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Homelessness is a complex social issue that requires a coordinated systems approach. In recent years, Canada has seen an emergence of integrated care, the joining of health care and social care, to address the needs of homeless persons. This article documents the findings of open-ended interviews with eleven members of the central east Ontario Housing and Homelessness Framework Steering Committee, comprised of service managers and the Local Health Integration Network. As the system planners for social housing and health care, respectively, members of the group work together to align system approaches for homeless persons. Research by this group identified three challenges of collaborating—their different histories and legislation, varied accountability structures, and differing roles and responsibilities within the central east region of Ontario. The study findings indicate that developing a joint document to guide the work was a process through which members began to work through these differences.

Anti-social behaviour statutes are proliferating in western societies, yet little statistical analysis has been conducted on their enforcement patterns and trends, particularly in Canada. A study of the Ontario Safe Streets Act enforcement in Toronto shows a 2,000 percent increase in tickets from 2000 to 2010, with most being issued downtown to homeless individuals. Further research shows that this increase is not the result of increasing crime rates, increases in aggressive solicitation practices, widespread complaints from businesses or the public, or police responses to gangs, nor is it for revenue generation. We argue such anti-social behaviour statutes are a misguided public policy response to the visibility of homelessness.

The demographic profiles of homeless youth are varied and play an integral role in the experiences these young people have. This article reports on detailed demographic data collected from 187 homeless youth in the Youth Matters in London study, and compares it to demographic profiles of youth in the general Ontario population and with samples of homeless youth from five major Canadian cities. Results indicate demographic data is not consistently collected and/or reported upon by researchers, making comparative analysis challenging while highlighting the need for a standardization of demographic data collection. Comparisons between homeless and housed youth indicate that the homeless youth had lower educational attainment, higher pregnancy/parenting rates, increased cohabitation, greater unemployment, and low annual incomes. Demographic comparison between the six homeless youth samples indicate some similarities and some key differences, particularly in relation to pregnancies/parenting, education, employment, and income. Implications for researchers, policy-makers, and service providers are discussed.

Purpose
People experiencing homelessness are high-users of hospital care in Canada. To better understand the scope of the issue, and how these patients are discharged from hospital, a national survey of key stakeholders was conducted in 2017. The paper aims to discuss this issue.


Design/methodology/approach
The Canadian Observatory on Homelessness distributed an online survey to their network of members through e-mail and social media. A sample of 660 stakeholders completed the mixed-methods survey, including those in health care, non-profit, government, law enforcement and academia.


Findings
Results indicate that hospitals and homelessness sector agencies often struggle to coordinate care. The result is that these patients are usually discharged to the streets or shelters and not into housing or housing with supports. The health care and homelessness sectors in Canada are currently structured in a way that hinders collaborative transfers of patient care. The three primary and inter-related gaps raised by survey participants were: communication, privacy and systems pressures.


Research limitations/implications
The findings are limited to those who voluntarily completed the survey and may indicate self-selection bias. Results are limited to professional stakeholders and do not reflect patient views.


Practical implications
Identifying systems gaps from the perspective of those who work within health care and homelessness sectors is important for supporting system reforms.


Originality/value
This survey was the first to collect nationwide stakeholder data on homelessness and hospital discharge in Canada. The findings help inform policy recommendations for more effective systems alignment within Canada and internationally.