3.7 I’ll Tell You What I Want, What I Really, Really Want: Integrated Public Health Care for Homeless Individuals in Canada

Modern advancements in travel have led to an unprecedented number of pandemic outbreaks in recent years. As a global city, Toronto has been particularly affected by events such as SARS and H1N1. It is well documented that some individuals fare better than others in these kinds of crises, and that vulnerability is often rooted in pre-existing social inequities. Among the most marginalized and at-risk groups are those who are homeless and/or dependent on social services for subsistence. This chapter takes a critical look at the fragmentation of homelessness and public health services in Toronto, using a study of the H1N1 pandemic. Homelessness is often associated with negative health outcomes, but is less often recognized as being a crisis of public health. Many organizations within homelessness sectors are not designed with public health considerations in mind, meaning that clients are often in congregate settings for extended periods without adequate ventilation and disinfection practices in place. Through this chapter, I argue that the best way to prepare the homelessness sector in Toronto for a pandemic outbreak, such as H1N1, is to redesign it as an integrated public health and social care sector. This chapter examines the current barriers that prevent full public health applications in homeless agencies and reimagines an approach that foregrounds integrated care and the individual needs of service users.

Publication Date: 
Canadian Observatory on Homelessness
Naomi Nichols; Carey Doberstein