Toronto homeless report barriers to health care

Most studies of healthcare for homeless people have been conducted in the United States, where it's not surprising that lack of money and insurance are the main barriers. But what about here in Canada, where we have publicly funded universal health care?

A new study finds that 17 per cent of homeless people in Toronto _one in six _ reported unmet health care needs. Women with dependent children had almost twice as much trouble getting access to healthcare as the general population of the city.

"The message here is that health insurance is a necessary part of the solution, but it doesn't eliminate all barriers to health care for people experiencing homelessness," said the study's author, Dr. Stephen Hwang of the Centre for Research on Inner City Health at St. Michael's Hospital.

The study will be published in the August edition of the American Journal of Public Health and has been published online.

The study found four groups of homeless people with higher likelihoods of unmet healthcare needs: those with poor physical or mental health, the young, and assault victims. Lack of a primary care provider is likely a contributing factor -- the study found that 32 per cent of homeless people in Toronto did not have a primary care physician, compared to only 9 per cent of general population. In addition, previous research by Dr. Hwang has shown that individuals who are homeless sometimes do not obtain the care they need because of past experiences with health care providers in which they felt unwelcome or judged negatively

Of those surveyed by Dr. Hwang's team, 41 per cent reported drug problems in the previous 30 days, 30 per cent had alcohol problems and 38 per cent had mental health problems. Twenty-nine per cent said they had been the victim of an assault.

It also found that 18 per cent of people approached during recruitment for the study never had health insurance in Ontario, primarily because they were refugees or had recently moved to the province. In addition, 31 per cent of study participants did not have a health insurance card in their possession, often because it had been lost or stolen.

About 5,000 people are homeless in Toronto each night. About 29,000 different individuals use shelters each year.

Source: St. Michael's Hospital