Poverty and Homelessness Flashcards
Health disparities (inequalities)
- wide variations in health services and health status in certain population groups
- could be avoided if reasonable action were taken (therefore socially unjust)
- social, economic, cultural, political inequalities = health disparities
Resilience
ability to cope in threat of hardship; personal autonomy
Factors leading to vulnerability
health inequities, DOH (income, gender, biology, age) SDOH (food, income, social status, social support, employment)
Poverty
1 in 7 Canadians (4.8 million people) live in poverty
Absolute Poverty
inability to obtain necessities for health
Low-Income cut-off
20% of income on food, shelter, clothing
Poverty and Illness (intersections)
- Low income is a risk factor for prevalence of: type 2 diabetes, hypertension, COPD, asthma and co-morbidities, infant mortality and decreased access
- Indigenous Health: diabetes, heart problems, arthritis, cancer hypertension
Homelessness
- Increasing globally
- Estimated: 235,000
- 3,634 homeless in Metro Van in 2020
- Difficult to obtain accurate stats d/t no address and transient
- Absolute homelessness
- Sheltered homelessness
- Hidden homelessness
- Intersectionality of poverty and gender, race, education
Homelessness & Healthcare
- Mortality & unintentional injuries
- HIV/AIDS
- Musculoskeletal disorders & chronic pain
- Hunger & Nutrition
- Skin & food infections
- Infectious disease - dental problems
- Respiratory illness - Bronchitis/pneumonia
- Chronic disease & disorders
- Sexual & reproductive issues
- Mental health issues
- Substance abuse
who is most at risk to experience poverty in canada?
Does poverty equally affect all groups of people?
Racialization of poverty:
poverty is disproportionately concentrated and reproduced among racialized group members
Race:
is a social construct (people are designated as different & subjected to differential and unequal treatment)
Metro Vancouver by the Numbers: in person, hand to hand count done roughly every 3 years
The 3,634 counted in March is an overall increase of 29 people from 2017
- all-time high
- counts over past five years steady increase from 1,746 recorded in 2015 to 2,223 in 2019
- 1,364 in 2015
Food banks
- 30,000 users
- 52% of food banks had increase
- food bank demand at all-time high in 2019
- 4 million pounds of food distributed each year
- increase in demand (cost of living, housing affordability, the cost of groceries, everything is going up)
Health is Political
Neoliberalism
- political & economic ideology
- intersecting factors contributing to poverty, homelessness, and food insecurity
- contributes to increased rates of poverty, homelessness, food security
- shifts focus away from political and structural causes
Violence: Increase in School Violence Bullying:
- physical bullying
- verbal bullying
- social bullying
- electronic bullying
- cyber-bullying
non-accidental acts, interpersonal and intrapersonal, results = physical or psychological injury to one or more persons
- Violence can be physical, psychological, sexual, financial, or spiritual in nature
- Cause of premature mortality, disability
- Significant factor in health care costs
- Canada 2005 - 2.04 homicides per 100, 000
- Domestic Violence 83% females
Community Mental Health
- Across the lifespan
- Stigma & discrimination
- All races, cultures, socioeconomic groups, sexes
- 1 in 5 canadians will experience mental illness in their lifetime
- The other four will be affected by the mental health of a friend or family member
Mental Illness in Canada
- Anxiety disorders (panic, OCD, PTSD, Stress, Phobias (most common mental illness)
- Depression
- Mood disorders: Bipolar
- Schizophrenia
- Grief and Loss
- PTSD
Mental Illness in Canada
- Anxiety disorders (panic, OCD, PTSD, Stress, Phobias (most common mental illness)
- Depression
- Mood disorders: Bipolar
- Schizophrenia
- Grief and Loss
- PTSD
Prevalence
By 2041 the number of Canadians living with mental illness will be over 1 million
- 1 in 5 Canadians will experience a Myocardial Infarction costing = Canada roughly 50 billion/year
- Not to mention the significant lost potential production, potential and progress
Psychoactive Drugs
- Psychoactive drugs are divided into categories according to their effect on the central nervous system and the experiences the drug may induce
- depressants (alcohol, heroin)
- stimulants (nicotine, cocaine, caffeine, amphetamines)
- Cannabis
- Hallucinogens (LSD, Ecstasy, PCP)
- Inhalants
- Caffeine: insomnia, irritability, anxiety, GI, headaches
Harm Reduction
- Rethink programs the focus attention on dangerous health problems (HIV, AIDS, Hep C, overdose)
- Refocus efforts to progressive change by: identifying SDOH, coordinate efforts (police, mental health addictions)
- Goal: reduce harm to individuals, strengthen capacity of individual and communities, reduce incidence of diseases
Supervised Injection Sites offer:
- Supervision of injections
- Emergency response to drug overdoses
- Injection related First Aid (wounds)
- Assess and referral to PHC services
- Harm reduction teaching & counselling
- Access to condoms, needles, injection equipment
- Education and referrals
Four pillars of Harm reduction
- Harm reduction
- Prevention
- Treatment
- Enforcement
Four pillars of Harm reduction: Harm Reduction
education, testing, immunizations, protection of self & others, disease spread of CD
Four pillars of Harm reduction: Prevention
promotion of healthy families/communities, prevention of substance use
Four pillars of Harm reduction: Treatment
access to programs with goals of healthier lifestyle (methadone, peer-counselling, housing)
Four pillars of Harm reduction: Enforcement
Preserve public order/safety (decrease organized crime, trafficking
Fraser Health: Blood Borne Pathogen Team
- Team of nurses in FHA who follow-up of HIV & Hep C cases with goal of decreased HIV and Hep C in community
- HIV = reportable disease
- provide support, education and help with partner notification
- STOP program: Seek & Treat for Optimal Prevention
- STIBBI
- on site testing for HIV testing (high-risk groups)
Tenets of Harm reduction
- education and outreach (street nursing)
- referrals to health & social services (housing, meds, safety)
- low threshold support services
- clean needle programs
Vulnerable Clients & Nursing Process: Regardless of setting, CHNs should do the following:
- create a trusting environment
- show respect, compassion, and concern
- not make assumptions
- coordinate services and providers
- advocate for accessible health care services
- focus on prevention
- Know potential resources
- Build capacity for client to build own support network
Primordial Prevention
- public policy that reduces structural inequities
- ex. Poverty
- Systemic factor: increases risk of substance use
- structural - realted to economic, employment policies, access to social services
- reducing poverty - involves transforming policy context guaranteed annual income for refugees
- increased child benefits
Primary Prevention - preventing problematic use
- affordable housing
- housing subsidies
- effective job-training programs
- employer incentives
- preventive health care services
Secondary Prevention
- early identification of when substance use becomes problematic/rapid support to assist individual in addressing root causes (reduce or end substance use)
- aimed at reducing the prevalence or pathological nature of a condition
- involves early diagnosis, prompt treatment, and the limitation of disability
Ex. - supportive and emergency housing
- counselling, treatment, recovery programs - individual vs. continuum.
Tertiary Prevention
reducing the harms of problematic use for individuals using substances and their families/communities
- aimed at restoring and enhancing functioning
- ex. Promoting psychosocial rehabilitation programs
- Child welfare - collaboratively supporting the health and well-being of family members living with problematic substance use
- can also include treatment
