Research Blog

A Glimpse into the World of Ill-Housed Individuals through the primary care lens: A Transformative Experience

Digital Art: A Glimpse into the World of Ill-Housed Individuals through the primary care lens. Created by Peyman Namdarimoghaddam with the assistance of generative artificial intelligence.

As a first-year medical student, I recently had the opportunity to delve into the realm of ill-housed individuals through a 5-week project that encompassed a comprehensive literature review about the role of primary care and shadowing experiences in both an urgent primary care center and an urban outreach clinic in Kelowna, BC. This experience has been truly eye-opening, allowing me to witness firsthand the challenges faced by this vulnerable population and observe the remarkable impact of a multidisciplinary approach to care.

My initial expectation was to encounter patients experiencing homelessness at the Interior Health Urgent Primary Care Center (UPCC), as it seemed to be a natural intersection point between healthcare and this underserved population. However, I quickly realized that the visibility of this group was far greater in an inner city clinic located in the downtown core, the Outreach Urban Health (OUH) clinic. This realization highlighted the critical role such outreach clinics play in addressing the unique healthcare needs of marginalized individuals.

The OUH clinic demonstrated an exemplary model of care, incorporating a diverse team of healthcare professionals ranging from doctors and nurses to psychiatrists, social workers, and life skills workers. This interdisciplinary approach enabled comprehensive and holistic care, addressing not only physical ailments but also the complex psychosocial needs of ill-housed individuals. Witnessing the implementation of the findings from my literature review within this clinic was both inspiring and affirming, reinforcing the importance of evidence-based practice.

One aspect that particularly impressed me was the clinic’s mobile outreach service. By reaching out to shelters and specific locations where marginally housed individuals are known to seek refuge, the clinic ensured access to care for those who face significant barriers in seeking traditional healthcare services. Furthermore, the clinic’s commitment to expanding telehealth services underscored the potential of technology in bridging the gap in healthcare accessibility. However, the practical challenges faced by this population, such as limited access to phones and reliable internet connections, served as stark reminders of the obstacles that still need to be overcome.

Collaboration between health and other agencies that provide services to ill-housed individuals  such as social services, community-based organizations, and emergency services, to holistically address the complex needs of this population emerged as a recurring theme throughout my project. The OUH clinic recognized the importance of connecting with external stakeholders, such as housing providers, to address the multifaceted needs of their patients. However, discussions within the clinic revealed a desire for improved communication and collaboration, suggesting that even successful models of care can continually strive for enhancement.

One area that left a lasting impact on me was the urgent need for diverse housing options for the marginally housed population. Traditional housing providers often reject individuals with complex conditions due to behavioral concerns, leaving them without stable shelter and exacerbating their healthcare challenges. Witnessing the dedication of the clinic team to finding housing solutions for these individuals highlighted the crucial role healthcare providers can play in advocating for systemic changes that address the social determinants of health.

My literature review reinforced the importance of a comprehensive approach to care for ill-housed individuals, encompassing not only medical interventions but also screening for chronic conditions, preventive care, mental health services, health education, advocacy, and patient satisfaction assessment. I learnt that Interior Health, the Kelowna Homelessness Research Centre, shelter providers and other stakeholders are prioritizing enhancing collaboration to better support the needs of ill-housed individuals as part of their pandemic recovery efforts.

In conclusion, this project has been a transformative experience that has allowed me to witness firsthand the challenges faced by ill-housed individuals and observe a model of care that embodies the recommendations put forth by the literature. The multidisciplinary approach, mobile outreach services, and collaboration with external stakeholders have demonstrated the potential to improve healthcare outcomes for marginalized individuals. However, it has also highlighted the persistent barriers and gaps that must be addressed to provide equitable and inclusive care. This experience has invigorated my commitment to advocating for change and has solidified my belief in the transformative power of comprehensive and compassionate healthcare for all individuals, regardless of their housing status.

Kelowna & Municipal Social Policy

Municipal governments (and other forms of local governments, most notably Regional Districts in the case of British Columbia) have the daunting task of addressing the day-to-day lives of their citizens, facilitating a process of local engagement that can achieve a “sense of community among members” in a way that tempers “individual ambitions with concern for others”.

 

PDF Report: Kelowna & Municipal Social Policy – A Historical Overview of Public Records (July 5 2022)

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The Enumeration of Individuals Experiencing Homelessness

As with other sectors, the provision of services to those experiencing or at risk of homelessness faces dual, interrelated pressures. Firstly, stakeholders must maximize impact, using limited resources to advance the most promising evidence-based practices in hopes of providing the best available support for those in need. Secondly, those in charge of funding or implementing programs and practices must then collect and monitor data for efficacy, and adapt to real-time trends. Enumeration of those experiencing homelessness at an organizational, community, provincial, and / or federal level represents a core tool, particularly as one core, overarching goal for each level is a reduction in such experiences (in addition to other individual-level outcomes related to experience and wellbeing).

The ways in which we have quantified experiences of homelessness have shifted and grown over time, in accordance with both our conceptualizations of the issue as well as shifting technological costs and capacities. There now exists a range of demand-side methods for estimating the prevalence of homelessness, many of which have been recently implemented at different levels and at different times. Continue reading “The Enumeration of Individuals Experiencing Homelessness”

KHRC Local Data Summary: Youth Precarity

This rapid data scan represents an incomplete collection of local data available on topics specific to youth, so far consisting of links to various sources of information specific to Kelowna, the Okanagan region, the province of British Columbia, and / or federally (depending on the availability of relevant data).

Topics areas covered to date include: Continue reading “KHRC Local Data Summary: Youth Precarity”

Kelowna and the CAEH 2021 National Conference on Ending Homelessness

Last November, policy makers, funders, researchers, advocates, community leaders, front line workers, and people with Lived Experience of homelessness from across Canada participated in the Canadian Alliance to End Homelessness’ virtual 2021 National Conference on Ending Homelessness. Over the weekend, CAEH released the presentation recordings to their YouTube channel, including four presentations on local topics by teams within the Kelowna area. Continue reading “Kelowna and the CAEH 2021 National Conference on Ending Homelessness”

Migration & Homelessness in Canadian Communities: A Summary of Evidence

The goal of this project was to discuss and inform assumptions regarding migration and homelessness through a presentation and analysis of available evidence, primarily through the review of available Point-in-Time count reports. While the focus of the paper is the context of British Columbia (and features Kelowna data whenever possible), national and international figures and analysis are included throughout. Seven sections of supporting evidence and analysis are presented in the full report, followed by a discussion section. While available evidence and analysis have their limitations, several shared observations have been reported, with important implication for how we might best meet the needs of individuals both experiencing homelessness as well as Continue reading “Migration & Homelessness in Canadian Communities: A Summary of Evidence”

Featured Researcher: Kyler Woodmass

Kyler Woodmass, MPIA

Associate Research Coordinator, KHRC


Can you tell us a little bit about yourself?

I was born and raised in the Central Okanagan. I completed an undergraduate degree in Psychology locally at UBC Okanagan before pursuing a Masters of Public and International Affairs at York University in Toronto. I then returned to Kelowna, accepting a position with the Canadian Red Cross’ Volunteer Experience and Engagement team before transitioning to the Kelowna Homelessness Research Collaborative. I have held a number of Continue reading “Featured Researcher: Kyler Woodmass”

Featured Researcher: John Graham

John Graham, PhD RSW

Principal Investigator, KHRC


Can you tell us a little bit about yourself?

In the 1980s I worked in human services with street involved individuals with the Anglican Church, and then with ex-convicts with the John Howard Society. After graduating with an MSW, I was a psychiatric social worker at the Clarke Institute of Psychiatry (now CAMH) in the early 1990s. I completed a PhD at the University of Toronto, and am now in my 28th year as a full time academic. Formerly Director of the School of Social Work at UBC, I have held administrative posts at other universities. I have led the Kelowna Homelessness Research Collaborative since Continue reading “Featured Researcher: John Graham”

Supporting Sector Staff: A Case for a $25 Target Wage

Wages are consistently identified as a critical factor in recruiting, retaining, and supporting workers within the homelessness support sector. However, non-profits within our support sector must also stretch their finite grant funding as far as they can to maximize the number of vulnerable individuals supported by their programs. Raising wages across the sector will require a commitment to a new balance of resources shared across employer organizations as well as their grant writers and the funder organizations. This resource is intended to advance discussions related to this goal, and links to external resources that support the adoption of a $25 target wage within new grant applications and program renewals in the local sector (and, arguably, across communities). This target, above both the minimum wage and living wage rates, is in line with local evidence on cost of living and the overall objective of recruiting and retaining a strong, talented sector workforce. Continue reading “Supporting Sector Staff: A Case for a $25 Target Wage”

A Basic Income: Context & the Recommendations of the BC Basic Income Panel

Canada has a history of debate, discussion, and pilot programs related to Basic Income, with renewed interest following the Ontario pilot and again in 2020 in response to the rapid spread of COVID-19. Last year, the Canadian Emergency Response Benefits (CERB) program, targeting those with lost income, reached 35.2% of all Canadian workers who had earned at least $5,000 in 2019 (Statistics Canada, June 2 2021). Its mechanism of rapid disbursement and the unprecedented disruptions caused by the pandemic have seemingly solidified Basic Income within the mainstream of political and policy discussions. In addition to presenting new types and levels of economic challenges, the COVID-19 pandemic has highlighted many longstanding challenges within our social support sector. As groups seek to advance an equitable recovery moving forward (see, e.g., CAEH’s July 2020 “Recovery for All” report), advocacy and debate around these and related policies will surely continue.

Continue reading “A Basic Income: Context & the Recommendations of the BC Basic Income Panel”