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Homelessness & Health in Canada explores, for the first time, the social, structural, and environmental factors that shape the health of homeless persons in Canada. Covering a wide range of topics from youth homelessness to end-of-life care, the authors strive to outline policy and practice recommendations to respond to the ongoing public health crisis. This book is divided into three distinct but complimentary sections. In the first section, contributors explore how homelessness affects the health of particular homeless populations, focusing on the experiences of homeless youth, immigrants, refugees and people of Aboriginal ancestry. In the second section, contributors investigate how housing and public health policy as well as programmatic responses can address various health challenges, including severe mental illness and HIV/AIDS. In the final section, contributors highlight innovative Canadian interventions that have shown great promise in the field. Together, they form a comprehensive survey of an all too important topic and serve as a blueprint for action.

Homelessness & Health in Canada explores, for the first time, the social, structural, and environmental factors that shape the health of homeless persons in Canada. Covering a wide range of topics from youth homelessness to end-of-life care, the authors strive to outline policy and practice recommendations to respond to the ongoing public health crisis. This book is divided into three distinct but complimentary sections. In the first section, contributors explore how homelessness affects the health of particular homeless populations, focusing on the experiences of hom.

IntroductionImprovements in the availability and effectiveness of highly active antiretroviral therapy (HAART) have prolonged the lives of people living with HIV/AIDS. However, mortality rates have remained high among populations that encounter barriers to accessing and adhering to HAART, notably people who use drugs. This population consequently has a high burden of illness and complex palliative and supportive care needs, but is often unable to access these services due to anti‐drug policies and discrimination. In Vancouver, Canada, the Dr. Peter Centre (DPC), which operates a 24‐bed residential HIV/AIDS care facility, has sought to improve access to palliative and supportive care services by adopting a comprehensive harm reduction strategy, including supervised injection services. We undertook this study to explore how the integration of comprehensive harm reduction services into this setting shapes access to and engagement with care.MethodsQualitative interviews were conducted with 13 DPC residents between November 2010 and August 2011. Interviews made use of a semistructured interview guide which facilitated discussion regarding how the DPC Residence's model of care (a) shaped healthcare access, (b) influenced healthcare interactions and (c) impacted drug use practices and overall health. Interview transcripts were analysed thematically.ResultsParticipant accounts highlight how the harm reduction policy altered the structural‐environmental context of healthcare services and thus mediated access to palliative and supportive care services. Furthermore, this approach fostered an atmosphere in which drug use could be discussed without the risk of punitive action, and thus increased openness between residents and staff. Finally, participants reported that the environmental supports provided by the DPC Residence decreased drug‐related risks and improved health outcomes, including HAART adherence and survival.ConclusionsThis study highlights how adopting comprehensive harm reduction services can serve to improve access and equity in palliative and supportive care for drug‐using populations.