This is our first instalment of the Friday "Ask the Hub" blog series. Have a homeless-related question you want answered? E-mail us at firstname.lastname@example.org and we will provide a research-based answer.
Dear Homeless Hub
I saw an article in NOW Magazine last week that said the city was going to redevelop Seaton House and make more of the beds permanent instead of shelter beds. The City of Toronto just released its findings for the 2013 Street Needs Assessment and the number of people sleeping on the streets has gone up! Shouldn’t we be adding more shelter beds instead of taking them away?
~Confused in Toronto
You’re right, it’s very important to understand the math behind homelessness. Too often, politicians and policy makers get focused on the solutions –building safe, secure and affordable housing with needed supports—and forget about the current state of affairs. While the housing is important, so is making sure the needs of people who are currently homeless get met.
As our recent State of Homelessness in Canada: 2013 report pointed out many people are homeless for only one night and 29% are homeless for less than a month. But, at least 200,000 people are homeless every year and across the country at least 30,000 are homeless every night. That means, as a country, we need to provide 30,000 beds a night until we have sufficient housing to meet demand AND we’re able to stem the flow of people into homelessness.
That’s the key point really. It's not as if we have a finite group of homeless people and once enough housing is built to house them, homelessness is over. New people become homeless every day. We need to address the upstream issues that are leading people to become homeless. Prevention is a big topic and one that we will be focusing a lot on over the next while here at the Hub.
But let’s look at the Seaton House numbers and the new Street Needs assessment numbers the City of Toronto just released. The city’s early report on numbers of the 2013 Street Needs Assessment show that both overall and street homelessness have gone up in the past 4 years. 24% more people are sleeping outside and 1% more people are homeless in Toronto, according to the count. Unlike most Alberta cities, and many others across the country, which are seeing significant drops in both categories, Toronto is seeing an increase.
|Location||Count||Share of total||Count||Share of total||Count||Share of total|
|Violence Against Women (VAW) shelters||171||3.4%||306||5.9%||356||6.8%|
|Health & treatement facilities||275||5.5%||223||4.3%||236||4.5%|
Source: City of Toronto, Street Needs Assessment Interim Report
Shelter operators have told me that they are running at almost full capacity, especially since July 2012. Another report in NOW magazine from March of this year, showed that, “shelters are operating closer to 100 per cent capacity than was previously thought, and are using beds on a daily basis that are supposed to be reserved for emergencies.”
According to the NOW article you mentioned, Seaton House has “543 beds, 240 are used as emergency shelter, and the rest are part of long-term care, harm reduction and infirmary programs.”
Since the goal of the redevelopment is to create more permanent housing, NOW points out, “emergency beds would be reduced from 240 to roughly 96. According to the report approved by council, the 140 men left over would be ‘absorbed into transitional housing programs or the emergency shelter system.’”
So, this is where we run into fuzzy logic and faulty math. Tonight, there will be close to 240 men using Seaton House. Tomorrow night there will be close to 240 men using Seaton House, and a few of them will be different. Next month, there will be close to 240 men using Seaton House and a significant percentage of them will be different. So there won’t be “140 men left over” as the report says, there may be several hundred.
The city’s move to build transitional and permanent housing units is important and a key step in solving homelessness, but there won’t be as stark a decrease in need as the city is predicting, unless significant prevention and homelessness reduction strategies are established in the interim. There is time; the ground-breaking isn’t until 2017 after all.
Every summer, for almost a decade now, the Conference on Ending Homelessness put together by the National Alliance to End Homelessness in Washington, DC has been a highlight for me. It has become a tradition. It reinvigorates me. It teaches me. It reminds me why we do this work – day in and day out.
There is no way to fully capture in this blog everything that was discussed at the conference. If you search the hash tag #naeh13 you can see the thread of some of the most dominant themes by some rather prolific tweeters.
In this blog, I wanted to reflect on the top three things that I took away from the conference this year – which may also be of interest to those unable to attend:
1. Success is possible.
It is inspiring to see the success of communities like New Orleans on track to end chronic homelessness. It is invigorating to see the results of the 100K Homes campaign, especially the 43 communities in the 2.5% club. It is refreshing to hear how communities like Grand Rapids and Cleveland made the necessary, but difficult, decisions to properly coordinate access into their homeless service delivery system. It is awesome to hear how organizations like UMOM in Phoenix transformed their resources to focus on serving people with higher acuity and many barriers to housing stability.
And I could go on. For anyone who feels that the job of working to end homelessness is an impossible task, take the time to look at those that are seeing success. But I should point out that each of these communities had to make tough choices to not provide business as usual. Success came from doing things differently – not doing the same things but expecting different results.
2. There is still confusion of some key concepts and terms
It is unfortunate – but an opportunity for improvement – to help people get greater clarity on several key concepts and terms: Housing First; Rapid Re-Housing; Prevention; Diversion; Acuity; Assessment; Collaboration; Case Management; Permanent Supportive Housing. For each of these, I encountered it used incorrectly on more than one occasion. If we are going to move forward collectively in the pursuit of ending homelessness, I think it will be important to all get on the same page when it comes to the concepts and terms used quite frequently. If we aren’t all on the same page, chances are we will think we are talking about the same things when we are not, or drawing upon a body of evidence and data in an incomplete or incorrect manner.
While I have addressed many of these in blogs and videos on our website, I think a consolidated glossary would probably be helpful too. I should really get on that.
3. Good data results in good decisions
The conference reinforced the importance of data many, many times. Data will only continue to become more important for decision-making as funding remains stagnant or decreases. And it is becoming more and more important for philanthropic investments.
It was encouraging to see communities like Tulsa use data so effectively for increasing the housing stock while also demonstrating social return on investment. It was excellent to see the likes of San Francisco demonstrate, through data, the relationship between the child welfare system and homelessness – and when the support intervention may work best. It was helpful to see how USICH and HUD both shared data to demonstrate where there has been effectiveness, and where improvements still need to be made.
It is a real delight to attend the Alliance conferences and learn. The next conference focuses on homeless youth and families and is being held in New Orleans in February. Stay tuned to endhomelessness.org to get more information – it is time and scarce money well invested!
Reposted with permission from OrgCode Consulting.
Iain De Jong works with OrgCode Consulting and also holds a part-time Faculty position in the Graduate Planning Programme in the Faculty of Environmental Studies at York University. Iain has worked in senior management and held professional positions in government, non-profits and the private sector, as well as considerable frontline and supervisory work with people experiencing co-occurring complex issues in their life such as chronically homeless people, persons with compromised mental wellness, community residents experiencing economic poverty, persons involved with sex work, and individuals experiencing addictions.
I’m a qualitative sociologist and while I sometimes like to play with numbers and images I’m often very limited in what I’m able to do myself. I was very excited to learn recently of a tool created by researchers from the School of Social Policy & Practice at the University of Pennsylvania.
Called Homelessness Analytics, the tool allows users to “explore maps, create customized tables, generate charts and funnel data into spreadsheets or databases to conduct independent analysis” according to the University of Pennsylvania, University Communications office.
They add, “Other functions include modeling and forecasting features that allow users to simulate expected changes in homelessness given changes in underlying indicators at the community level. As an example, a user can create a model of the relationship between median rent costs and the rates of homelessness in a specific region to better understand how changes in the housing market could impact homelessness.”
The tool was created by researchers Dennis Culhane and Tom Byrne, who also work with the National Center on Homelessness Among Veterans.
In the school’s press release Culhane says “This technology provides a new way to examine the problem of homelessness and is a terrific example of what can be achieved through collaborative efforts between academic and government partners.”
It’s a very easy tool to use. I queried the trends in homelessness between New Orleans and Houston (thinking back to the blog on New Orleans recovery) and was easily able to generate a chart that tracked changes over several years.
The website is full of information compiled from dozens of sources, including the American Community Survey, the Centers for Disease Control’s Behavioral Risk Factor Surveillance System, HUD’s Fair Market Rents, the National Survey on Drug Use and Health, and the U.S. Department of Agriculture’s Food and Nutrition Service Program.
Homelessness Analytics was built by Azavea, a development firm in Philadelphia that specializes in the creation of location-based Web and mobile software. In 2011, Azavea also worked with the City of Toronto to develop Toronto Wellbeing, a web application used to measure, monitor and map community wellbeing across 140 neighbourhoods.
See the full report from University of Pennsylvania, University Communications office.
Yesterday, the United Nations marked World Hepatitis Day, a day to “prevent and defeat hepatitis”, a virus infection that affects 1 in 3 people around the world. This number is much smaller for most people in Canada. However, it continues to be quite prevalent amongst those experiencing homelessness. Hepatitis refers to 5 viruses (labeled A through E). The studies in this post focused on Hepatitis B and C, both of which are contracted through bodily fluids. Hepatitis B virus is 50-100 times more infectious than HIV. Hepatitis B can be lethal, but it can also be prevented with a 3 dose vaccination. Hepatitis C can lead to long-term kidney failure and kidney cancer. Hepatitis C is treatable, and in many cases curable, with antibiotics.
The risk of contracting either of these infections can be made even greater with use of injection drugs and participation in higher risk sex (in exchange for money). Both of these activities can be coping mechanisms for those who are most marginalized and experiencing homelessness. The researchers I have worked with to complete these summaries have focused on hepatitis as it relates to: prevalence, prevention, palliative care and education.
Dr. Judith A. Stein completed research on homelessness and the prevalence of hepatitis infections. Her work was predominantly done in the “skid row” neighborhood of Los Angeles. Those who are homeless with hepatitis are less likely to know that they are infected. Those who had consistent case management and medical support were more likely to be aware of their infection. A second study by the same author focused on vaccination for Hepatitis B. The requirement of 3 doses to immunize for hepatitis B is often seen as a barrier to treatment. Those who experience homelessness may find it difficult to return to places to receive 2nd and 3rd doses. The research found that case management was the most important to help people complete the process.
Another study of palliative care also addresses risk associated with hepatitis. Dr. Stacey A. Page noticed a connection between the prevalence of hepatitis, HIV and cancer to a lack of access to healthcare. Barriers to continued treatment prevent people from accessing the care that they need. The research looked at records of those who were homeless when they died. The majority of those who died would have been more comfortable had they had access to treatment at their end of their life.
Education programs are important in order to prevent Hepatitis infection, and to inform people about possible treatments. Dr. Adeline Nyamathi completed a study of two different Hepatitis and HIV education programs for youth experiencing homelessness. One of the programs focused on a nurse-led model, while the other focused on an art intervention model. It is important evaluate the effectiveness of interventions. This research provides a strong argument for the need to test our assumptions, and to understand the importance of good field staff in running successful programs.
Isaac Coplan is a Masters student in Environmental Studies at York University. Isaac is working with Research Impact and the Homelesshub on Knowledge Mobilization. Isaac’s main research interests are in youth homelessness and social exclusion in Canada.
I am proud to be a contributor to the first of a series of annual reports on household food insecurity in Canada. The report is an initiative of PROOF, a Canadian Institutes of Health Research (CIHR) funded research program launched in 2011 to identify effective policy interventions to address household food insecurity.
I have two main sources of frustration as someone who has been involved in food insecurity research in Canada for the past 15 years. First, I am appalled by the lack of government attention directed at household food insecurity. In Canada, we have social policies that are meant to mitigate poverty, but we have no policies that target food insecurity, a clear indicator of brutal material deprivation, and one that is closely linked to poor health. Second, I have always been troubled by the media’s and others’ continued reliance on food bank use statistics to define the problem of food insecurity or hunger in our country. Although understandable since other numbers have not been readily available, these statistics diminish the magnitude of this very serious social and public health problem by counting only those who use food banks.
While food bank users represent a very vulnerable group of food insecure, they account for roughly one-quarter of food insecure Canadians. Consider the difference between the 851,014 people who used food banks reported in the Food Banks Canada 2011 Hunger Count and the 3.9 million people living in food insecure households that same year captured in the nationally representative, Canadian Community Health Survey. This shows that many more people than those who seek food assistance are struggling to get enough food.
PROOF’s report on household food insecurity, 2011 marks the beginning of an initiative to make regular, timely summaries of national population statistics on food insecurity more publicly available. The report reveals that almost 3.9 million Canadians experienced some level of food insecurity in 2011, including 1.1 million children! The problem is not under control, with over 450,000 more people experiencing food insecurity in 2011 than in 2008. The report provides detailed information about the extent of food insecurity, what the problem looks like in each province and territory, trends over time, and who is most affected. This information directs us to where urgent policy development is needed. For example, two-thirds of people who rely on social assistance in Canada are food insecure which tells us something out the inadequacy of this policy vis a vis food insecurity. At the same time, the largest numbers of food insecure are found among households who report wages, salaries or self-employment as their main source of income, suggesting that employment in and of itself is not protective.
We hope that the release of this report will draw attention to the true magnitude of the number of people that face insecure access to food and raise critical awareness of the necessity for this problem to be recognized in policy making. The seriousness of the situation, its impact on individuals, families, communities, on our health care system and economy overall, cannot be overstated, and effective responses are urgently needed from all levels of government.
Naomi Dachner is a Study Coordinator in the Department of Nutritional Sciences at the University of Toronto. Since her MSc – an ethnographic study of food access among homeless “squeegee kids” in Toronto – Naomi has continued research in the area of food insecurity where she has coordinated a variety of community-based research projects, often taking a leadership role in the qualitative dimensions these projects, including: an examination of nutritional vulnerability among homeless youth, studies of charitable responses to hunger in Canada, and an examination of meal services in Salvation Army shelters. Currently, Naomi coordinates PROOF, a 5-year program of research to identify policy options to reduce household food insecurity.
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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.