Homeless migrating to the Downtown Eastside face tragic statistics

A Simon Fraser University study has found that most homeless people currently residing on the Downtown Eastside have migrated there from somewhere else in the last 10 years.

The study by health sciences professor Dr. Julian Somers tracked migration and levels of service in a sample population of homeless living in the Downtown Eastside and found that 52% of people they interviewed resided in the area, but only 17% of those people said they lived there 10 years ago.

Their research also painted a tragic picture of the lives of Vancouver’s most vulnerable population. Participants in the study were an average age of 41 years and had first experienced homelessness 11 years before the study. Females made up 26% of the sample and 54% self-identified as Caucasian. 68% were single or never married.

On average, they had also been homeless for a total of 58 months with 30 months of continuous homelessness. Almost three-quarters were found to have a psychotic disorder like schizophrenia, bipolar disorder, or a mood disorder and over half met criteria for substance dependence. In total, 18% were at a high risk of suicide.

Their physical health was also noted as particularly troublesome, with 70% of them having three or more chronic medical conditions and one-third having a blood-borne infectious disease.

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The study found that the participants had experienced worsening conditions in the last 10 years, including a tripling of how many times they used community medical services and hospital services. Their criminal convictions and welfare receipts also doubled. In the year before the study, the each participant spent on average 12 days in hospital, received nine income assistance payments, and received one criminal conviction.

Ten years prior to their recruitment, only 17% of participants were located in the Downtown Eastside and 23% were in other parts of Vancouver. The remainder were in other parts of the province (39%) or had unknown status (20%). In the next 10 years, the number of participants living on the Downtown Eastside grew to 52%, mainly from migration from other areas of B.C. and out of province.

The researchers found this particular statistic interesting, as their move to the Eastside paralleled their worsening conditions.

“The DTES is home to a high concentration of resources for the homeless such as shelters, food, low rent accommodations, street nurses and drop-in health facilities,” states the study, published online this week. “However, it is also an area rife with problems including substance use, crime, sexually transmitted infections and poverty. Features of the environment, such as single room occupancy hotels, have been shown to be associated with poor health status and disease risk. The high prevalence of multimorbidities in the current sample coincides with their exposure to high-risk settings.”

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Somers and his colleagues conclude that people who are chronically homeless and mentally ill are at high risk of an early death and “becoming trapped in a costly ‘revolving door’ involving healthcare, the justice system, and the street.” Their research suggests that interventions and services for the at-risk population should be located further away from the places where street homelessness, mental illness, and substance abuse are most common.

“Despite the high concentration of services and supports in the DTES, members of the current sample experienced significant personal decline rather than recovery, as evidenced by their involvements with criminal justice, large increases in acute care and prolonged homelessness.”