Without a home, where is the heart (and your health)?

Wednesday evening at 7:00 pm at the Bruneau Centre at MUN, there is a screening of a documentary film about homelessness. Victoria, BC filmmaker Krista Loughton followed four individuals with chronic homelessness and addictions, and the result is a passionate and emotional tale told from the point of view of the individuals. The screening is being sponsored by End Homelessness St. John’s, and Loughton herself will be on hand as she is in the province researching homelessness among Indigenous populations.

Why should we be concerned about a film about homelessness that was shot in Victoria? What impact does homelessness have on Newfoundlanders? Sure, with our reputation for hospitality, surely God homelessness isn’t a problem here, is it?

By now I hope most of you can sense the sarcasm in my tone. Yes, other cities in Canada have a radically worse homelessness problem than we do on our fair island, but we do have some of the highest health care spending in the country. 

What do a few homeless people have to do with our health care spending? More than you know. 

Almost a year ago, End Homelessness St. John’s conducted it’s first survey of the homeless situation in St. John’s. The results were terrifying. And lasted in the news cycle for about three days. What do you expect? It was also around the time when the dreaded Fentanyl crisis was first making landfall in Newfoundland, and stories about understaffed and underpaid Pathologists were making us all fear another cancer misdiagnosis and Cameron Inquiry

So, facts about homelessness in St. John’s was easily pushed under the rug. Out of sight, out of mind for the vast majority of us Townies who have only ever seen one or two individuals bundled up in sleeping bags on Water Street, although the folks peddling for spare change at streetlights certainly has picked up since last year. But, other than an eyesore that makes us all uncomfortable in our gut, awkwardly saying “sorry” when asked for money while we sheepishly avert our eyes towards the Avalon Mall, what does the plight of these few individuals have to do with health care in Newfoundland?

Let’s start with the immediate. When you don’t have money, you don’t eat. When you don’t eat, your body doesn’t work properly. When your body doesn’t work properly, you are susceptible to all the communicable illnesses (I’ll bet pretty penny they aren’t even able to afford transportation to a flu shot clinic, let alone have the knowledge/education/priority setting skills to get a flu shot). That’s just the flu, don’t forget our fellow Newfoundlanders who are Labradorians, for whom Tuberculosis is still an actual thing! Just today was the announcement that an autopsy will be performed on a 14 year old boy from Nain to determine if his death was caused by TB. Even here on the island, shelters and the closed quarters associated with them are the main source of transmission amongst this group. Plus, lack of money also usually means poor food/cheap food, or what I like to call shitty, unhealthy food. I’ll lead you to water here and highlight that there is a plethora of research about food choices and it’s impact on your health. But I’m sure you already knew at least a little something about that.

Next immediate threat is the physical stress on your body from being outdoors 24/7. Exposure to sun (skin cancer), car exhaust (lung cancer/emphysema/GI tract cancers), snow and ice (frostbite, common cold etc), and walking around all day (foot ulcers/trench foot- yes, like from World War I trench foot) are just the tip of the iceberg when it comes to the assault on the body when you are homeless. And there are approximately seven MILLION websites and blogs from moms/single moms/stay at home moms/working moms/yogis/naturopaths/gurus/dharmas/ etc etc etc, PLUS honest to God medical research, that highlight the link between physical stress and illness, so I won’t even touch on it here. But you get my point: homelessness = stress = poor health.

I love that we live in a country that continues to hold all of it’s citizens as equal recipients of health care (at least on paper, but I digress). In a former life, I volunteered as a nurse with the Out of the Cold program in Toronto, performing foot care on homeless men at a shelter on Friday nights. My ex husband and I would start there on Fridays. He did security, I did blood pressure checks. Then we’d count our blessings and head to our local for beer and nachos. Sometimes I would see some of our “regulars” at my job at a downtown ER. Most times they didn’t recognize me because they were in a diabetic coma, or just had a seizure from alcohol withdrawl, or were septic from what started as frostbite and was now going to need an amputation. Each of those three conditions are COMMON reasons to present to an ER in Toronto. (Hell, we even had a presenting complaint called NFA- No Fixed Address, as in the reason for your ER visit was homelessness. The more appropriate triage now is in relation to a “social problem”.) But, the three I just listed are life threatening, a require multiple paramedics, nurses, physicians, respiratory therapists, lab techs, an inpatient bed with or without requiring ICU, IV therapy, multiple medications, x-rays or CT scans, and on and on and on. Can you see what I’m getting at? Homelessness costs us a lot of health care dollars. And this is just the biggies that come to mind after hearing about this documentary screening. I’ll refrain from delving into the particulars at this point.

Now that we have clarified how, at least on a few big ticket health care items, homelessness leads to increased health care spending. So, why hasn’t homelessness been identified as a priority to decrease the burden on the health care system. 

Allow me to say what everyone else is too polite or embarrassed to say: on some level, each and every one of us who goes to work every day and pays taxes has a hard time believing that these individuals who find themselves homeless haven’t ended up that way because it was their own fault. It’s the dirty secret that we as Canadians hold close to our chest, that we only admit when we get fired up at some union rally. We work hard, and we can’t help but feel that if these people worked hard, they wouldn’t be homeless.

There, I said it. Without making actual eye contact with each other, let’s just assume that we all feel or have at some time felt the same way, cause you’d be lying if you said you never thought it at least once in your life. 

So, allow me for a moment to paint a mental picture. I’m an educated, well spoken (minus the occasional potty mouth), tax paying and financially responsible member of society. I also divorced my husband almost six years ago, not even two years after purchasing our house, meaning there were immediate financial implications (I kept the house) and I am now a single income household. I watch the direct deposits from my job enter my bank account, and then promptly disappear to a mortgage, car payment, insurances, food, power, a phone bill, an RESP payment, and a credit card payment. Month to month I do pretty good. Then hockey season starts for my son. Then I need new tires for my car. Then the hot water breaks and I need to replace it. Then the credit card is not as “paid down” as I thought it once was.

This is the picture of not just me personally, but the picture MANY of us face. In January, Ipsos conducted a survey that found that one in three Canadians are now in a “debt trap”, in which they are unable to cover their monthly expenses and make any debt repayment. Thankfully, I’m still able to put something on my not-so-paid-down credit card each month, but I do still have that debt. And my car is getting older. And my house will soon need upgrades. And my appliances are over 10 years old. Any day now, catastrophe could strike. I’m brought back to a conversation my ex had with one of our Out of the Cold homeless friends, who had fallen on hard luck and turned to alcohol when his wife left him. After being a successful contractor, here he was. He said, “with the right combination of shitty luck, any one of us are no more than two months away from living on the streets”. And he’s not wrong. 

So yes, homelessness is closer to each of us than we realize. And it’s scary, kind of like the “at any given time, you’re never any further than 10 feet away from a spider” scary. And just as a fear of spiders is only real to the person experiencing arachnophobia, so too is the pang of fear felt by the residents of this province who know exactly what I’m talking about in the above paragraph. Unless you’ve held your breath and felt your heart beat pick up a little at the end of the month, despite your best efforts to make ends meet, this may all be lost on you.

And to those people I reiterate the obvious. We are spending too much on health care, that we can all agree on. I have identified just a few ways in which homelessness is adding to the cost of health care. Now, God love ya, but get your heads out of your asses. There are so many reasons for ill health. Homelessness is a slam dunk. Want to save a few health care bucks? Let’s get some insight into how we can help these poor fellow Newfoundlanders and Labradorians. I sincerely hope to see some policy makers at the screening Wednesday night.

At the very least, let's all continue to agree we love Canada, where health care is available to everyone. Now, let's expand the conversation about how we keep our health care system available for all Canadians.

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