Homeless in Edmonton face health challenges, but stable housing can help: report

Homeless people in Edmonton are at greater risk of a slew of physical and mental health concerns and are having a disproportionately large impact on the health-care system.

That’s according to a report that Edmonton city council’s community and public services committee received from Alberta Health Services (AHS) executives on the effects of homelessness on the health-care system at a committee meeting Tuesday.

“Being homeless is a risk factor for so many downstream health effects: injury, assault, poisoning, amputations, frostbite,” said Dr. Chris Sikora, lead medical officer of health for the Edmonton zone, who gave the report alongside Selene Tash, executive director of community health services for the Edmonton zone.

A count from Homeward Trust shows that as of Monday, there were more than 2,800 homeless people in Edmonton, almost a third of whom were sleeping outdoors. About half were “provisionally accommodated,” meaning their housing is temporary or lacks security.

To study the health problems that homeless people are more susceptible to, AHS identified a group of more than 1,100 people that are known to use homeless shelters in Edmonton and tracked the broad health challenges they had over a three-year period.

Eighty per cent had drug or alcohol dependence. About half dealt with skin infections or injury. Almost 40 per cent had open wounds and 30 per cent had pneumonia. Almost half of the patients dealt with drug poisoning.

Sikora gave an update on another health issue that people in Edmonton’s inner city were uniquely affected by: the shigella outbreak that began last fall. By the end of January, AHS reported 200 cases of the infectious disease usually found in developing countries. Two thirds of the cases required hospitalizations. Only four cases were reported in January.

Sikora said a study done by the University of Alberta’s injury prevention centre found that from 2019 to 2020, homeless people in Edmonton made 5,800 visits to the emergency room. The leading causes for these visits were poisonings, violence, falls, environmental factors – especially cold – and suicide.

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However, stable housing contributed to a decrease in visits to the emergency room and length of hospital stays for people experiencing homelessness.

The report contained a high-level evaluation of “a handful” of people who got into permanent supportive housing. When comparing their medical visits two years before landing housing and two years after, there was a decrease in visits and the severity of stays.

“After being housed, there was a 58 per cent drop in the number of inpatient admissions and 81 per cent drop in the overall number of inpatient bed days,” said Sikora.

Sikora added there was a nearly 50 per cent drop in the number of visits to emergency departments and a decrease of 68 per cent in the number of noted addictions and mental health-related EMS events.

“Housing works,” he said.

The executive director of Radius Health agreed, saying that she sees her patients get housing and then stabilize in their medical conditions.

“Unfortunately, we also see patients lose their housing for one reason or another and then completely destabilize in their health status,” said Tricia Smith.

Smith said one of the interventions most needed to keep the homeless population as healthy as possible is hygiene facilities, like the ones the city provided during the shigella outbreak.

“We need public bathrooms, showers, we need laundry facilities, but we need them permanently, not just when there’s an emergency,” she said, adding that while these are sometimes available in shelters, they’re only open in the evening.

Bradley Lafortune, executive director of Public Interest Alberta, said minimum shelter standards are needed as well as a “massive reinvestment” in permanent supportive housing and near-market housing.

“We need investments in wraparound supports and services so that those supports and services can walk alongside individuals when they’re being housed and rehoused, so that we don’t see a failure in Housing First policies,” said Lafortune.