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Presenter: Hiren Rawal , MSW, RSW Sudbury & District Health Unit

Impact of Homelessness and Family Separation on the Health of People R esiding in Northern Ontario. Presenter: Hiren Rawal , MSW, RSW Sudbury & District Health Unit Public Health 2014- CPHA Conference May 29, 2014 Co-authors : Dr. Carol Kauppi , Dr. Arshi Shaikh . Introduction.

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Presenter: Hiren Rawal , MSW, RSW Sudbury & District Health Unit

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  1. Impact of Homelessness and Family Separation on the Health of People Residing in Northern Ontario Presenter: HirenRawal, MSW, RSW Sudbury & District Health Unit Public Health 2014- CPHA Conference May 29, 2014 Co-authors: Dr. Carol Kauppi, Dr. Arshi Shaikh

  2. Introduction The primary conditions that shape health of people go beyond medical treatments and lifestyle choices1. Various living and working conditions are found to have immense impact on health1,2. In particular, safe and secure housing, and family and social connections are necessary for the health and well-being of individuals1.

  3. Research Objectives Using the social determinants of health perspective, a study was designed to examine the effects of homelessness and family separation on the health and well-being of youth and adults living in Sudbury, Ontario.

  4. Research Method • A qualitative research design was used. • Participants were recruited with the help of service providers. • Sampling strategies: criterion, purposeful, snowball • In-depth semi-structured interviews were conducted.

  5. DemographicFeaturesofParticipants

  6. Results Lived experience of family separation. Lived experience of homelessness or near homelessness. Impact on health and well-being.

  7. Lived Experience of Family Separation • Broad conceptualization of family. • Painful memories of separation from • Biological, foster or adoptee parents, siblings, caregivers and friends during childhood and adolescence • Separation from partners, children and grandchildren during adulthood

  8. Lived Experience of Family Separation • The experiences of separation from family were characterised by • Placement in foster care, group homes, and residential schools • Death of a caregiver/family member(s) • Natural disasters • Epidemics in the community • Running away from home • Being kicked out/thrownaway • Repeated separations and reunions with biological families.

  9. Personal Narrative “Somebody [CAS] came and picked me and my brother up. Again I was ripped away from my family”. [Gordon]

  10. Lived Experiences of Homelessness All participants encountered unstable lives and homelessness in their adulthood. Sleeping rough on the streets. Struggle for survival. Migration and transience.

  11. Lived Experiences of Homelessness • Housing issues and homelessness in First Nations communities. • Substandard housing • Lack of basic amenities • Overcrowding • High cost of hydro • Chaotic and stressful life • Racism and discrimination outside the First Nation communities.

  12. Personal Narrative “Extremely dangerous, every day you are always worried about. [I say to myself] ‘Okay, when am I going to get robbed, when am I going to get stabbed or who’s gonna try to punch me out....” [Adam]

  13. Impact on Health and Wellbeing Emotionally devastating Feeling of depression and immense sadness Sense of deep loss Emptiness and worthlessness Withdrawal from social relationships Fear, anxiety, and insecurity

  14. Impact on Health and Wellbeing (cont’d) Concerns over physical and emotional safety Lack of belongingness and rootedness Self-blame and dejection Intergenerational trauma Violence and suicide Substance abuse as a coping strategy Manifestation of multiple mental illnesses

  15. Implications for Public Health Recognize the interconnections between familial (e.g., family separation), social (e.g., homelessness) and health issues. Among Indigenous people, the above issues are intertwined with the larger systemic issues of ongoing colonization, and racism/discrimination. Need to devise interdisciplinary and inter-sectoral health promotion and prevention activities by utilizing social determinants of health and health equity frameworks2. Need to involve Indigenous and non-Indigenous people in every stage of planning and implementation of health promotion initiatives2.

  16. References Mikkonen, J., & Raphael, D. (2010). Social determinants of health: The Canadian facts. Toronto: York University School of Health Policy and Management. Sudbury & District Health Unit (2009). Overview of the health equity mapping project: A report on process, results and recommendations for practice.Sudbury, ON: Author.

  17. Acknowledgements I would like to recognize the contribution of Participants Service providers Research team of Poverty, Homelessness and Migration-SSHRC CURA

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