COVID-19 IMMUNIZATION FOR THE HOMELESS: AN ABSOLUTE MUST FOR THE CANADIAN HEALTHCARE

These days, every news channel you encounter is covering some aspect of the COVID-19 vaccine. One interesting but controversial topic is who should be given priority. On February 2, Canadian Alliance to End Homelessness and Canadian Network for the Health and Housing released a joint statement, advocating to prioritize COVID-19 immunization for people experiencing homelessness1. Should the homeless be given priority to the COVID-19 vaccine? For a plethora of reasons, the answer to this question should be an enthusiastic “yes”. The following will inform and inspire you to agree!  

Vaccines have always worked; they currently work and will continue to work as science advances. To date, almost 250 million COVID-19 vaccine doses have been administered worldwide. All Canadian provinces have started immunizing the priority populations. According to the Canadian government website, priority populations include adults of 70 years and above, health care workers and indigenous communities2. As important as it is to vaccinate these vulnerable demographics, the homeless population and shelter residents must also be included as a priority group. In fact, Montreal started the movement in mid-January to administer 500 doses to the homeless3. While the doses were limited, this initiated a movement across other provinces: Toronto, and later Vancouver, to consider and vaccinate their homeless citizens 4,5. But, how about the province of Alberta and more specifically, the City of Edmonton? Before getting to that, let us consider why supplying the homeless with the COVID-19 vaccine is crucial.

Residents of Vancouver Downtown Eastside encouraged to get COVID-19 vaccines. Image taken from CBC British Columbia5. 
Residents of Vancouver Downtown Eastside encouraged to get COVID-19 vaccines. Image taken from CBC British Columbia5. 

A key recent study in Toronto found that the homeless individuals, compared to the general population, were 20 times more likely to be admitted to the hospital due to COVID-19; more than 10 times more likely to require intensive care; and over 5 times more likely to die from COVID-196. It is shocking and deeply concerning to reflect on these staggering statistics.  Perhaps even more surprisingly, it becomes apparent within the long-standing scientific literature that homelessness dramatically increases a person’s exposure to infectious diseases. For example, North American studies report the prevalence of hepatitis-B up to 13% in homeless youth compared to 0.8% in the general population7. Another example is HIV, where its prevalence is about 6% in homeless youth compared to 0.3% in young adults7. While the routes of transmission for these viruses are different, the rates of respiratory diseases that transmit similar to COVID-19 (e.g. influenza) are also higher in the homeless population8

You may wonder why homeless people are at high risk of exposure to infectious diseases. This is a multifactorial problem that may be specific to each disease. Generally, one important reason is that homelessness is associated with a number of chronic diseases that are usually left untreated and increase the chance of getting an infection. For instance, many homeless people present with heart, lung or kidney disease, asthma and certain underlying immunologic diseases such as cancer8. These all increase the likelihood of hospitalization and death following an infectious disease. Another reason is that many shelters are overcrowded which makes it easier for the virus to jump from one person to another. So, if we knew all this, why did we not prioritize the homeless population’s access to get the COVID-19 vaccines? 

Immunization for the homeless is difficult. One challenge is the lack of accessible health care resources. Even though most vaccines are free of cost in Canada, systematic barriers still exist. For example, those that live without a fixed address and proper identification documents have a hard time receiving care in some Canadian health care settings7. Other related issues include lack of consistency in vaccine eligibility knowledge and irregular vaccination policies among the homeless youth7. Poor access to health care ultimately translates into missed opportunities for vaccination, and it is also associated with distrust of the healthcare system and providers. Importantly, homeless people that have never encountered healthcare settings, or have never felt included in personal healthcare decisions are much less willing to receive care and trust physicians8. Another factor is that some homeless individuals may feel that healthcare providers lack compassion for the homeless. Finally, there is the issue of vaccination resistance. There are two types of vaccination resistances: intentional non-adherence, as in actively not accepting vaccination; and unintentional nonadherence, a passive process that leads to not getting vaccinated such as forgetfulness, scheduling conflicts or lack of knowledge about vaccine efficacy and safety9. Homeless individuals often exhibit the latter form of vaccination resistance as a result of the poor accessibility to receive vaccination information8,9. An accessible and effective education about vaccination safety and efficacy may help a great deal in addressing unintentional non-adherence in the homeless population. These challenges collectively make vaccination difficult and costly in this population. Considering all these difficulties, it is still possible to implement successful immunization programs when healthcare providers address these challenges in this vulnerable population. 

There have been a few successful immunization programs in the homeless population. To give an example, in a large study conducted in Vancouver, 8723 individuals were immunized in an influenza/pneumococcal vaccination campaign and 3,542 were vaccinated for hepatitis-A and -B10. While it is not clear how many of these people were homeless, the targeted Vancouver area was estimated to have a large number of people living on the streets. Importantly, the vaccines were administered using outreach in a non-traditional setting, “vaccination blitz”. This meant that public health nurses and volunteers would visit different sites within the targeted area and vaccinate as many people as they could. This strategy turned out to be a great success as compared to traditional hospital vaccination programs: a lot of people participated. Preliminary results from the study showed that the rates of hepatitis-A infections and the number of hospital visits due to pneumonia decreased in the 3 months following the blitz10. Interestingly, COVID-19 vaccination blitz programs are currently underway in the United States (e.g. Chicago)11. Vaccination in non-traditional settings has proven to be effective mainly because it increases the accessibility of vaccines, decreases distrust of the healthcare setting and reduces vaccine resistance8,10. Canada and Edmonton could use such methods to deliver vaccines to the low-income neighbours within the homeless community. Prime Edmonton locations might be tent city or the neighborhood surrounding the coliseum. 

On February 19, the government of Alberta released a plan for phase 2 of COVID-19 vaccination which will take place from April to September12. The homeless and residents of shelters are in group C after group A (e.g. elderly and indigeous Albertans) and group B (those with underlying health conditions). While this step taken by the Alberta government is a good start, immunization of the homeless should have been initiated earlier similar to other Canadian provinces. In addition, no clear timeline has been given for when each group will be vaccinated, and group C will be vaccinated only after groups A and B are completed. Perhaps most surprising of all is that homeless individuals are not included in group B, while it is known that a large proportion have underlying health conditions that are untreated. It is also important to note that Alberta is currently facing a vaccine shortage, shipment issues and under-funding for healthcare. Nevertheless, the living conditions of people living on the streets is unacceptable and requires immediate attention. The homeless are readily exposed to the virus and in grave danger of suffering from its consequences. We must demand better health care for this highly vulnerable population.

Phase 2 and Group C of Alberta’s COVID-19 immunization plan. Image taken from Global News(13).
Phase 2 and Group C of Alberta’s COVID-19 immunization plan. Image taken from Global News(13).

While you may have little power to directly change the plans of our government, I know we can all play our part and do better to provide support and care for the homeless. Actions to achieve this can be as simple as educating yourself and the people around you by spreading awareness about increasing accessibility of vaccination for the homeless. I encourage you to have a look at the resources I have listed below to more deeply inform yourself on this important issue. 

Additional Information:

Track COVID-19 Vaccines Worldwide: https://ourworldindata.org/covid-vaccinations

COVID-19 Vaccines in Canada: https://www.canada.ca/en/health-canada/services/drugs-health-products/covid19-industry/drugs-vaccines-treatments/vaccines.html

Alberta COVID-19 vaccination plan: https://www.alberta.ca/covid19-vaccine.aspx?utm_source=google&utm_medium=sem&utm_campaign=Covid19&utm_term=Vaccine&utm_content=v1&gclid=Cj0KCQiA-OeBBhDiARIsADyBcE7zobONx0ljacgmSnDrhP2zZGNtMg47N98G2CIq51yoh9Yd0qC-zmcaAraBEALw_wcB

CDC’s frequently asked questions – COVID-19 vaccination in the homeless population: https://www.cdc.gov/coronavirus/2019-ncov/community/homeless-shelters/vaccine-faqs.html

Key Advocacy/Research Groups to Follow and Support:

Canadian Network for the Health and Housing:  http://cnh3.ca

Canadian Alliance to End Homelessness: https://caeh.ca

Dr. Stephen Hwang Research Team (world renowned Canadian scientist addressing homelessness and health) http://stmichaelshospitalresearch.ca/researchers/stephen-hwang

Science Up First (addressing misinformation about COVID-19 vaccines): https://www.scienceupfirst.com

Works Cited

  1. “STATEMENT: prioritize vaccinations for people experiencing homelessness, Canadian Network for the Health and Housing, 2 Feb. 2021, http://cnh3.ca/prioritize-vaccinations/
  2. “Vaccines and treatments for COVID-19: vaccine rollout”, Government of Canada, 25 Feb. 2021, https://www.canada.ca/en/public-health/services/diseases/2019-novel-coronavirus-infection/prevention-risks/covid-19-vaccine-treatment/vaccine-rollout.html
  3. “Montreal to begin vaccinating homeless population after spike in COVID-19 cases”, Montreal, CBC News, 13 Jan. 2021, https://www.cbc.ca/news/canada/montreal/montreal-homeless-vaccination-quebec-1.5871668
  4. “City of Toronto and partners start COVID-19 vaccination pilots for people experiencing homelessness and frontline workers in select shelters”, City of Toronto, 18 Jan. 2021, https://www.toronto.ca/news/city-of-toronto-and-partners-start-covid-19-vaccination-pilots-for-people-experiencing-homelessness-and-frontline-workers-in-select-shelters/
  5. “Vancouver health authority rolls out COVID-19 vaccine on downtown eastside”, CBC British Columbia, 30 Jan. 2021, https://www.cbc.ca/news/canada/british-columbia/vancouver-health-authority-rolls-out-covid-19-vaccine-on-downtown-eastside-1.5895158
  6. Richard, Lucie, et al. “Testing, infection and complication rates of COVID-19 among people with a recent history of homelessness in Ontario, Canada: a retrospective cohort study”. CMAJ Open. vol 9, no 1, 2021, E1-E9
  7. Doroshenko, Alexander et al. “Challenges to immunization: the experiences of homeless youth.” BMC public health. vol 12, no 338, 2012
  8. Beers L, et al. “Increasing influenza vaccination acceptance in the homeless: A quality improvement project”. Nurse Pract. vol 44, no 11, 2019, 48-54 
  9. Gadkari, Abhijit S, and Colleen A McHorney. “Unintentional non-adherence to chronic prescription medications: how unintentional is it really?.” BMC Health Services Research. vol 12, no 98. 2012
  10. Weatherill, Shelagh A., et al. “Immunization Programs in Non-Traditional Settings.” Canadian Journal of Public Health”, vol 95, no. 2, 2004, 133–137
  11. “Chicago Targets 15 Hard-Hit Communities For A Vaccination Blitz To Fight Disparities”, WBEZ Chicago, 17 Feb. 2021, https://www.wbez.org/stories/chicago-targets-15-hard-hit-communities-for-a-vaccination-blitz-to-fight-disparities/86b224d5-21dc-4914-936b-bd64d8c93855
  12. “Alberta premier announces priority list for second round of COVID-19 vaccinations”, The Star, 19 Feb. 2021, https://www.thestar.com/news/canada/2021/02/19/residents-in-long-term-care-supportive-living-fully-vaccinated-alberta-premier.html
  13. “Alberta announces details about Phase 2 of COVID-19 vaccine rollout”. Global News. 19 Feb. 2021, https://globalnews.ca/video/7651379/alberta-announces-details-about-phase-2-of-covid-19-vaccine-rollout

Written by: Amir Ali Adel

Edited by: Jane Porter

ALBERTA’S RACIST ROOTS AND WHY THEY MATTER

As an Albertan, how much do you know about anti-black racism and its beginnings in our community? In 2017, Alberta became the fourth province in Canada to recognize February as Black History Month, and yet still, the majority of Albertans—admittedly, myself included—know very little about the complex history of African-Canadians in our province. So what is that history and why has it been so largely undiscovered? And, more importantly, why should we pay attention to it? In this post, I not only want to discuss and celebrate the rich history of Black peoples in Alberta but delve into the institutionalized racism of the past that has set the stage for the many struggles the Black community still face today.

A Glimpse into African-Albertan History

Growing up in Edmonton, the only curricular mention of African-Canadian history started and ended with the story of the Underground Railroad: the secret network of abolitionists working to help enslaved African-Americans escape in favour of the free British North America (now known as Canada). Despite this, the history of mass Black migration to Alberta doesn’t even begin with the Underground Railroad. The portrayal of Canada as an anti-racist haven (which is what the Underground Railroad seems to describe) is a massive misrepresentation that undermines the struggle that early Black migrants faced and allows for the Canadian exceptionalism myth to cloud our current understanding of discrimination in our own country.

Following Oklahoma’s passing of its first Jim Crow law in 1907, over a thousand African-Americans migrated from the Southern United States to small Albertan farming towns near Edmonton. Surprisingly, despite settling in a small prairie town after the Civil War, interviews with their descendants show that early Black settlers in Alberta built strong ties and thriving communities with other European farming families (Simons). However, after the Great Depression hit in the 1930s, most farming families were forced to move to Edmonton and were now under employment of white employers. Consequently, the discrimination that they faced was present in every major social institution. This was propagated by politicians and media outlets, who voiced speeches titled “We Want No Dark Spots in Alberta”, and called the migration of a few decades earlier a “Negro invasion” (RETROactive). In fact, in an attempt to restrict immigration into the prairie provinces in the early 1900s, the Canadian government covertly offered medical examiners bonuses for rejecting any Black immigrant at the border by fabricating any medical condition that would justify their rejection. In Edmonton, Mayor Dan Knott (1931-34) was in association with the Albertan chapter of the white-supremacist hate group Ku Klux Klan (KKK), and while serving as mayor, authorized the groups’ cross burnings on public grounds. Meanwhile, his name continues to title a junior high school in southeast Edmonton. 

Amid rampant discrimination, there arose many remarkable individuals who fought and advocated for their fellow Black Albertans. Charles Daniels, a Calgarian inspector for the Canadian Pacific Railroad, bought a ticket to the theatre, and while he paid for a front-row seat, he was directed to the “coloured” designated balcony. He protested, and after being offered a refund, he refused and left—an action that garnered media attention all over Alberta. Violet King was the first Black person to acquire a law degree in Alberta and the first female Black lawyer in Canada. She advocated for the challenges that women of colour face in the workplace. Her brother, Ted King, was the president of the Alberta Association for the Advancement of Coloured People (AAACP), through which he directed a lawsuit against a Calgarian motel’s discriminatory policy that reached the Canadian Supreme Court.

Current Issues: BLM & Black Youth

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Hundreds of Edmontonians marched from the Alberta legislature to City Hall on June 2, 2020, in protest of the killing of George Floyd and racism. (Taken from CTV Edmonton)


Black Lives Matter (BLM), while beginning as an American movement in 2013, rapidly transformed into a global phenomenon that has taken shape in the form of protests, rallies, and various campaigns in hundreds of cities around the globe. In Edmonton, several BLM protests took place in June 2020, all in response to decades of racism that present itself in the actions of municipal institutions, such as the Edmonton Police Service (EPS) and Transit System (ETS). For example, a major campaign against EPS involves carding, which examines the immensely disproportionate rates of street checks and racial profiling among Black and Indigenous populations (more information about carding can be found on Edmonton-based writer Bashir Mohamed’s blog linked below). Hate-motivated attacks based on anti-Black racism are also sickeningly prevalent in our city, seen by two recent incidents of physical assault upon Black Muslim women near the Southgate mall and LRT station (Antoneshyn). 

What we need to understand is that these events do not happen in isolation, but rather are only a few examples of the discrimination faced by the Black community at all levels of society. And, more importantly, the systemic, long term effects to these communities and their youth cannot be overlooked. A study done at Toronto’s York University in 2015 indicates that Black youth experience higher drop-out rates, higher expulsion/suspension rates, and poorer educational outcomes as compared to their white counterparts (Kelly). As mentioned before, African-American history (without the “white saviour” narrative) is rarely highlighted in school curriculum. Furthermore, due to a variety of factors such as intergenerational trauma and cultural expectations, Black youth face multiple barriers while seeking mental health support (Pasiuk). 

What can Albertans do?

2021 may be a new year, but it will be a far cry from a fresh start unless we continue to become aware of and advocate for the issues that affect us, our peers, and our communities. Historically, our province has never been an exception to anti-Black racism and we have a long way to go before it is. Below, I am linking a variety of organizations that actively combat racism in Edmonton, as well as resources that you can use to learn more. I encourage you to continue to educate yourself on anti-racism and get involved in your community in any way possible.

More Information On:

The Underground Railroad: https://www.thecanadianencyclopedia.ca/en/article/underground-railroad

Jim Crow Laws: https://www.okhistory.org/publications/enc/entry.php?entry=SE017

Dan Knott and the Albertan KKK:

https://www.cbc.ca/news/canada/edmonton/a-dark-chapter-should-edmonton-s-kkk-history-be-acknowledged-1.3872961

Charles Daniels, Violet King, and Ted King:

https://www.sprawlcalgary.com/calgarys-unknown-civil-rights-hero

https://www.thecanadianencyclopedia.ca/en/article/violet-king

https://www.thecanadianencyclopedia.ca/en/article/ted-king

Anti-Racism Resources & Organizations to Support 

Bashir Mohamed’s Anti-Black Racism Tool-Kit: https://www.bashirmohamed.com/blog/2020/6/2/edmontontoolkit

Black Lives Matter YEG:

https://blmyeg.ca/

Black Women United YEG:

Experiences Canada Anti-Racism Resources:

https://experiencescanada.ca/resources/anti-racism-resources/

Works Cited

Antoneshyn, Alex. “’Could Have Been Me’: Somali Community Reacts to Hate-Motivated Attack Outside Edmonton Mall.” Edmonton, CTV News, 11 Dec. 2020, edmonton.ctvnews.ca/could-have-been-me-somali-community-reacts-to-hate-motivated-attack-outside-edmonton-mall-1.5224222.

editor, RETROactive. “African American Immigration to Alberta.” RETROactive, 11 Oct. 2018, albertashistoricplaces.com/2015/02/12/african-american-immigration-to-alberta/.

Kelly, Jennifer R. “Opinion: It’s Time to Address Systemic Inequities in Schools for Black Youth.” Edmontonjournal, Edmonton Journal, 4 Jan. 2021, edmontonjournal.com/opinion/columnists/opinion-its-time-to-address-systemic-inequities-faced-by-black-youth-in-school.

McMaster, Geoff. “Citizen Historian Determined to Expose Edmonton’s Racist Past to Reconcile and Move Forward.” University of Alberta, University of Alberta, 14 Feb. 2020, http://www.ualberta.ca/arts/faculty-news/2019/february/citizen-historian-determined-to-expose-edmontons-racist-past-to-reconcile-and-move-forward.html.

Pasiuk, Emily. “Black Youth in Edmonton Face Barriers When Seeking Mental Health Support, Study Shows | CBC News.” CBCnews, CBC/Radio Canada, 21 Nov. 2020, http://www.cbc.ca/news/canada/edmonton/black-youth-mental-health-edmonton-university-of-alberta-study-1.5806363.

Simons, Paula. Edmonton Journal. “Paula Simons: Moving New Film Untangles Alberta’s Complex Black History.” Edmontonjournal, Edmonton Journal, 23 Feb. 2018, edmontonjournal.com/entertainment/movies/paula-simons-moving-new-film-untangles-albertas-complex-black-history/.

“Woman Charged after ‘Hate-Motivated’ Attack Outside Edmonton Mall: Police.” Edmonton, CTV News, 16 Dec. 2020, edmonton.ctvnews.ca/woman-charged-after-hate-motivated-attack-outside-edmonton-mall-police-1.5233321. 

Written by Kritika Taparia

Edited by Amir Ali Adel

HOMELESSNESS IN LGBTQ+ YOUTH

As much as we would like to believe that the discriminatory treatment of LGBTQ+ people has diminished in modern times, especially in progressive countries like Canada, we must remember that it hasn’t been too long since homosexuality was demedicalized and decriminalized. Discrimination against sexual minorities still prevails as suggested by the data from Statistics Canada: sexual minorities are violently victimized more often than their heterosexual counterparts. Similarly, such discrimination is also reflected in homelessness. According to a survey conducted in 2016, young people (aged 13-24) contribute to 20% of the Canadian homeless population, and of those, 29.5% identify as members of the LGBTQ+ community (Gaetz 6). This amount is almost as much as the contribution of Indigenous youth (30.6%) and is substantial considering that the LGBTQ+ community makes up a smaller population in Canada than the Indigenous community. The disproportionate representation of the homeless youth population by minorities suggests that there may be social factors causing this over-representation. This post focuses on sexual minorities, addressing the question, “what are the social causes behind LGBTQ+ youth homelessness, and what are the possible solutions to it?”

Many past researchers point out structural factors such as the disapproval of non-heteronormativity and non-cisnormativity in familial relationships caused by prejudices, as the primary cause of homelessness in LGBTQ+ youth (Gaetz 34). It is not surprising that most youths depend on their parents for financial support; during adolescence, it is difficult to find a stable source of income and obtain stable housing, in addition to the potential for financial illiteracy. Given this fact, it is predictable that LGBTQ+ youth will be financially (and emotionally) challenged if they leave their families, expecting a rejection of their identity, and forced evacuation should their sexual orientation be revealed. Support system failures are another major factor that contribute to LGBTQ+ youth’s homelessness (Gaetz 34). For instance, research shows that the foster care system fails to accommodate LGBTQ+ youth, despite them being over-represented in the system. LGBTQ+ youth experience prejudice-based discrimination at higher rates and have more frequent departures from their families as a result (Fraser). This was further exemplified by Feinstein et al.’s finding that 56% of LGBTQ+ foster youth felt safer sleeping on the streets than in their foster homes (Fraser). Similarly, LGBTQ+ youth homelessness can also be attributed to institutional failures at providing smooth transitions for the youth from institutional care to professional housing (Fraser). The foster care system fails to assure the youth that it is not necessary for them to leave their care when they become adults, and that they can apply to be housed as adults through a mature-level foster care program instead. The homelessness institutions often manifest heteronormativity and cisnormativity through their institutional policies (Fraser). Several of the youth  have received biased treatments based on their gender identity or sexual orientation; for example, institutions segregated LGBTQ+ youth based on biological sex rather than self-identified gender and presumed heteronormativity and cisnormativity for individuals when filling out admission forms (Fraser).

There are three typical ways in which LGBTQ+ youth interact with homelessness agencies: conforming to agencies with heteronormative and cisnormative policies, resisting agencies with these policies, or getting recognition from agencies that are accepting LGBTQ+ youth (CĂ´tĂ©). While conforming to these policies as a sexual minority may allow one to stay in the agency, it would also impose more stress on the individual on top of the stress coming from their parents’ unacceptance. In comparison, resisting such policies would most likely mean leaving the agency in lieu of standing up for their rights. Neither of the two results in the LGBTQ+ youth’s happiness. In fact, research has shown that the only solution that results in their happiness would be the creation or fostering of an LGBTQ+ specific homeless agency. I had the pleasure of interviewing Corey Wyness, a coordinator of an educational institution for sexual minorities at the University of Alberta, called the CHEW project. He described the CHEW project as an institution that strives “to create health, happiness and hope for queer and trans youth that face the area of poverty, mental health, homelessness” (Wyness). He described his role as a coordinator as “overseeing the whole project”, as well as dealing with “a lot of mental health and crisis intervention” (Wyness). When asked about how the CHEW project helps the struggling youth, Corey answered, “we have a drop-in center where young adults can come for basic needs like shower, food, and sleep” (Wyness). He added that “they can just hang out and have fun playing video games” (Wyness) indicating that the centre tries its best to create a friendly environment for the queer and trans youth, because they are aware of the importance of creating a sense of family.  Although the centre serves its purpose by providing the youth with a memorable, happy experience, Corey mentioned that “a lot of our youth are homeless” (Wyness). He states that they are only “scratching the surface of all the kids out there who identify as queer and trans and are homeless” (Wyness), due to the limited resources for the homeless LGBTQ+ youth. He brought up that “the CHEW project is kind of the only one specific for queer and trans youth” (Wyness), although foruntately, other places are  beginning to understand queer and trans youth better. In the end, he stated that “the whole system needs an overhaul” (Wyness) implying the importance of  reducing heteronormativity and cisnormativity embedded in our society.

Actively informing others of homeless LGBTQ+ youth’s struggles is essential to effectively addressing the needs of the diverse homeless population that consists of many minority groups. As an individual that strives for the betterment of society, one should always vocalize the need for the disappearance of stigma against sexual minorities. I encourage anyone reading this to learn more about the CHEW project for themselves, and find ways to support the homeless LGBTQ+ youth by getting involved in their local communities.


Works Cited

CĂ´tĂ©, Philippe-Benoit, and Martin Blais. “Between Resignation, Resistance and Recognition: A Qualitative Analysis of LGBTQ+ Youth Profiles of Homelessness Agencies Utilization.” Children and Youth Services Review, vol. 100, 2019, pp. 437–443., doi:10.1016/j.childyouth.2019.03.024. 

Fraser, Brodie, et al. “LGBTIQ+ Homelessness: A Review of the Literature.” International Journal of Environmental Research and Public Health, vol. 16, no. 15, 2019, p. 2677., doi:10.3390/ijerph16152677. 

Gaetz, Stephen. “Without a Home: The National Youth Homelessness Survey.” Without a Home: The National Youth Homelessness Survey | The Homeless Hub, http://www.homelesshub.ca/YouthWithoutHome. 

Wyness, Corey. “Homelessness in LGBTQ+ Youth.” 11 Jan. 2021. 


Written by Erica Kim

Edited by Sara Assaf

A CANADIAN COLONIAL LEGACY: HOMELESS INDIGENOUS YOUTH

Introduction: 

Homelessness impacts people of all identities, but none so much as people of Indigenous identities. Indigenous peoples are inordinately affected by homelessness, and this is only amplified when considering rates of youth homelessness. It is estimated that between twenty-five and thirty-five thousand Canadian homeless youth identify as Indigenous (2).  When considering disproportionate representation in youth homelessness, it is critical to understand North American and Canadian-specific forms of colonialism that have direct relationships to youth’s experiences today (1). Legacies of North American colonialism such as parental neglect, physical and sexual violence, and family or personal poor mental health are only some of the challenges faced by Indigenous youth that contribute to homelessness (2). In conversation with an elder in the Metis community, it is evident that these risks to Indigenous youth are long-endured and unchanging. Supports to those at risk of homelessness (or even the homeless themselves) are not highly accessible, and psychological legacies of colonialism are often found to be at the root of Indigenous youth homelessness. Although social programs are created to aid and support homeless youth, it can be a further challenge to promote access to these resources, especially due to the historical treatment of indigenous youth in residential schools.  

Colonization of Indigenous Peoples: 

Historical context is key to understand the disproportionalities in homelessness when discussing homelessness as an Indigenous issue. European colonialists settled the land that is now known as Canada, beginning the interaction between themselves and the Indigenous people who occupied this land for millennia (1). Colonialism is the practice of overtaking a region outside of a colonialist’s own country and economically exploiting the land or people of that region. Although interactions such as the fur trade benefited both ethic groups, actions of colonialism by the British Empire (and later by Canadians) caused enduring negative legacies for indigenous peoples (1).

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European perspectives on the Indigenous way of life can be summarized as considering Indigenous peoples as “savage” and “uncivilized”.  These perspectives drove missionary interaction and mistreatment of Indigenous peoples, leading to large-scale operations and legislative actions that have supported negative legacies of Indigenous treatment in Canada. The most notable examples are residential schools and the Indian Act (1). Residential schools were created in their first form pre-confederation, and involved horrific mistreatment of Indigenous youth, who were stripped of their cultural identity and their community and family through “education”. The Indian Act was a post-confederation piece of legislation that required assimilation of Indigenous peoples and denied Indian status to many Indigenous men and women. The act also removed Indigenous autonomy to self-govern, giving the Canadian government veto power over any band’s decision (1). 

Residential schooling of Indigenous youth continued until 1996 in Canada, and left devastating repercussions that will remain for generations (1). Assimilation was a pillar of these institutions and abuse within them was frequent. The Indian Act was amended in 1920 to require all Indigenous children to attend residential school. The peak of residential school attendance was during the 1960’s during an era of gross forceful removal of children from their homes called the “Sixties Scoop”.  Life at Residential school was often faced with hunger, unsanitary living conditions, and emotional or physical abuse by those responsible for the youth’s well-being (1). Legacies of these horrific conditions in residential schools, that we now characterize as cultural genocide, can be directly related to the significant rate of homelessness effecting today’s Indigenous youth. 

Interview: 

A recent study found that homeless Indigenous youth cited reasons of physical or sexual abuse, and personal or parental drug and alcohol abuse or mental health issues as reasons for leaving home. 54.4% of homeless Indigenous youth experienced pre-street physical abuse, and 23.3% of homeless Indigenous youth experienced pre-street sexual violence (2). In an interview with an Edmonton local MĂ©tis residential school survivor who experienced homelessness for a majority of her life, she cited her reason for leaving home to be parental violence against herself and her siblings. Growing up in an environment with a father struggling from severe alcoholism, she suffered through physical and psychological abuse and ultimately felt that the only option for her survival was to leave home. Though she is uncertain about her father’s experiences with residential school, she found it highly likely that he experienced negative treatment in a residential school. After leaving home, however, her challenges only grew during her time on the street. Post-street exposure to drugs and alcohol as coping mechanisms is common for Indigenous youth: 45.1% of homeless Indigenous youth are hospitalized due to a drug or alcohol overdose (2). She explains that her experience frequently involved drug addiction and routine hospitalization as a result. Often, she elaborated, youth on the street are taken advantage of by older homeless people in order to secure drugs and alcohol, or to exchange drugs and alcohol among one another. It should be stated that alcoholism and drug addiction are considered diseases and are not based solely on the individual’s choices. For more details please read the previous blog post “The Russian Doll of Stigmatization”. 

Programming and Aid: New Solutions

When asked “what do you think would be the most helpful resource for Indigenous youth who have left home?”, the local elder responded that she believes it is the accessibility of information on where to get aid from social programs that is the largest challenge. Once homeless youth know where to access aid, the last hurdle facing Indigenous youth is trusting that source of aid. Non-indigenous removal of indigenous children from their homes is deeply intertwined with the legacy of residential schooling, leading to a lack of trust between indigenous children and programs like child-protective services (2).  While it has always been an immense challenge for homeless Indigenous youth to trust shelter or child-protective services for aid, she believes that this it is more possible now than ever before for Indigenous youth to trust those resources due to the Truth and Reconciliation governmental campaign that is advocating for better supports for today’s Indigenous peoples who are still impacted by the devastating legacies of colonialism (1).

Resources and supports for homeless populations are not always readily accessible to those who may need them. When addressing her transition off of the street, the interviewee indicated that during her experience she was unaware of services such as Hope Mission, the Mustard Seed, or local women’s shelters until she was much older. If she had had access to those supports earlier on in her life after leaving home, she believes that her life may have taken a turn for the better. Although she was unsure about what the best way to inform homeless youth about support systems would be, her recommendations included putting up signage around homeless communities, and to teach young school children what to do when they are in a crisis situation. 

A national study on homeless Indigenous youth recommends that indigenous-led preventative and interventional programs for domestic issues should be formed as a method of reducing Indigenous homelessness (2). This study found that many of the homeless Indigenous youths who have interacted with child-protective services have had negative experiences with these kinds of organizations. These negative experiences include but are not limited to abusive foster homes, culturally unaware foster homes, or removal from an otherwise supportive community (2). By developing an Indigenous-led, culturally aware network of support for Indigenous youth in conjugation with psychological aid for traumas faced as a result of the legacies of colonialism, it may be possible to reduce Indigenous youth homelessness. 

References:

1. Anonymous What We Have Learned: Principles of Truth and Reconciliation  [Online]. http://nctr.ca/assets/reports/Final%20Reports/Principles_English_Web.pdf [Nov 21, 2020].

2. Kidd SA, Thistle J, Beaulieu T, O’Grady B and Gaetz S. A national study of Indigenous youth homelessness in Canada. Public Health 176: 163-171, 2019.


Written by: Jane Porter

Edited by: Kritika Taparia and Anson Wong

PART 2: HOW COVID-19 HAS WORSENED DISPARITIES AMONG HOMELESS WOMEN

Through researching domestic violence and homelessness, I sought out a second shelter for insight on how these conditions affect cultural and religious minorities. In this blog, I had the privilege of engaging with Nisa Homes, where I spoke with a caseworker named Majeda. Majeda started by explaining how her role at the home was to work one on one with the incoming women, primarily regarding client referrals, and administration. Being a caseworker, Majeda is the one to receive the initial calls from women in need, and in a way, she is the bridge to the safe haven that is Nisa Homes for women.

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In Canada, approximately 27.3% of all homeless individuals are women (State of Homelessness in Canada, 2016). In addition to this,  women of colour, and more specifically minorities, whether by race, disability, age, or household status, are at higher risks for poverty. According to Homeless Hub, 37% of all First Nations women (living off reserves), 28% of all visible minority women, and 33% of all women with disabilities in Canada, are threatened with poverty and face a greater risk for homelessness than their white female counterparts. Rates of homelessness are increased amongst minority women due to factors such as cultural or religious stigma resulting from domestic violence, social pressures, and citizenship concerns. 

Majeda began by discussing how the first day at the home is always the hardest and busiest. With the pandemic, Nisa Homes had to increase their safety measures – ensuring to conduct test questionnaires, requesting that all new residents take a shower, wash all articles of clothing, and sanitize any other products they brought with them upon arrival. What makes Nisa Homes special is that they cater specifically to Muslim women, ensuring to accommodate to their fellow sisters in cultural and religious aspects. This is especially important as cultural stigma prevents many women of colour experiencing domestic violence from coming forward. Those who are considering leaving their partner must also consider the keen judgments they would face in their cultural or religious communities.

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An interesting point Majeda made was that immigrant and refugee women were at an unfair disadvantage amid the pandemic, as they had to endure greater financial issues as a result of their citizenship status. Many refugee women who wished to apply for some form of status during quarantine were limited by the government’s shutdown of services. Due to their lack of citizenship, the women were also unable to apply for income support, and Majeda explained that even with the women who were able to successfully apply, they had to wait a minimum of one week to be approved before funding would be received. The delays, and excessive difficulty in finding stable housing following their departure from a toxic household or partner, definitely impacted the women’s decisions who were coming into the home. Refugee women were faced with a global virus, limited means of getting citizenship, a lack of financial resources, and no means of travelling due to restrictions. These are circumstances that many of us do not consider during such a trying time despite them holding great significance all across Canada. “Barriers built up more and more” Majeda started, explaining how they feared that the women would become a name on a never ending wait list to the government. 

    

Majeda expressed that one positive outcome caused by the pandemic for Nisa Homes, was that the organization was finally able to receive government funding! As a newly started charitable organization with several branches across Canada, it is difficult for them to receive funding for their cause, yet fortunately due to nationwide recovery support, Nisa Homes was able to accrue financial resources, allowing them to better help women at the home and save up money for future endeavors. Prior to these support funds, the majority of their funding was to be acquired through one organized holiday dinner, during the month of Ramadan. With the pandemic, community outreach had increased and Majeda expressed her appreciation for this, exclaiming “people are very very kind, especially [within] the Edmonton community.”   Another positive outcome Majeda informed me of was that since March, the home has had zero positive cases! When asked about what the situation was like in March, Majeda stressed how she received at least double the amount of phone calls during the first few weeks, indicating an increase in the rates of domestic violence and/or homelessness. In dealing with potential cases, Majeda explained that money was set aside should anyone at the home test positive and need to quarantine separately in a hotel.  

Nisa Homes’ is willing to take both homeless women and women who are fleeing domestic violence and needing shelter, highlighting their accessibility. Following the women’s departure, the caseworkers reach out to women who’ve stayed at the shelter for approximately three months following to inquire about their progress and reassure them of their growth. Majeda expresses how caseworkers take pride in building long term relationships with the women, and that former women still message her to this day. Should women need resources after departure, Nisa Homes privately conducts community call outs across their social media, and will supply the women with resources (Food hampers, gift cards, etc.) Majeda says that the home is always open to women who need to return, stating: “They might be in a worse situation when they leave this time than [when they did] last time.” Remote help is also available at NISA Homes, for women who are unsure of their needs and uncertain if they are ready to stay at the home, but still want to receive some form of support from other Muslim women. The pandemic has certainly increased the amount of remote case files, as well as referrals, to assist in the high demand. What saddened me was when Majeda stated, “Some [women] are in denial, but they still want help”, referring to those who may make the initial phone call, but for any given reason, may not be able to come to the home themselves.

When Majeda was asked if she was willing to share a story, she politely agreed and recalled one woman who, when she first reached out, could barely talk on the phone, and for weeks could not get out of bed. She explained to me that slowly, through small steps, she “got on her feet and hit the ground running”, starting her own business in the shelter’s garage! I found this to be quite admirable, and a very clear example of how Nisa Homes helps women feel empowered.  

The last question that I asked Majeda, similarly to the previous womens’ shelter coordinator was,  “What would you say to women struggling to come forward?” to which, she responded with the following: 

“It takes a lot of courage, yes it’s scary, yes it’s a jump into the unknown: but if you’re in danger, every moment of anxiety and fear is worth it, because the second you leave, you give yourself the power to do anything. You’ll have more support [when you break through] than you’ll ever know. No one here can judge you.”  (Majeda)

Volunteering for and vocalizing the needs of marginalized groups is essential, especially with homelessness and poverty being such prominent issues in Canada. Through speaking with Majeda and the coordinator, I learned a lot about the internal roles of these organizations, and I encourage others to reach out to charitable organizations and read articles on these issues to do the same. One student-led womens’ group on campus that directly works with Nisa Homes to further their initiative, is the newly created Women Empowering Women group on campus, for example. Although not everyone may have the means to donate, what’s important is speaking up and spreading the message across to reach those that do. After all, when you have more than you need, you should aim to build a bigger table, not a higher fence. Attached below is a list of resources: with articles, both organizations and clubs featured today, and websites for aid, of which I encourage you to utilize in learning more! 

Resources 

https://www.wingsofprovidence.ca/

Find Help Across Canada

https://theseed.ca/

Student Groups 

https://instagram.com/girltogirlyweg/

Articles 

https://www.feministrecovery.ca/the-plan

https://www.ctvnews.ca/health/coronavirus/covid-19-increases-risk-for-canada-s-invisible-homeless-women-study-1.5000474

https://www.refinery29.com/en-us/2020/08/9941797/covid-homeless-women-mothers-children-risk

Works Cited

Nisa Homes. 2015. What is Nisa Homes? Nisa Homes. Retrieved from https://www.nisahomes.com/aboutus

WINGS of Providence. 2020. Who we are. WINGS of Providence. Retrieved from https://www.wingsofprovidence.ca/who-we-are.aspx

Ali, Nadia. October 2016. Domestic Violence & Homelessness. The Canadian Observatory on Homelessness: Homeless Hub. Retrieved from https://www.homelesshub.ca/blog/domestic-violence-homelessness

World Health Organization. November 2017. Violence against women. World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/violence-against-women#:~:text=Global%20estimates%20published%20by%20WHO,violence%20is%20intimate%20partner%20violence.

Canadian Women’s Foundation. February 2018. The Facts about Gender-Based Violence. Canadian Women’s Foundation. Retrieved from https://canadianwomen.org/the-facts/gender-based-violence/#:~:text=Half%20of%20all%20women%20in,since%20the%20age%20of%2016.&text=67%25%20of%20Canadians%20say%20they,experienced%20physical%20or%20sexual%20abuse.&text=3-,Approximately%20every%20six%20days%2C%20a%20woman%20in%20Canada,killed%20by%20her%20intimate%20partner.

Homeless Hub. 2019. Single Women. About Homelessness. Homeless Hub. Retrieved from  https://www.homelesshub.ca/about-homelessness/population-specific/single-women
Homeless Hub. 2019. Who is Homeless? About Homelessness. Homeless Hub. Retrieved from https://www.homelesshub.ca/about-homelessness/homelessness-101/who-homeless

Written by: Sara Assaf

Edited by: Erica Kim and Anson Wong

HOW COVID-19 HAS WORSENED DISPARITIES AMONG HOMELESS WOMEN

Part one of a series exploring how COVID-19 has worsened disparities amongst homeless minorities. 

        As often as we’d like to imagine “when this is all over”, we must admit that there is privilege in such a hopeful sentiment; the pretence that aside from the temporary health measures and minor inconveniences we’ve had to face, that the general aspects of our lives will soon return to their objective normal, is rooted in privilege and to an extent, misinformation. Economic decline, increased unemployment rates and shortages across the nation have all led to increased rates of homelessness, a condition that has unfortunately worsened in Canada and is found to have impacted minorities disproportionately. Today I shall discuss how the pandemic has disportionately impacted homeless women in Canada, who not only face oppression by class, but must also endure oppression by gender, as a result of the domestic violence that drives women out of their homes, threatening their survival. According to the World Health Organization, 1 in every 3 women will experience domestic abuse or violence at least once in their lifetime, and according to the Canadian Women’s foundation, on any given night in Canada, 3,491 women and their 2,724 children, must sleep in shelters because they face risks in their own homes.  This, combined with the 70% of spousal violence that is not reported to the police (Canadian Women’s Foundation, 2018), makes it instinctively clear that the rates of family and gender based violence greatly impact the percentage of women who are a part of Canada’s homeless population today. To better understand the conditions these women must face, I sought out the leaders of two local long term women’s’ homeless shelters: WINGS of Providence, and Nisa Homes, both of which specialize in providing quality care and programming to women who have faced homelessness, domestic violence and food insecurity. In today’s blog, reflection will take place primarily through utilizing the WINGS’ coordinator’s experiences. 

      I first interviewed the program coordinator at WINGS, who informed me of their mandate to “accept women with children who are leaving intimate partner abuse” as a second stage shelter organization. The shelter itself offers many services to women, housing wise; there are multiple apartments available, each equipped with security services on site. WINGS’ offers group programming, community referrals and counselling to support victims, and focuses on promoting the womens’ personal growth.  When the pandemic was first announced in North America, WINGS was forced to suspend all programs and suddenly was faced with providing aid during a nationwide shortage. While allocating resources was difficult, when asked about what she found to be the biggest issue women must face at the shelters, the coordinator exclaimed that it was dealing with their new terms of isolation that caused the women the most dread. Employees and clients were constantly concerned about who was going to get sick and how fast, with the striking fear of death in their minds as they pondered “what was this gonna mean?” for the future. She identified how women experiencing domestic violence now had to make the difficult decision of choosing between permanently leaving their households – with a heightened fear for their safety and financial stability due to the pandemic, or to alternatively stay where they were and endure abuse in silence. This is not to mention the risks some women have to take to even make the first step of leaving, and the chance that, should they have to return for any reason, they face the threat of being punished for their decision. Often, victims of domestic violence struggle to come forward and have difficulty recognizing patterns of abuse for a multitude of factors. They may choose not to leave based on their children, cultural stigma, financial risks, or simply their own denial. “It’s not as easy as packing a suitcase,” the coordinator starts, “it takes a lot of guts, courage and strength” she continues, emphasizing how important it is to WINGS, to provide women with the right support in handling their situations, especially amidst the virus.

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            The coordinator stressed that the lack of services available and increased quarantining were seen as imminent threats to the shelter, especially in terms of maintaining stable mental health. She expanded on isolation in explaining how many women felt stuck and even began to resent the shelter, as they were starting to become psychologically affected by the quarantine. The coordinator however, while saddened by the “new normal” the women had to face, wanted to assure them that despite their panic, “We are still here” – that the organization would continue to help women in their time of need. While there were a large portion of staff working remotely, many of the employees, including herself, have remained onsite since March, exhibiting a clear commitment to sustain their mandate. Regular check-ins were conducted to ensure the well being of the women. Aside from the government mandated precautions, WINGS was limiting their group work, increasing individual care, and hosting online events as much as possible. As the WINGS’ shelter consists of a series of apartments,  should they show symptoms or test positive, the women were asked to quarantine independently in their own units.

     An interesting claim made by the coordinator was that the organization actually experienced reduced rates of incoming women, resulting from the unawareness of the availability of their services. With the abundance of children now staying with WINGS, the shift to online learning in schools meant that WINGS’ had to purchase new devices in order to satisfy learning needs. When group interactions were permitted, the WINGS staff began to host group events, holding pizza nights and providing families with craft and care packages to engage with their children. They even brought in the Easter Bunny to lift the childrens’ spirits.  The coordinator explained that with the shut down, all fundraising events had to stop and the main donors of the shelter no longer had the financial means necessary to support WINGS. This resulted in mass community outreaches, in order to meet the growing demand and inflation in necessities for women. “I love Edmonton, we have good friends.” The coordinator expressed her gratitude for local support towards the shelter. With the help of the local community, WINGS’ was able to stay running and meet the increasing demand.

    Although WINGS’ as a shelter does not tend to take in homeless women, they recognize that homelessness and domestic violence are not mutually exclusive. WINGS prioritizes womens’ safety, and with an increase in domestic violence cases with isolation, the coordinator admits that at times they did have to redirect women to other shelters, but reassured me that they “Never left them hanging.” They partnered with other organizations to accommodate the consistent transfers, and provided women with viable alternatives and resources for support. In the case that they cannot help someone directly, they ensure to redirect them to available organizations and find someone that can.   

   With COVID-19, the average women’s stay of six months at the shelter was now increased to a year, resulting from the difficulty to find stable housing or established real estate services. A positive outcome of this was that the women and WINGS’ employees built stronger relationships, and had more time to rehabilitate and heal. Following their departure, the staff at WINGS bid the women farewell and assume they have stable supports in place to independently embark on future endeavours. When asked if WINGS’ as an organization had any stories they recall from the women staying with them, the coordinator made sure to direct me to their website, where there are newsletters with testimonies available for public use. The last question I asked was “What would you say to women struggling to come forward?” to which, she responded: 

“Reach out, there is help, we are here, you don’t have to stay away, we all need help, healthy people do..we all need to tell our stories” (WINGS)

     WINGS’ accepts volunteers throughout the year, and more information may be found on their linked website. Another way to get involved is to volunteer with local organizations, such as the YWCA, Girl to Girl YWEG (Young Women’s’ Empowerment Group), or the Womens’ Emergency Accommodation Centre (WEAC) in Edmonton, who all aim to reduce the disparities faced locally by women. 

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     Volunteering for charitable organizations and donating to shelters are essential actions valuable to reducing disparities among women who face homelessness. Feel free to utilize the resources below to stay informed and help in any way you can: aid websites, articles, student groups, and organizations are all great places to start & listed below!  

Resources 

nisahomes.com/

Home

https://endingviolencecanada.org/getting-help-2/

https://theseed.ca/

Student Groups 

https://www.facebook.com/girltogirlyweg/

Articles 

https://www.feministrecovery.ca/the-plan

https://www.ctvnews.ca/health/coronavirus/covid-19-increases-risk-for-canada-s-invisible-homeless-women-study-1.5000474

https://www.refinery29.com/en-us/2020/08/9941797/covid-homeless-women-mothers-children-risk

Works Cited

WINGS of Providence. 2020. Who we are. WINGS of Providence. Retrieved from https://www.wingsofprovidence.ca/who-we-are.aspx


Ali, Nadia. October 2016. Domestic Violence & Homelessness. The Canadian Observatory on Homelessness: Homeless Hub. Retrieved from https://www.homelesshub.ca/blog/domestic-violence-homelessness

World Health Organization. November 2017. Violence against women. World Health Organization. Retrieved from https://www.who.int/news-room/fact-sheets/detail/violence-against-women#:~:text=Global%20estimates%20published%20by%20WHO,violence%20is%20intimate%20partner%20violence.

Canadian Women’s Foundation. February 2018. The Facts about Gender-Based Violence. Canadian Women’s Foundation. Retrieved from https://canadianwomen.org/the-facts/gender-based-violence/#:~:text=Half%20of%20all%20women%20in,since%20the%20age%20of%2016.&text=67%25%20of%20Canadians%20say%20they,experienced%20physical%20or%20sexual%20abuse.&text=3-,Approximately%20every%20six%20days%2C%20a%20woman%20in%20Canada,killed%20by%20her%20intimate%20partner.

Written by: Sara Assaf

Edited by: Erica Kim