Homeless left in the cold when it comes to getting medical help

  • July 22, 2010
homelessTORONTO - Canada's universal health care system is pretty universal — except if you're homeless, according to a St. Michael's Hospital study.

One in six homeless people in Toronto, 17 per cent, say they need care for a medical condition and haven't been able to get it. Homeless women with dependent children have almost twice as much trouble getting to see a doctor as mothers generally do in Toronto, said the study by Dr. Stephen Hwang of the Centre for Research on Inner City Health at Toronto's St. Michael's Hospital. The study will be published in the August edition of the American Journal of Public Health.

A finding that homeless people find it difficult to access health care — 32 per cent don't have a regular doctor, compared to just nine per cent of the general Toronto population — is "not entirely surprising," said Hwang.

"I think the main message here is the magnitude of it, knowing that the unmet needs are 17 per cent. It's important to know that it's not 35 per cent and it's not five per cent," he said.

A recent similar American study found about one-third of homeless there have unmet medical needs, Hwang said.

At the Good Shepherd Centre on Queen Street East, run by the Little Brothers of the Good Shepherd, Br. David Lynch is not surprised the homeless aren't getting as much medical care as they should.

"That's why we have a nurse on staff," he said.

The centre tries to divert homeless people away from emergency room visits "because that's not good health care," said Lynch. "You don't go to emergency rooms when you really need to see a family doctor."

Hwang and Lynch believe the difference between the homeless and the rest of us in getting to see a doctor has a lot to do with societal attitudes toward the homeless and a sense of exclusion that people feel when they're out on the street.

"Many of these people lack the networks of support and connections, and sometimes feel excluded by society," Hwang said. "They feel looked down upon or marginalized."

The fact that the homeless aren't included in society is a direct challenge to Christian ideals, said Lynch.

"That's the ideal, that we as Christians embrace each other is the Gospel's mandate," he said. "To put that in practice is somewhat more difficult."

We can't pretend they don't exist, said Lynch.

"Homelessness is not my problem. It's not your problem. It's our problem," he said. "Only when we tackle it together will we find long-lasting solutions."

Churches should be a part of the solution, said Hwang.

"The role of the Church and of other community-based groups that help to connect and build the self-efficacy and ability of individuals to help themselves is also very important," he said. "The answer to every problem is not necessarily a government program."

About 5,000 people a night are homeless in Toronto. In Hwang's study, 41 per cent of the people his team interviewed reported drug problems, 30 per cent said they had trouble with alcohol and 38 per cent had mental health issues. Twenty-nine per cent said they had been the victim of an assault.

Homelessness in Toronto has decreased over the last 10 years, said Hwang.

"Over the last 10 years I've seen tremendous progress in Toronto. So I think there's a prospect for things to get better," he said. "I'm hoping to not do another study like this in 10 years."

"We're doing what we can on fundraising dollars. We need more help," said Lynch.

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