Midterm 1 - Weeks 1-5 Flashcards
What is Health Promotion
Enabling or empowering people to increase control over, and improve their health
To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and realize aspirations to satisfy needs, and to change or cope with the environment.
Health is, therefore, seen as a resource for every-day life, not the object of living
Characteristics of Family
The Vanier Institute of the Family (2018) define family as “any combination of two or more person who are bound together over time by ties of mutual consent, birth, adoption and/or placement”
“…unique and whomever the person defines as being family. They can include, but are not limited to, parents, children, siblings, neighbors, and significant people in the community”
Wright and Leahey (2013) state “the family is who they say they are”
Functions of Family
Physical maintenance and care of members
Addition of new members through procreation or adoption
Socialization of children and social control of members
Production, consumption, distribution of goods and services – basic economic unit
Affective nurturance — love
Characteristics of Family: Form
Way family is composed or structured
Characteristics of Family: Structure
Characteristics and demographics of individuals that make up the family
Defines the roles and positions the individuals
Characteristics of Family: Function
behaviours and activities used to maintain the family unit and meets family and individual needs
Trends in Canadian families
Married couples (66%) are the dominant family structure (2017)
51.1% of couples have children; 48.9% of couples are without children
Baby busters ( born between 1965-1976) contribute to increasing number of couples without children
Multigenerational households were the fastest growing households between 2001-2016
Large cohort of aging baby boomers
Families are smaller
Number of households has increased
Percentage of one person households has increased from 7% in 1951 to 28% in 2016
More women live alone than any other age group
What is the impact of the low fertility rate which is below the expected population replacement rate ?
is not enough people to take care of the elderly
less income taxes being paid
What is Family Health Nursing?
A provision of care where the nurse uses nursing processes to assist the family and its members in achieving the highest potential health through coping and adapting to various health and illness situations
First Level: Family as context
the individual is main nursing focus and the family is secondary
Second Level: Family as sum of its parts
focus on individual family members as separate entities (divorced couples, context is the family, but multiple clients)
Third Level: Family subsystems as client
focus on dyads and triads
Fourth Level: Family as client
focus on the entire family
care for the individual, the family and society simultaneously
Fifth Level: Family as a component of society (family is the client, society is the context)
family is one of society’s basic institutions
What is a Community
Concept of community as a collection of people who interact with one another and whose common interests or characteristics form the basis for a sense of unity or belonging
A group of people with a common characteristic or interest living in together or in a particular area within a larger society
An interacting population of various kinds of individuals in a common location
A social group of any size whose members reside in a specific locality, share government and often have a common cultural and historical heritage
Examples of some communities:
Citizens of a town
Group of farmers
Prison community
Tiny village in Labrador
Members of Mothers Against Drunk Driving (MADD)
Professional nurses
Community as client of care:
The unit of care is the entire community. The nurse can concentrate on both the community and the family simultaneously, but the community is the main focus
Community as context for care:
The family is the focus of care. Families live within community contexts- creating and defining the communities within which they interact impacts family health
What is Community/Public Health Nursing
Focuses on increasing health of individuals and the community at-large
Focuses on determinants of health (e.g., socioeconomic, and physical environment, education, culture, biological endowment and more)
primary prevention
reduces the impact of existing risk factors for a potential problem and thus reduces the occurrence of disease
secondary prevention
screening, detection and early treatment
tertiary prevention
reduces the impact of long-term disease and disability
targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease
Primary health care (PHC)
promotes healthy lifestyles as a pathway to disease and injury prevention
provides continuing care of chronic conditions and recognizes the importance of the broad determinants of health.
Involves a broad range of health-care providers (CIHI, 2006).
Primary Care
service at the entry of the healthcare system
“Responsible for coordinating the care of patients and integrating their care with the rest of the health system by enabling access to other healthcare providers and services”
Primary care is where the care takes place
Public Health (PHN)
provide health promotion, disease and injury prevention, health protection and surveillance, population health assessment and emergency preparedness
link individual & family health experiences into the population health framework
Work within public health agencies mandated under provincial and territorial legislation
Home Health (HHN)
Provide chronic disease management, curative care, health promotion and education, rehab care, palliative care, social support and maintenance,
focus on clients & families
practice in homes, schools or workplace and integrates health promotion, teaching & counseling with provision of care
Why Study Family/Community Health Nursing?
Earlier discharges from hospital means that family caregivers are continuing treatments in the home setting (Patrick & Edmunds, 2004)
80% of health care is provided by non-professionals including family members.\
Health is a way of living or behaving that is readily communicated within such institutions as the family
Community Nursing Theories
Theory provides roots that anchor both practice and research in the nursing discipline
There has been a lack of theory development in the CHN field
As a result, broad theoretical perspectives, conceptual models, frameworks, and Indigenous perspectives must be considered
The CHN metaparadigm: person, environment, health, nursing AND social justice
Medical model discourse
(Absence of disease) sees achieving/maintaining health as a mechanistic, technical process
Behavioral/lifestyle model discourse
Focus on lifestyle changes, behavioral risk factors
Socio-environmental model of health
Dynamic process of interrelation between systems, including living conditions, lifestyle, environment, and more sees achieving/maintaining health not just as result of MD care
what is the concern with the behavioural model
victim blaming
Socio-Environmental Approach to Health Promotion
Focuses on underlying (root) causes
Social and economic inequities (e.g., poverty, social exclusion)
Acts to reduce inequities
Promoting social justice
Advocating for common good
Acting for social change
Eliminating victim blaming
Ottawa Health Charter- Five health promotion strategies
- Build healthy public policy- Involves advocacy for any health, income, environmental, or social policy that fosters greater equity or increases resources for health.
- Create supportive environments- Involves generating living, working, and playing conditions that are safe, stimulating, satisfying and enjoyable and protect the environment.
- Strengthen community action- Involves supporting those activities that encourage community members to participate and take action on issues that affect their health.
- Develop personal skills- Involves supporting personal development through the provision of information such as health education, to increase options available to people to exercise more control over their own health.
- Reorient health services- Involves moving beyond health sector’s responsibility for providing clinical and curative services in a health promotion direction that is sensitive to the needs of the community.
Risk Factors
behavior patterns which tend to lead to poor health. They are modifiable through strategies that create behavior change.
Have control
Risk Conditions
circumstances over which people have little control that can affect health status and are often a result of public policy. They are modified through collective action and social reform.
Health Equity
Health equity is a social justice goal focused on pursuing the highest possible standard of health and healthcare for all people, and taking into account broad social, political, and economic influences and access to care.
People’s daily experiences and their access to [health] services intersect in ways that are highly dependent on their sex/gender, ethno-cultural heritage, socioeconomic status or class, sexual orientation, religion, ability, nationality and other fluid intersections.
Health Inequities Examples
“There are a number of social factors that influence whether Indigenous peoples access health services.
Indigenous peoples do not have access to adequate pain medications because physicians are reluctant to provide Indigenous patients with pain medications due to common perceptions of addiction.
Indigenous peoples also have barriers accessing a family physician because physicians are reluctant to take on new patients with complex health needs.”
Indigenous peoples have more complex healthcare needs as many lack resources, educational reasons, environment etc
Physicians are reluctant because it is simpler for them to just take on patients with simple problems like ear infections not someone with an ear infection along with diabetes, high blood pressure etc
Equipping for Equity
The EQUIP model for equity in health care includes three key dimensions:
1. Trauma and Violence Informed Care
2. Harm reduction
3. Culturally Safe Care
Upstream
Upstream Approach looks like… primary prevention
Downstream
Downstream Approach looks like… secondary and tertiary prevention
Mental Health
The capacity to think, feel and act in ways that enhance the enjoyment of and ability to face life’s challenges
A positive sense of well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity
Mental Illness
Refers to a group of diagnosable conditions
Some combination of altered thinking, mood, behavior or will that can be linked with distress and impaired functioning
Canadian Trends- Mental health/illness
1 in 5 Canadians will experience a MI
1 in 4 Seniors has a MI
1 in 7 children and youth have a mental illness
LARGEST group affected is between ages 10-29 years
Mental illness is disproportionately represented in the homeless population (one third have serious MI)
Suicide
One of the leading causes of death in Canadian youth
Mortality is 4x higher in men; hospitalizations higher for women but this trend is changing
Youth suicide – high risk groups include Indigenous youth; youth whose parents have a MI; students experiencing stress, anxiety and depression
A client reports that they want to “end it.” How would you respond?
- Acknowledge their feelings
- How long has this been going on for
- Previous suicide attempts
Risk Factors for Mental Illness
Genetics and Heredity – biomedical model
Root causes can be viewed through a systemic lens ie. people who live with chronic oppression, poverty, domestic violence
People who have experienced complex traumatic situations ie. Indigenous intergenerational trauma & colonization
Ageism, racism, sexism, etc.
Target Groups to End Stigma
- Youth
- Healthcare Providers
- Media
- Workforce
Recovery Model
Challenges the status quo that living with MI leads to a diminished life
Recovery is a personal process where some people may live with symptoms in recovery and others look to being symptom free
both experience more control and optimism about recovery
Persons are central in planning their own care
Recovery actions plans are concerned with support and self-help
Maternal Health/Women’s Health
Maternal health refers to the health of women before conception, during pregnancy, childbirth, and the postpartum period (perinatal period)
Encompasses family planning, preconception, prenatal and postnatal care
Canada is a leader in maternal child health care globally
Still barriers remain- disparities in access to care
Maternal Health- Immigrant and Refugee Women
Inadequate social support and poverty
Experience negative mental health outcomes in perinatal and postnatal period
Maternal Health - Indigenous Women
have high incidence of adolescent pregnancy, high and low birth weight babies, pregnancy-associated diabetes, and poorer nutrition
Colonization and medical model have resulted in birth experiences that remove Indigenous women from their community, isolating women without social support
Maternal Health Risks and Challenges
Maternal Behavior
- maternal education level; teenage mothers; older mothers
- Breastfeeding widely accepted as best nutrition for an infant, but many women still face discrimination
Lack of social support and life stress
- Lack of housing, nutrition, etc.
- Linked to adverse birth outcomes: preterm/ Low birth weight babies; large for gestational age; fetal mortality
Lack of income
- Canadian Public Health Policy- 50-week maternity and paternal benefit
- However, benefit is only a maximum of 55% of a woman’s salary, to a maximum of $573/week (Government of Canada, 2020)
- Infant outcomes poorer in low-income neighborhoods and in indigenous communities (increased morbidity and mortality)
Relational Approach to Maternal-Child Health Promotion
Recognizes strengths of women and children
Screening tools must “not replace conversation” to understand the context of women’s lives
CHNs inquire about what is significant to women and children
Do not assume role of expert
Work together to address inequities and conditions that marginalize women and children
Facilitate access to services and programs that enhance health of women and children
Child Health- Importance of Relationships
Secure, stable attachments contribute to safety and security (infant bonding)
Child health - Nutrition
Critical in early years –breastfeeding for up to two years or longer; introduce foods at 6 months
Concern with obesity
Child health- Physical Activity
Concern re. sedentary lifestyles and link to childhood obesity
Child health - Injury
Immigrant children age 0-4 at greater risk of unintentional injuries than Canadian counterparts
Playground equipment, bicycling, tobogganing, swimming, trampolines
technical approach
relies on locators or geographic regions and includes four different types of communities
not isolated communities
have Rd access and are within 90 kilometres of physician services
semi isolated communities
also have Rd access but they are greater than 90 kilometres to physician services
Isolated communities
do not have Rd access but they do however have good telephone service and scheduled air transportation flights
remote communities
are very isolated meaning that they have no access to flights or roads and have minimal access to telephone
social approach
Defines rural based on features and services that are normally associated with larger population sizes
for example, having different stores or restaurants in the community
socio-economic context of rural communities can also impact the health of its members
- many rural and remote community communities contain resources associated with industries such as oil mining gas or agriculture
rural and remote communities might also rely on their natural resource base to sustain economic viability and if these resources become depleted they must find alternative means for the economy Lastly access to employment opportunities that offer an actual reasonable living wage can be limited in rural and remote areas
Rural Statistics
2.5 million Ontarians or 19% of the province’s population.
Of this population 1.4 million live in areas under 10,000 in population
30% of Ontario Indigenous population reside in non-urban settings and growing
Projection- decline in youth and young adults and increases in people 45-64 years and > 65 years
On average, there are half as many nurses per 100 000 people in rural Canada compared to urban Canada
Rural and remote RNs often have less education due to limited access to continuing education
Health Variations Among Rural, Remote, and Indigenous People
Increased rates of low income and individuals with less than secondary education
Increased rates of smoking and obesity
Life expectancy at birth lower in Indigenous communities
Higher mortality risks r/t circulatory disease, injuries, suicide, respiratory disease, and diabetes
Experience social exclusion
Family Health Nursing
A provision of care where the nurse uses nursing processes to assist the family and its members in achieving the highest potential health through coping and adapting to various health and illness situations
When assessing a family use these steps
- use strength-based nursing assessments (strengths and thoughts are subjective (what one person considers a strength another person may think it is not a strength)
- Create rapport - therapeutic relationship
- gather info using exploratory strategies and a prior
- check your own personal thoughts, feelings, biases
McGill Model of Nursing
All families possess capabilities or the health potential (strengths, motivation, resources) that serve as the basis for health promotion behavior.
The degree to which a family engages in health-related problem-solving and goal attainment, reflects the process of family health promotion.
The outcomes of health promotion are competence in health behaviour and improved health status.
Genogram
Focuses on family structure through composition, health history and relationships
Ecomap
Focuses on family within the context of their community
Spiralling Process
Phase 1: Exploring or getting to know
- Nurses need to continuously look for strengths
Phase 2: Zeroing In
- Identifying specific, workable goals and then prioritizing them
Phase 3: Working out
- Putting the plan into action
Phase 4: Reviewing
- Appreciating strengths, resources and how they are feeling
Community-as-Partner Model
The core of the assessment wheel represents the people who make up the community
The environment is divided into some subsystems:
- Physical environment, education, safety and transportation, politics and government, health and social services, communication, economics, and recreation
The solid line surrounding the community core and its subsystems represents its normal line of defense (NLD)
Stressors can penetrate the lines of defence surrounding the community and affect equilibrium
CHNs assess and analyze the community’s reaction to stressors and implement primary, secondary and tertiary interventions
Community Capacity Model
Capacity Building:
“Process to strengthen the ability of an individual, organization, community or health system to develop and implement health promotion initiatives and sustain positive health outcomes over time” (Yiu, 2020, p.251)
Allows community members to take action and responsibility towards their own development
Community Health Promotion Model
community health promotion model
holistic approach to promoting the health of the community
acknowledges the interplay of the different determinants of health and allows for health promotion by using the nursing process which includes assessing analyzing planning intervening and evaluating
the community health nurse assess what determines the health of the community /analyzes the community strengths and needs/ plans the health promotion strategies /implements prevention interventions using primary secondary or tertiary approaches/ and then evaluates the results of the interventions/ after evaluation the nursing process can repeat again if the intervention was not effective
Community Health Promotion Model
community health promotion model
holistic approach to promoting the health of the community
acknowledges the interplay of the different determinants of health and allows for health promotion by using the nursing process which includes assessing analyzing planning intervening and evaluating
the community health nurse assess what determines the health of the community /analyzes the community strengths and needs/ plans the health promotion strategies /implements prevention interventions using primary secondary or tertiary approaches/ and then evaluates the results of the interventions/ after evaluation the nursing process can repeat again if the intervention was not effective
difference between community health promotion model vs community as a partner model
a major difference between this model and the community as a partner model is that we do not see the communities’ lines of defence and buffers not depicted within the specific model
PISO
P- who is the population?
I- what is the intervention?
S- where is the setting?
O- what is the anticipated outcome?
describes the issue being examined
who the population/ is what the intervention will be /what the setting is it /what the anticipated outcome of the intervention will be
Environmental Scan
Preliminary scan
Windshield Survey: Can occur by driving, walking, or using public transit through the community
Problem Investigation
In response to a problem or concern
Resource Evaluation
Assessing and evaluating existing resources and services
Needs Assessment
Assessing whether there are needs, deficits or service gaps
Community Participation
Surveys
Forums
Focus groups
Windshield surveys
Literature reviews
Census or government data
Community Involvement
Community governance
- A group of community members (stakeholders) take the lead
Community development
- Facilitating involvement of community members by aiding the community in identifying and strengthening aspects that will help support the health concern
Community mobilization (buy-in)
- A few community members start taking action to develop solutions and eventually the larger community will “buy in”
Empowerment
Empowerment
“a social process of recognizing, promoting, and enhancing peoples abilities to meet their own needs, solve their own problems and mobilize the necessary resources in order to feel in control of their own lives”
Empowerment Requires
Access to information
Range of options
Assertiveness to express ideas and to stand-up for oneself
Belief that one can make a difference
Learning to think critically
Nursing Empowerment is….
A process by which people gain greater control over their health and …
Involves enhancing the capacity of individuals, families, or communities to make choices to achieve their political, social, cultural and health goals.
Canadian Community Health Nursing Standards of Practice
- Health Promotion
- Prevention and Health Protection
- Health Maintenance, Restoration and Palliation
- Professional Relationships
- Capacity Building
- Health Equity
- Evidenced-Informed Practice
- Professional Responsibility and Accountability
Capacity Building
A process that strengthens the ability of an individual, an organization, a community, or a health system to develop and implement health promotion initiatives and sustain positive health outcomes over time
What does capacity building look like as a CHN
Encourages and supports the community to be active in stating and taking ownership of health issues, and decision-making
Partner with clients and communities to promote capacity by recognizing barriers to health and mobilizing and building existing strengths
Community Asset Mapping
Used to:
- Outline the assets and capacity
- Identify strengths
- Identify potential resources for interventions
Data Collected:
- Skills and experiences
- Services
- Physical and financial resources
Assets = resources
Assets can be physical structures, community services (transportation), and the people of the community
CHNs and Inter-sectoral Linkages
Collaborative actions that involve more than one specialized agency completing different roles to achieve a common goal
CHNs work with different sectors such as education, housing, public works, etc. and coordinate efforts
Efforts viewed in terms of upstream or downstream inter-sectoral thinking
- Upstream is primary (looks to prevent things before it happens)
Older Adults Health Promotion
- Physical Activity and Fall Prevention
- Healthy Eating
- Medication Safety/Polypharmacy
- Immunizations
- Sexual Health
- Mental Health
- Elder Abuse
- Healthy eating = issues with income, accessibility, no interest, dental care, poor vision, decreased taste
polypharmacy
5+ meds
Gender Identity
(which is how you, in your head, define and understand your gender based on the options for gender you know to exist),
Gender Expression
(the ways you demonstrate gender through your dress, actions, and demeanor)
Biological sex
(the physical parts of your body that we think of as either male or female)
True/False: Gender inequities are most prominent in low- and middle-income countries
True
T/F: Individuals who do not identify as either male or female have equal access to healthcare
False
Indigenous Notions of Gender
Prior to colonization, gender relations were more equal
Different expressions and definitions of gender
Gender is more than a fluid concept between being a man or a woman
“Two Spirit” represents individuals with masculine and feminine spirits in one body
Institutionalized Gender
Institutionalized gender highlights the distribution of power between genders in politics, education, religion, media, medical field, and social institutions in society
Leading cause of death in Canada (men)
Men
1. Cancer
2. Heart disease
3. Unintentional injuries
4. Chronic lower respiratory diseases
5. Stroke
6. Diabetes
7. Suicide
8. Influenza and pneumonia
9. Alzheimer’s disease
10. Chronic liver disease
Leading cause of death in Canada (women)
- Cancer
- Heart disease
- Stroke
- Chronic lower respiratory diseases
- Unintentional injuries
- Alzheimer’s disease
- Diabetes
- Influenza and pneumonia
- Kidney disease
- Septicemia
- Heart attack signs/symptoms are different between women and men
- Women signs/symptoms = nausea some shortness of breath – women’s signs get called atypical symptoms rather than its normal for women compared to men. Women get looked at as atypical
Drug dose gender gap
(antidepressants, antiseizures, etc.) – only recruited men for research studies
Leading Health Issues (men)
- Cardiovascular disease
- Respiratory disorders
- Stress, depression
- Suicide
- Accidental injuries
- Addiction/substance misuse
Leading health issues (women)
- Violence, abuse
- Anxiety, depression, stress
- Body dissatisfaction
- Getting older, poverty
- MSK disease
- Autoimmune diseases
- Cardiovascular disease
Medullary sponge kidney (MSK)
is a congenital disorder, meaning it is present at birth. MSK occurs when small cysts (sacs) form either on tiny tubes within the kidney (known as tubules) or the collecting ducts
Gender Bias
Overgeneralization- the assumption that if it is good for men, it is good for women
Gender and sex insensitivity- ignoring these variables
Gender-Based Lens
Using a gender lens to examine a context to identify the unique constraints and opportunities men and women face
Enables CHNs to examine the impact of biological sex, gender, and gender bias to uncover where men, women, and transgender people are facing barriers in accessing programs and services
Gender-Based Plus Lens (GBA+) :
Allows CHNs to further consider role of race, ability, class, sexual orientation, and Indigenous status
Applying Gender Lens: Ask
- How is the problem different for men and women ?
- How are the different contexts in the lives of boys and girls , men and women addressed?
- How is diversity within subgroups of women and men, boys and girls identified and taken into account?
- What intended and unintended outcomes for men and women can be identified?
- What other social, political economic realities are taken into account?
What is the Role of the CHN?
Challenge the status quo
Advocate to eliminate gender-based inequities
Encourage all CHNs to engage in GBA+ training
Take upstream action to eliminate oppression and discrimination
Collaborate with transgender individuals to enhance their visibility
Use a gender-based lens in health promotion
Step 1: Situational Assessment
Carried out to:
Learn more about a population of interest
Identify community wants, needs, and assets
Set priorities
What is the situation
What influences are making it better/worse
What can be done
Step 2: Develop a data gathering plan
Community health status reports produced by public health units
Canadian community health survey
Public health agency of Canada
Step 3: Gather the Data
- Environmental Scans
- Quantitative
- Qualitative
- Environmental scan (windshield scan)
- Are there grocery stores or food desert
- What resources are in that area
- Transportation
- Quantitative: research studies, stats, epidemiology reports, systematic reviews; content analysis
- Qualitative: interviews, focus groups, good for capacity building
Step 4: SWOT Analysis
S = Strengths (internal + helpful)
W = Weakness (internal + harmful)
O = Opportunities (external + helpful)
T = Threats (external + harmful)
Step 5: Communicate the information
Communicate key findings to each of your stakeholders
Step 6: Consider how to proceed with planning
How do you perceive your ability to affect the situation with the available time, financial resource and mandate?
Logic Model
A program planning and evaluation tool
A diagrammatic representation of a program
Shows relationships among program components
Logic Model Planning Stages
CAT
Components
Activities
Target groups
SOLO
Short term Outcomes
Long-term Outcomes
Components of a Logic Model
Goal: The overall long-term health goals
Inputs: The resources invested
Outputs: Products that are produced
- Activities: Interventions that will be carried out
- Audience: Whom the program is targeting
Outcomes: The changes expected to results
SOLO
- Outputs are what is produced from those resources
Additional Components of Program Planning
- Assumptions: Underlying theories and beliefs about the program and its context which can influence the development of a program
- External factors: factors that impact the program, but are beyond the control of program planners
Program Evaluation
Evaluation is an ongoing and dynamic process that determines what works and what else needs to be done
- supports further refinement of program activities
- helps to identify gaps
Evaluation Stages
formative - what are others doing
- What does the community need
- Will it work or is it working
Process =
- How are we doing
- What actually happened
- What was supposed to happen
- Outcome
- Did we do it
- Did we achieve our objectives
- Did we reach our overall goal
Poverty, Homelessness, and Food Insecurity Stats:
Nearly 15% of people with disability live in poverty
1.3 million children live in poverty (1 in 5)
1 in 5 racialized families lives in poverty in Canada, as opposed to 1 in 20 non-racialized families
Poverty and Poor health
Poverty is both the cause and consequence of poor health
Individuals may have to make choices that put their health at risks
Low income is a risk factor for: Type 2 diabetes, hypertension, asthma, chronic pulmonary disease
Individuals living below the poverty line experience depression at a rate 58% higher than the Canadian average
The cultural and social barriers faced by marginalized groups can mean limited access to health services
Poverty and Indigenous Peoples
Indigenous populations experience persistent inequitable access to:
Income
Employment
Housing
Food security
Education
Poverty in Rural Canada
Limited employment opportunities and access to supportive infrastructures
Much higher incidence of poverty in the north, with 31.1% of families with children living in poverty, compared to 9.9% in south.
Rural areas are also more susceptible to poverty due to limited employment opportunities and resources
Comparing the north and south ends of Canada, there is roughly 20% more families in the north who live in poverty
MBM
Market basket measure
MBM = addresses beyond the physical needs – its looking at transportation, shelter, other resources
Canadian government uses MBM the limitation is we cannot compare internationally
LICO
low income cut-off
based on family income vs the cost. How much they are spending on food, shelter other needs. More detailed and focused based on low income/poverty in different areas people live. Ex living in PEI vs living in Toronto
Homelessness: stats
Indigenous people are overrepresented among the homeless population in all urban centres in Canada (28-34% ), while they are only 4.3% of Canadian population
35,000 Canadians are homeless on a given night
At least 235,000 Canadians experience homelessness in a year.
1 in 7 people in homeless shelters are children
Health and Homelessness
Morbidity and mortality are higher in homeless populations
Nearly two people in their 40’s die every week in Toronto due to homelessness
Morbidity = illness
Mortality = death
Factors
- Climate
- Disease (communicable)
- Tuberculosis
- Street life
- Chronic disease (copd)
- Nutritional
- Dental issues
- Cleanliness (skin conditions)
Housing First
Began in the 1990s in New York and Toronto
Underlying principle: ALL people deserve housing
Housing is provided first then supports are provided including physical and mental health, education, employment, substance abuse and community connections
Housing is not contingent upon readiness or compliance
Food Insecurity
In 2014 in Canada, 4 million individuals experienced some level of food insecurity
Food insecurity is associated with poor health and linked to diabetes, hypertension and poor mental health
Poverty, Homelessness, and Food Insecurity: Role of the CHN
Upstream interventions
- Advocating for public policy (for housing, minimum wage, social assistance)
- Increased social assistance rates
- Affordable housing and childcare
Downstream strategies:
- Facilitate access to care for people who have barriers and access to care: building trusting relationship, preserving respect, acknowledging client concerns as important, being sensitive to people’s life circumstances
