People experiencing homelessness in Canada include a disproportionate number of individuals from racialized and newcomer communities. Racialized persons are defined as individuals who are non-Caucasian. Factors such as discrimination, language barriers, historical trauma and colonization have a cumulative effect -- they are also linked to experiencing homelessness and being unable to break the cycle of homelessness in Canadian society.
Because the realities experienced by individuals who are part of racialized and newcomer communities are different from that of other communities, it is important to recognize the unique challenges they may face. Connecting individuals to resources that are culturally appropriate makes it possible for their needs to be effectively addressed.
Below are some of the marginalized groups in Canadian society, who are especially at risk for experiencing homelessness for a multitude of reasons:
While Indigenous Peoples make up a small portion of the general population in urban areas in Canada, they account for a large percentage of those experiencing homelessness. In Toronto, for example, only 0.5% of the general population is Indigenous, and yet they make up about 15% of those who are experiencing homelessness. What is more, Indigenous Peoples make up to 90% of those experiencing homelessness in northern Canadian cities like Whitehorse or Yellowknife, while making up roughly only a sixth of both cities' populations.
A number of different circumstances can account for this overrepresentation of Indigenous Peoples amongst those experiencing homelessness. This includes the historical trauma and oppression faced by Indigenous Peoples, who were subjected tomaltreatment and cultural erosion through the exploitations of colonization, residential schools and the 60s Scoop. The aftermath often includes unstable families and homes, and various issues within Indigenous communities such as substance use, addiction, community violence and health issues.
Addressing these issues is not as simple as connecting individuals and families to social services and general resources. Cultural considerations need to be taken into account in order to properly address the issue of homelessness specific to Indigenous Peoples.
For example, within Indigenous cultures, the conceptualization of “home” and therefore what it means to experience homelessness, is more than simply having or lacking a roof over one’s head. Homelessness also includes variables such as relationships and connections to human kinship, earth, lands, waters and territories, animals, plants, spirits, elements, traditional songs, teachings, ancestors and names.
Furthermore, Indigenous homelessness does not fit neatly into the four Canadian categories of homelessness: unsheltered, emergency sheltered, provisionally sheltered, and at risk of homelessness. A definition that takes these important considerations into account is being worked on, and is set to be released in the fall of 2017.
Racialized Groups and Homelessness
Canada is comprised of a number of racially diverse groups, some of who are at an increased risk for experiencing homelessness:
- In Canada, 1 in 5 racialized families will live in poverty compared to only 1 in 20 non-racialized families.
- Racialized women earn an average of 32% less in the workplace.
- Youth who end up experiencing homelessness are more likely to belong to a marginalized and discriminated against group in terms of race, ethnicity, gender and sexuality.
- 28.2% of those experiencing homelessness are members of racialized groups, compared to the Canadian average of 19.1%.
- Indigenous Peoples make up only 4.3% of the overall Canadian population but comprise 30.6% of the youth homelessness population.
Refugees and Newcomers to Canada
Many of the challenges faced by refugees and newcomers to Canada parallel those faced by Canadians who are at risk of experiencing homelessness. For example, newcomers frequently struggle with finding good quality, permanent, appropriately located, yet affordable housing.
Refugees to Canada who are not privately sponsored are given help from settlement agencies to find housing arrangements -- but contrary to popular belief, they do not get to jump the waitlists for affordable housing. As a result, settlement agencies often look outside of subsidized housing and to the private housing market, which can be risky due to the chance of finding housing that is too expensive, overcrowded or illegally rented.
In addition to struggling with the need to find suitable housing, many refugees deal with a number of personal problems such as psychological distress, unemployment, a lack of social capital, language barriers, discrimination, lack of access to transportation and lack of credit history.
The barriers that newcomers and refugees to the country face put them at an increased risk for homelessness and core housing need compared to other groups. For example, 10.1% of newcomer youth experience homelessness.
What Can Be Done?
Taking into account the many cultures present in Canada is an important step towards providing effective services. It has been said that homelessness is a culture, and that services delivered by individuals with first-hand experience may contribute to better outcomes. This may mean having more staff with a history of experiencing homelessness, or perhaps hiring more ethnically diverse teams to help administer services in a culturally appropriate way. This will mean taking into account the historical, social, political and economic contributions that have created homelessness for people from various backgrounds.predominantly white and middle class, although the populations that most frequently access these services tend to be members of various racialized and marginalized communities.
Marginalized groups, which often include non-English speakers, racialized communities, those who are experiencing homelessness and newcomers to the country, tend to deal with more health problems for a number of reasons, including a lack of information and difficulties accessing health care. As the service models offered are more likely to reflect white, middle class values, the needs of racially and ethnically diverse groups may not be adequately met.
Across Canada, a number of culturally diverse services have emerged in hopes of providing services that will address the needs of Canada’s many groups and communities.
Services in Ontario:
Indigenous Housing and Services:
Across Toronto, a number of housing, health, legal, employment and cultural services are available to serve the Indigenous community. Some of them include:
- Anishnawbe Health Mental Health Crisis Line: Provides mental health services for crises 24/7.
- Anishnawbe Health Toronto: provides traditional healing, counselling that is culturally appropriate for youth and families involved with the child protection system, teaching and Healing Circles, Spiritual Ceremonies, education regarding diabetes
- 416-360-0486, aht.ca
- Native Child and Family Services of Toronto
416-969-8510, 655 Bloor St W, nativechild.org, firstname.lastname@example.org
For more Indigenous Peoples-specific services located in Toronto, visit: https://www1.toronto.ca/wps/portal/contentonly?vgnextoid=0e1ed4b4920c0410VgnVCM10000071d60f89RCRD
Access Alliance Multicultural Health and Community Services:
This is a registered organization and United Way member agency that serves the community of Toronto, by providing services for immigrants and refugees who are newcomers to the city.
For more information: http://accessalliance.ca/about-us/
Services in British Columbia:
Aboriginal Homeless Outreach Program:
Serving communities in British Columbia and managed by the Aboriginal Housing Management Association (AHMA), this program provides outreach workers for Indigenous Peoples that are19 years and older who have housing and health concerns.
Services are free and outreach workers listen to the health and housing needs of individuals. Connections are made to appropriate services and housing that is available. Services are provided with an Indigenous Peoples specific perspective.
For more information: https://www.bchousing.org/housing-assistance/homelessness-services/aboriginal-homeless-outreach-program
ISS of BC: Immigration and Settlement Services:
This organization is focused on providing services and supports to immigrants, including refugees. Services include settlement, education and employment programs. Support programs are offered in over 45 languages in the Metro Vancouver, Squamish and the Okanagan regions.
For more information: http://issbc.org/welcomecentre/
Indigenous Peoples-Specific Support and Programs in Alberta:
This is an Indigenous Peoples-owned, staffed and operated charity that aims to provide a variety of programs to Indigenous Peoples who may be facing homelessness, domestic violence, living with HIV/AIDS and addictions. This charity also provides culturally-sensitive training, education and referral programs for organizations.
For more information: http://www.shiningmountainslcs.ca/
Aboriginal Driver's License Initiative:
This program helps Indigenous Peoples with obtaining and maintaining a valid driver’s licence. It recognizes the barriers a lack of transportation can pose to success in employment. The three main areas of the program focus on: bringing awareness to the issue, education and training to help persons who are a part of the Indigenous Peoples community obtain their driver’s licences, and the accessibility of registration services (particularly in remote areas of Alberta).
For more information: http://indigenous.alberta.ca/Projects-and-Partners.cfm
Urban Society for Aboriginal Youth (USAY):
This non-profit organization is focused on assisting Indigenousyouth in the urban setting of Calgary, Alberta. They aim to provide urban Indigenousyouth with services and resources such as career planning, business etiquette, personal finance, and Blackfoot teachings.
For more information: http://www.usay.ca/about
Comments? Questions? Post them on Community Workspace on Homelessness:
The Community Workspace on Homelessness is an interactive, online platform that enables people to share information about and discuss issues related to homelessness. Different communities are able to share their knowledge, collaborate, and provide resources through this space.
Family homelessness in Canada continues to be an emergent and troubling issue.
In Calgary, for example, homelessness decreased by 1.3% overall between 2008 and 2014; at the same time, the number of families accessing shelter and short-term housing increased by 31%.
Homelessness for families is an especially troubling issue, because most are single mothers who have experienced long histories of trauma related to violence and abuse. The presence of children also makes it disturbing. Moreover, demographic data from Calgary’s family shelters shows that half of the families are Indigenous and approximately 30% are newcomers to Canada.
Understanding homelessness for families and developing subsequent responses require an understanding of gender and culture-related pathways into homelessness. Our research project, “Understanding Mothers Experiencing Homelessness,” was grounded in critical social theory, which connects individual issues to structural issues of power and exclusion. This research method examines structural barriers and the implications of power differences, which can help us to understand inequities in service delivery and policy development for people considered vulnerable. This elevates the analysis away from “problems with individuals,” towards “problems with public systems,” allowing more holistic responses.
For this research, we spent 12 months conducting retrospective one-on-one interviews with 15 mothers. We also engaged a small group of mothers living in short-term housing and a committee of community-based service providers and government representatives to provide advice and guidance throughout the project.
Some of what we learned was anticipated as all the interviewees had experienced long-term poverty, violence and interactions with child intervention authorities. They also had limited social and familial supports.
What Did the Mothers Tell us?
What we did not anticipate, however, was the fact that most of the mothers who volunteered to participate were newcomers to Canada. All of them had experienced multiple types of abuse in childhood, by spouses, partners, government officials or by other authority figures. Because of this, all of them felt “trapped” between multiple public systems with emergency shelters as their only available form of support. Many of the mothers talked about difficulties proving their residency status in Canada due to their partners withholding documentation as form of control, or because they had fled a violent situation. Most were unable to access affordable housing, social assistance and health care because they had no identification and no means to access it. The biggest barriers to exiting homelessness were structural barriers, which were essentially “siloed policies” -- sectors that were not collaborating and complicated or inaccessible services. Also, shelter staff felt ill-equipped to deal with the complications of immigration policies and processes, and the complexity of trauma faced by mothers and children.
What Should We Do?
With the advice and guidance of our group of mothers and our community advisory committee, we developed several recommendations:
1) Enhance and expand the continuum of housing and support options in the family sector. Formalized partnerships between shelters and immigration/settlement agencies could help bridge gaps between the homelessness and immigration systems. Families need flexible funding for costs associated with processing status applications or obtaining identification and rent supplements that follow them. This means rent supplements can be portable – tied to the tenant and move with the tenant from unit to unit -- attached to a specific housing unit or program. For example, if a family is in a housing program for two years and has access to rent supplements and case management, they could keep their rent supplement even when they no longer need case management.
2) Promote strong social networks for women including peer support. Including someone who has lived the same social experience and has successfully “moved on” is emerging as a promising practice in violence interventions and in housing programs. Inclusion of peers could be an important first step in helping vulnerable and victimized women to build healthy networks and relationships.
3) Recognize the complexity of family homelessness and focus on culture and trauma. Many of the women had experienced multiple forms of violence, sometimes at the hands of authority figures. An inherent fear of authority or retribution may impact discussions of violence, mental health or substance use. Women may not trust persons in authority including service providers, because of previous traumatic experiences at the hands of people they thought they could trust. More research is needed to develop a framework for cultured and trauma-informed care that is reflective of diverse and multiple experiences. One place to start is to recognize the profoundly difficult pathways into homelessness for women and children, and acknowledge that provision of housing without recognition of cultural experiences, and the need of supports for trauma, is not likely to lead to a sustainable end to homelessness.
4) Scan the eligibility criteria and data collection approaches of affordable housing providers. All of the women we interviewed experienced multiple barriers to accessing affordable housing. Many cited a lack of information, long wait lists or unclear rules about eligibility. There is also no transparent communication about the eligibility criteria of agency clients and/or any shared data on affordable housing clients. Calgary’s affordable housing “universe” is in need of an assessment of current capacity gaps, to make evidence-informed decisions about how to fill gaps and ensure the available housing is going to people who need it the most.
5) Increase efforts to prevent family violence. Multiple experiences of violence led the women to lose or jeopardize their social networks. These experiences drove them into poverty, which ultimately led to homelessness. Interagency collaboration outside of the homelessness sector, including those working in violence prevention, immigration and settlement agencies, legal advice and low-income legal support agencies, education and health care could lead to a “violence prevention task force,” which would develop and share best practices for identifying, screening and intervening for violence. Recognizing and preventing family violence is an upstream mechanism for preventing family homelessness.
If we can prevent multiple forms of violence and bridge gaps between immigration, homelessness and violence sectors to develop holistic supports for women, we have the potential to end and prevent homelessness for families. Continued increases in the number of families experiencing homelessness is unacceptable. It's time to change the way we tackle family homelessness.
Read the full report: http://homelesshub.ca/familyhomelessness
Agger, B. (2006). Critical social theories: An introduction. Boulder, CO: Paradigm Publishers.
This year, I was privileged enough to be part of a team of committed people involved in the production of a policy brief called “Child Welfare and Youth Homelessness in Canada.”
The policy brief is based on the results of the 2016 pan-Canadian study on youth homelessness, “Without a Home: The National Youth Homelessness Survey,” which found 57.8% of youth experiencing homelessness reported some type of involvement with child protection services over their lifetime. Compared to Statistics Canada indicating that 0.3% of the general public receive child welfare services, youth experiencing homelessness are 193 times more likely to report interactions with the child welfare system. This finding should shock people; it suggests that we are falling short of obligation to protect and care for children and youth in Canada.
What’s even more outrageous, given the settler colonial context in Canada, is that Indigenous children and youth are over-represented in both child welfare services and among youth experiencing homelessness. In 2016, the Canadian Human Rights Tribunal ruled that the federal government discriminates against Indigenous children on reserve by failing to provide the same level of child welfare services that exist elsewhere. Both underfunding (levels of support are lower than the provincial average for children in care who are off reserve) and the approach to delivering care have systematically disadvantaged Indigenous children and youth.
Moreover, the survey also showed LGBTQ2S youth and racialized youth are disproportionately represented among young people experiencing homelessness across Canada due to systemic forms of discrimination.
The stark results of last year’s survey are consistent with previous studies conducted in Canada over the last decade. Structurally and systemically, youth-serving institutions and the Canadian government have been unable to ensure all young people living in Canada experience access to justice – that is, experiences of relational fairness in any institutional setting where policy and law are applied or produced. We have been similarly unable to ensure that all young people have access to the basic things they need to survive: nutritious food, clean water, safe and appropriate housing, and timely access to healthcare services, including those required for mental wellness.
When I was doing the field research for “Youth Work: An institutional ethnography of youth homelessness,” I was shocked to discover how many young people using an Ontario youth shelter had been involved, or were still involved, with the province’s child welfare services. The research suggested that there were insufficient safe and appropriate housing options for adolescent youth in care in some small towns. Once a young person had exhausted the available foster families and group homes designated for youth, there were few options available to the child welfare workers, seeking to ensure the young people in their care were stably housed. In turn, this housing instability often disrupted young people’s access to education and their connections with family and friends.
Over the course of two years of fieldwork, I sought opportunities to collaborate with the local Children’s Aid Society (CAS) agency to do some research for them about young people’s experiences in care, including changes youth would like to see to the delivery of housing supports. I also invited the child protection workers and other local professionals to participate in a professional development opportunities I organized for shelter staff, so that shelter workers could improve their understanding of the institutional and policy organization of other institutional contexts shaping the lives of young people staying at the shelter. Back then, I was a doctoral student desperate to ensure that the research I was doing made some difference to the people who were participating in the project -- youth experiencing homelessness and housing insecurity and the adults seeking to support them.
Since then, I have continued to walk the line between research and policy/practice change, working side-by-side with youth and community organizations to identify problematic policies and practices that contribute to processes of marginalization and exclusion, and then to try to do something about the problems we’ve identified. But it always feels as though this last part remains slightly out of reach. As I also continue to study the ways that knowledge can contribute to social and institutional change processes, I have learned that a certain timeliness or receptivity to an idea is as important as compelling evidence.
Almost a decade ago, when I was a doctoral student working away on my dissertation research with a youth shelter in a small Ontario town, we did some good things at the local level. But none of them led to wide-scale changes to the institutional policies and processes that background young people’s experiences of homelessness and other forms of exclusion. The conditions weren’t right -- there was no “A Way Home Canada,” a national grassroots movement to end youth homelessness. The “Homeless Hub” and the “Canadian Homelessness Research Network (renamed “Canadian Observatory on Homelessness” in 2012),” were in their infancies. Housing First was not a conceptual or pragmatic shift people were talking much about, and nobody was talking about prevention. A lot has changed since then and not just within the homelessness serving/policy/research sectors, but within the other institutional sectors that influence how/whether people experience housing precarity.
On July 19th, Ontario released a blueprint for building a new system of licensed residential services for youth titled, “Safe and Caring Places for Children and Youth.” The blueprint is grounded in the experiences and insights of young people who have experienced residential care in this province. It highlights the importance of youth participation in policymaking processes and articulates a plan to ensure all young people receive safe, high-quality, culturally-appropriate residential care services, whether the use of residential services is part of a child welfare care agreement or protection order or because they are detained under the Youth Criminal Justice Act.
In 2014, the province of Alberta similarly raised the upper limit of eligibility for accessing The Support and Financial Assistance Agreement, a post-intervention service available to youth after the age of 18, to 24 years old. Since then, there has been an 80% increase in the number of agreements in the province over the last three years. By expanding the scope of eligibility to include more youth, young people have the opportunity to continue to access services and supports as they transition into adulthood.
Improving the quality, stability and appropriateness of housing and other supports for young people in care is an important way that child welfare organizations can contribute to the prevention of youth homelessness at the Primary Prevention level. Primary prevention of youth homelessness means “working upstream" to address structural and systems factors that more broadly contribute to precarious housing and the risk of homelessness for young people. Child welfare organizations can play a significant role in reducing housing precarity and increasing educational and social stability for young people who rely on residential services during adolescence.
Policy and practice moves to improve access to and experiences of services in Alberta and Ontario also suggest that provinces are paying attention to the ways that institutional practices and policies have contributed to the systemic marginalization of particular groups, and importantly, the role the state can play in rectifying the problems they’ve had a hand in creating.
I encourage provincial and territorial governments to continue to show leadership in this regard. Involve young people in the policy-making process so as to ensure that the decisions we make about their lives and wellbeing reflect their experiences and knowledge. Young people have critical insights that we are wise to heed. Commit to making a substantive contribution to the prevention of youth homelessness by disrupting the flow of young people from state systems of care into housing precarity; intervening to ensure young people do not lose their housing; and ensuring young people who do experience homelessness are supported to become and remain stably housed.
The Child Welfare and Youth Homelessness in Canada: A Proposal for Action outlines clear conceptual shifts that are required in order to work together to sever the links between child welfare involvement and youth homelessness. The conceptual shift that underpins all of the recommendations we make are a commitment to equity and human rights. All young people living in Canada have fundamental rights that are encoded in laws and treaties. Human rights treaties provide a constitutional or legal framework to ensure that all people experience fair and equal access to housing, education, healthcare, work, life, safety, justice, freedom of expression, freedom of movement, and freedom from discrimination.
Moreover, the state is responsible for ensuring all people experience these rights. Given the documented links between child welfare system involvement and youth homelessness, among other social, educational, and health issues experienced by children and youth who have been in state care, we need to ensure that the child welfare system actively supports the equitable inclusion and care of all young people. Research on the disproportionate involvement of Indigenous, racialized and LGBTQ2S youth in child welfare services and among street youth populations reveals systemic patterns of inequality, exclusion, and neglect are evident. Clearly, the state has failed to act on its responsibilities as a human rights protector.
Equality cannot be realized by treating everyone the same way. For equality to be realized, an equitable approach to policy-making and service delivery is required. This means putting the needs and experiences of those the state has failed at the forefront of policy and programmatic decision-making, including within the child welfare system and the youth homelessness sector. Following the release of the "Child Welfare and Youth Homelessness in Canada," The COH and A Way Home plans to follow up with the federal, provincial and territorial leaders. This would ensure there is an ongoing dialogue about the recomendations, allowing the COH and A Way Home to support ongoing policy development that align with the recommendations -- not as outsiders, but as partners.
See the recommendations made in our proposal at: http://www.homelesshub.ca/childwelfare
When it came into force in 2000, the Ontario Safe Streets Act (SSA) was a reactionist policy to the increasing visibility of individuals experiencing homelessness across Ontario’s cities, particularly those who would panhandle or squeegee. In an effort to deter those activities, the Act prohibits solicitation in specified spaces and any solicitation in an “aggressive manner.” The fines associated with each offence can be as little as $65 and as high as $1,000.
Seventeen years later, the vaguely worded legislation has proven to have unacceptable consequences for many Ontarians experiencing homelessness. For those unfortunate enough to spend extended periods of their lives living on the streets, these minor fines can have massive effects. Advocates with Fair Change Community Legal Clinic have come across many clients with accumulated fines in the tens of thousands of dollars. Just this past fall, Fair Change made international headlines when they helped Gerry Williams successfully appeal $65,000 of crippling fines.
But tired of a piecemeal approach and disillusioned by government inaction, advocates with Fair Change have taken the battle to court, to prove that the SSA is not only unconscionable, but also unconstitutional.
The SSA and its stubborn existence is evidence of why we must rethink the way we engage our community’s most vulnerable. Beginning in the early 80s, lawmakers in many jurisdictions subscribed to the peculiar view that the best way to help the marginalized is to marginalize them further through imposing fines for partaking in the sorts of activities that they rely on.
As a province, we have sought to address poverty by criminalizing it. Although this logic may have been acceptable 30 years ago, it cannot be tolerated in 2017. Decades of legal and sociological research have demonstrated that this approach is ineffective and inefficient. A report from the Canadian Observatory of Homelessness suggests that the SSA is expensive administratively. Prosecuting the SSA costs the province approximately $2 million per year. But because the vast majority of those issued tickets under the SSA are experiencing homelessness, very few fines are collected. Between 2000 and 2010, only about $8,000 in fines were collected.
This is why many jurisdictions, which adopted this approach to policing many years ago, have long abandoned it. Yet Ontario has somehow fallen behind and this policy seems to be lost in a cycle of harmful inertia. In fact, and what’s perhaps most troubling, tickets issued under the SSA are on the rise.
As the litigation surrounding the SSA continues, we cannot forget that repealing the Act will be only one victory in the larger battle against poverty. As Ontario takes measures to avoid poverty and prevent homelessness, moving away from the SSA would be a vital step in the right direction.
People who experience homelessness are not the problem. The problem is those of us who allow homelessness to persist. So when you’re walking on the sidewalk or driving down the street and see a person experiencing homelessness, you should feel uncomfortable. But rather than burying that feeling or attributing it to the person experiencing homelessness, search for the steps that you can take to address the true problem of poverty. Start by standing against the SSA, but certainly don’t stop there.
Reproductive health deals with the reproductive processes, functions and system at all stages of life. Although reproductive health is a universal concern, certain groups face inequalities when accessing healthcare. Socioeconomic status, education level, age, ethnicity and religion can all have an influence on how individuals maintain their reproductive health. As a result, people experiencing homelessness who are economically marginalized often do not have access to the supports, resources and information they need.
According to the World Health Organization, reproductive and sexual ill-health accounts for 20% of the global burden of ill-health for women, and 14% for men. Transgender and non-binary individuals who are disproportionally affected by homelessness also face unique reproductive health issues. They face obstacles to accessing quality healthcare, including gender-based discrimination that may occasionally result in refusal of treatment, and a lack of LGBTQ2S cultural competency. Compounded with the discrimination, erasure and transphobia often normalized in the shelter system, the reproductive health care needs of transgender individuals experiencing homelessness are frequently unaddressed.
Evidently, reproductive health is a universal issue that impacts various populations in different and extensive ways. This blog post will focus on three key areas of reproductive health relating to different populations who experience homelessness: menstruation, pregnancy and contraception.
The difficulties associated with homelessness are extensive, and include a lack of food, shelter, healthcare, mental health supports, and other vital resources. People experiencing homelessness who menstruate have the additional burden of managing their periods — a monthly occurrence that is unavoidable and expensive. Combined with the stigma that surrounds menstruation, women, trans men, and other people experiencing homelessness who menstruate often lack support that would help mitigate many of their problems. The upkeep of menstrual hygiene is a matter of dignity, but it is also crucial in order to avoid damaging reproductive and gynaecological health.
A recent study examined how women experiencing homelessness in the U.K. manage menstruations in a context of financial and social vulnerability. Many of the participants interviewed described the difficulty of prioritizing their limited funds for sanitary products. They were forced to make a decision between cheap self-made solutions and more reliable, but expensive, store-bought products. Those unable to purchase menstrual hygiene products have to manage the problems that arise from using homemade solutions, such as chemical irritation or yeast infections. Homemade solutions can also increase the likelihood of toxic shock syndrome and other life-threatening health risks.
Transgender individuals disproportionately experience homelessness when compared to the cisgender population. Those who were assigned female at birth and are grappling with gender dysphoria (distress because of a mismatch between physical appearance and gender identity) may have preferences over the sanitary products they use to reduce their dysphoria. The experience of homelessness and financial vulnerability removes much of the autonomy people have over how they manage their periods. Therefore, in the interests of both mental and physical health, it is important that menstrual products are widely available to those who are unable to afford them.
In Toronto, there is the Period Project, a street outreach group providing people living unsheltered with free sanitary items. In the U.S., there is Distributing Dignity, a women-led non-profit distributing pads, tampons and bras to people accessing homeless shelters, those who have aged out of the foster care system and families impacted by HIV/AIDS. New York City recently became the first city in the U.S. to require public schools, jails, and homeless shelters to provide free pads and tampons. In the Canadian Observatory on Homelessness’s Point-in-Time Toolkit, we recommend that communities include sanitary products as an honoraria item.
Other activist groups and movements advocate for the “tampon tax” be eliminated from state laws to those who cannot afford menstrual products. They argue the opportunities to enjoy fairly priced, tax-free products are not luxuries; rather, they are necessities. Menstruation is often overlooked and forgotten in reports addressing the health needs of people experiencing homelessness, and therefore fails to come to the attention of policymakers and service managers.
Homelessness and pregnancy
The stress of homelessness can have significant negative impacts for those who are pregnant. Due to compromised health, people who are pregnant and experiencing homelessness face greater health risks. They often have difficulty accessing healthcare and prenatal programs, which can result in potential prenatal complications going unnoticed. No one should be without a safe, stable place to call home, especially during pregnancy since this additional strain on the body can be life-threatening. The emotional and psychological aspects of pregnancy, birth, motherhood and/or the loss of a child can have further negative implications, especially for a vulnerable and marginalized population.
Pregnancy rates are also substantially higher among youth experiencing homelessness than in the general youth population. The adversity of life on the streets means that young people are exposed to increased sexual activity with more partners and increased exposure to STIs. To address this, effective and accessible pregnancy prevention and family planning programs for youth experiencing homelessness are needed.
Moreover, the relationship between substance use and homelessness is complex, and rates of substance use are disproportionately high among those experiencing homelessness. There are numerous potential harms associated with the use of substances during pregnancy, including Fetal Alcohol Spectrum Disorder (FASD), which can occur as a result of alcohol use during pregnancy, and Neonatal abstinence syndrome (NAS), a condition that a newborn may experience if exposed to addictive opiate drugs while in the womb. Homelessness and parental substance use may reduce neonatal well-being through prematurity and low birth weight.
Pre- and post-natal care programs help to prevent potential health problems throughout the course of the pregnancy. Toronto Public Health’s Homeless At-Risk Prenatal (HARP) team provides intensive prenatal case management to high-risk pregnant women experiencing homelessness in Toronto, focusing on service coordination as a primary intervention.
In spite of this, available services go underutilized often because of parents’ reluctance to self-identify as “homeless” or “underhoused.” According to Ontario’s Ministry of Health and Long-Term Care the number of babies born in the past six years to parents while experiencing homelessness in Ontario each year ranged from fewer than five to eight. However, there is a huge discrepancy between the number of pregnancies that occur and the number that are recorded. Young Parents No Fixed Address (YPNFA), a network of organizations working to address the challenges faced by youth experiencing homelessness or street-involved youth, pregnant and parenting youth and their children, have found this number to be much higher. As reported in July 2017 by Toronto Star, an estimated 300 babies were born into homelessness in Toronto each year between 2012 and 2014. Parents’ fear of losing custody has prevented them from disclosing their housing status, and has resulted in a significant underrepresentation of the scope of the issue.
Much like menstrual hygiene products, methods of contraception can often be costly and difficult to obtain. In Canada, street nurses play a crucial role in contraceptive education and provision for people experiencing homelessness. This can include distributing condoms and other contraceptives, HIV and pregnancy testing as well as educating those experiencing homelessness on safer sex practices.
People experiencing homelessness, particularly young women involved in the sex trade, are at increased risk of sexually transmitted diseases, including hepatitis, chlamydia, gonorrhea and HIV infection. Also, both men and women experiencing homelessness are at increased risk for disease due to injection drug use, multiple sexual partners and unprotected sex.
While access to contraception has increased substantially in recent years, low-income individuals are still twice as likely to use no contraceptives compared to higher income earners. Accessible birth control is one of the easiest ways to reduce costs on the healthcare system, but unlike in the U.S., U.K. and several countries in Europe, there is no universal subsidy for contraception in Canada.
A recent survey conducted by the Society of Obstetricians and Gynaecologists in Canada (SOGC) reported that 61% of Canadian women have had an unintended pregnancy. Following these alarming results, SOGC launched SexandU.ca to raise awareness about contraception and sexually transmitted infections. SexandU.ca provides accurate, credible, and up-to-date information and education on topics related to sexual and reproductive health.
Reproductive health is an extensive topic and this blog post covers only three areas of focus; there are still many other important and complex issues. You can learn more about sex workers and the sex trade in the topics section of our website. You can also help to continue this conversation on the Community Workspace on Homelessness at workspaceonhomelessness.ca.
(Image source: https://www.period.org)
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The analysis and interpretations contained in the blog posts are those of the individual contributors and do not necessarily represent the views of the Canadian Observatory on Homelessness.