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Apr. 13, 2004. 01:00 AM
Homeless women ‘crisis’
In Toronto, they're dying at 10 times the normal rate
AIDS, drugs, suicide common causes, researchers find
ELAINE CAREY
MEDICAL REPORTER
Homeless women in Toronto are dying at 10 times the rate of other women
between 18 and 44, according to a new study released today in the Canadian
Medical Association Journal.
A commentary accompanying the study calls the "stunning" death rate among
homeless women "a clarion call to our society and our health care community.
This smouldering public health crisis can no longer be ignored."
HIV-AIDS and drug overdoses are the most common causes of death among
younger homeless women. Depression leading to suicide was also a high risk,
according to the study, co-authored by Dr. Stephen Hwang of St. Michael's
Hospital and Dr. Angela Cheung of the University Health Network.
Yet homeless women get little attention and few treatment programs, said
Hwang, who is part of St. Michael's inner city health research unit.
"It's one of the reasons I wanted to do the study because they are just as
disadvantaged as homeless men," he said in an interview. "Their death rate
reflects the really disadvantaged circumstances that homeless women are
living in."
Women don't fit the stereotype of homelessness, he said. "Most people
imagine an older man sitting on a street corner. The women tend to make
themselves less visible. They avoid putting themselves in the public eye."
The study followed 1,981 women who used Toronto shelters during 1995,
tracking their health over the following three years and comparing their
death rates with the broader Canadian population, and with similar studies
of homeless women in Montreal, Copenhagen, Boston, New York, Philadelphia
and Brighton, U.K.
Homeless men in Canada have a death rate much lower than those in the United
States. But there is no similar advantage for women, Hwang said.
"Just putting a health card in someone's pocket doesn't mean everyone is
going to get exactly equal access to exactly equal health care," he said.
The death rate for homeless women aged 18 to 44 in Toronto is almost
one-third higher than in Boston, even though Canada has universal health
care.
That's "a curious and troubling observation," according to Dr. James
O'Connell, president of the Boston Health Care for the Homeless program, who
wrote the opinion piece accompanying the Journal article.
"Impoverished women and men without homes bear an undue and unacceptable
burden of illness and are dying prematurely in our streets, in the very
shadows of our towering health care institutions," he wrote.
-----------------------
`You see people die off and you go to a lot of funerals.'
Cathey Milley, client of 416 Drop-In Centre
----------------------
O'Connell added: "This public health crisis will not be ameliorated until
housing and health care become a fundamental right for every human being."
Tracking the homeless using records is difficult, Hwang said, acknowledging
the study authors found evidence some women used different names to enter
various shelters. As well, if any of the women died outside Ontario, the
researchers wouldn't have learned of their deaths.
They did find death certificates for 26 of the women, 21 of whom were under
age 45. Older women tracked in the study — those aged 45 to 64 — were also
more likely to die prematurely than women who weren't homeless. But their
death rates were much closer to the norm for their age.
Most homeless women have mental health problems as well as addictions and
that "puts them at the bottom of the totem pole — they're not a priority as
far as anyone's concerned," said Joy Reid, director of the privately run 416
Drop-In Centre on Dundas St. E., where homeless women come for food,
companionship, clothing and health care.
Cathey Milley, 49, used to know all the women at the centre, but she said
they're all gone now.
"Now it's a lot of new people — only because the ones who used to come here
have died, and that's really sad," said Milley, sitting at a table in the
living room of the house that serves as home to 250 women like her every
day.
"You see people die off and you go to a lot of funerals."
Belinda Greville, 45, has been spending her days at the 416 Drop-In for nine
years, since she found herself homeless after a life of abuse, drugs and
trouble with the law.
"They've helped me stay stable in some ways so I can keep moving," she said.
"In a place like this, I feel secure and the people I know don't judge me.
They accept me for who I am."
Asked where she sleeps at night, she pointed to the Council Fire shelter
across the road. "But they fill up quick," she said.
Toronto's 15 shelters for single women have a total of 565 beds but they
housed a record high of 5,683 different women during 2002. "We're certainly
seeing more women who have complex problems, serious mental health issues
and addiction issues," said Fiona Murray, manager of planning and
development for Toronto's hostel services.
If a homeless woman does decide to go to a hostel, "there's a good chance
there won't be a bed to go to," said Lynn Hemlow, a registered nurse who
struggles to provide health care and preventative programs at the 416
Drop-In. "For men, it's different. There's a huge, huge organization."
With files from Canadian Press
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