimated average life expectancy of people experiencing homelessness?

A

42-52 years

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3
Q

Most people who experience homelessness experience it once in their lifetime and for a short period of time (less than a month). TRUE OR FALSE

A

true

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4
Q

What is the Universal Declaration of Human Rights (1948)?

A
  • first to codify housing as a human right
  • Article 25: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age, or other lack of livelihood in circumstances beyond his control” - not legally binding
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5
Q

What is the other human right called about homelessness?

A

International Covenant on economic, Social and Cultural Rights (1966)

UN treaties:
- convention on the rights of the child, convention on the rights of persons with disabilities, etc.

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6
Q

What is the national definition of homelessness in 2012?

A
  • “range of housing and shelter circumstances… [that] encompasses a range of physical living situations” (COOH, 2012)

“Homelessness describes the situation of an individual, family or community without stable, permanent, appropriate housing, or the immediate prospect, means and ability of acquiring it. It is the result of systemic or societal barriers, a lack of affordable and appropriate housing, the individual/household’s financial, mental, cognitive, behavioural or physical challenges, and/or racism and discrimination. Most people do not choose to be homeless, and the experience is generally negative, unpleasant, unhealthy, unsafe, stressful and distressing” (COOH, 2012)

  • later defines “appropriate” as meaning “affordable, safe, adequately maintained, accessible and suitable in size”
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7
Q

What was UN Habitat’s definition of houselessness?

A
  • “An individual with no access to housing will be considered as houseless all over the world” (UN Habitat, 2001)
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8
Q

What is the definition of Indigenous homelessness developed by Jesse Thistle, in collab with various Indigenous stakeholders

A

“Indigenous homelessness is a human condition that describes First Nations, Métis and Inuit individuals, families or communities lacking stable, permanent, appropriate housing, or the immediate prospect, means or ability to acquire such housing. Unlike the common colonialist definition of homelessness, Indigenous homelessness is not defined as lacking a structure of habitation; rather, it is more fully described and understood through a composite lens of Indigenous worldviews. These include: individuals, families and communities isolated from their relationships to land, water, place, family, kin, each other, animals, cultures, languages and identities. Importantly, Indigenous people experiencing these kinds of homelessness cannot culturally, spiritually, emotionally or physically reconnect with their Indigeneity or lost relationships” (Thistle, 2017)

  • defines homelessness as more than just a lack of “a structure of habitation” and situates it within the legacy of colonialism, including, but not limited to racism, dispossession of lands, “destabilization of culture” and language and intergenerational trauma
  • Homelessness as “being without All my RElations”
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9
Q

The prevalence of homelessness is _____ greater among Indigenous people compared to the general population in urban areas in Canada

A

8 times

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10
Q

How do you describe the experience of homelessness?

A
  • an extremely stressful, dignity-depriving, and marginalizing experience
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11
Q

What are adverse physical health outcome examples?

A

◦ Cardiovascular disease (Al-Shakarchi et al., 2020)

◦ Infectious diseases (e.g., HIV, HCV, TB) (Beijer et al., 2012)

◦ Heat stroke and sunburn (Hwang, 2001)

◦ Hypothermia and frost bite (Hwang, 2001)

◦ Traumatic brain injuries (Stubbs et al., 2020)

◦ Accelerated aging (Suh et al., 2020)

◦ Skin problems (e.g., scabies, lice) (Hwang, 2001)

◦ Poorer dental health (Hwang, 2001)

◦ Food insecurity (Hernandez et al., 2019)

◦ Violent/criminal victimization (Nilsson et al., 2020)

◦ Death (Cancer, heart disease, and substance use disorders = often top causes of death) (Funk et al., 2022)

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12
Q

What is the life expectancy of homeless people

A

42-52 years

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13
Q

What are adverse mental health outcome examples of homelessness?

A

◦ Suicide (Ayano, Tsegay, et al., 2019)

◦ Serious mental illness (Ayano, Shumet, et al., 2020; Ayano, Solomon, et al., 2020; Ayano, Tesfaw, et al., 2019; Fazel et al., 2008),)

◦ Drug and alcohol dependence (Fazel et al., 2008)

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14
Q

What are risk behaviours of homelessness?

A

◦ Individual choice vs. context/environment individuals are in

◦ E.g., needle sharing, unprotected sex

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15
Q

What does PEH stand for

A
  • people experiencing homelessness
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16
Q

What are some significant barriers to access to preventive health services for PEHs?

A

◦ Competing priorities/demands (prioritizing immediate needs [e.g., subsistence]) (Gelberg et al., 1997)
◦ May lead to acute crisis, emergency department use, hospitalization (White & Newman, 2015)

◦ Lacking ID (Sanders et al., 2020)

◦ Perceived discrimination, dehumanization (Wen et al., 2007)

◦ Inadequate/lacking health insurance (Baggett et al., 2010; B. White & Newman, 2015)

◦ Lacking family doctor/usual service provider (White & Newman, 2015)

17
Q

What are some institutional admissions that homelessness is associated with?

A
  • hospitalization
  • frequent emergency department use
  • criminal justice system involvement
  • shelter use
18
Q

What is the revolving door syndrome

A
  • keeps happening over. andover again
19
Q

What is the number of poeple experiencing homelessness in Canada

A
  • a minimum of 235000 people experience homelessness each year
  • 35000 each night
20
Q

What is the iceberg of homelessness?

A
  • tip: visible homelessness
  • middle : hidden homelessness
  • bottom : at risk of homelessness
21
Q

Estimated ___ of PEH are experiencing “hiddne homelessness”

A

80%

22
Q

Explain chronic homelessness

A
  • refers to the long-term experience of homelessness (ex. >1year)
23
Q

explain episodic homelessness

A
  • refers to recurrent homelessness
24
Q

explain transitional homelessness

A
  • refers to the short term experience of homelessness (ex. less than a month)
25
Q

What are some subpopulation of PEH

A
  • Indigenous peoples
  • family
  • youth
  • seniors
  • sexual and gender minorities
  • immigrants and refugees
  • people fleeing violence
  • people experiencing mental illness and addictions
26
Q

What is SMI

A
  • serious mental illness
  • defined as a mental, behavioural, or emotional disorder resulting in serious functional impairment, which substantially interferes with or limits one or more life activities. The burden of mental illnesses is particularly concentrated among those who experience disbaility due to SMI (National Institue of Mental Health, 2022)
27
Q

What is the prevalence of serious mental illness among PEH?

A

between 25-30%

28
Q

Among people experiencing homelessness and serious mental illness in the Vancouver at home study,…

A
  • 88% reported experiencing at least one adverse childhood experience (ACE)
  • 42% reported 5-10 adverse childhood experiences
29
Q

ACE total score significantly associated with several adverse health/social outcomes, some of which include:

A
  • experiencing 2 or more mental disorders
  • alcohol and substance dependence
  • high risk of suicidality
  • longer duration of homelessness (marginally significant)

implications for prevention

30
Q

What are the factors associated with greater homelessness duration among PEH + mental illness

A
  • younger age of first experiencing homelessness
  • learning disabilities during childhood
  • daily drug use
  • alcohol use
  • high school not completed