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Health challenges for

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Health challenges for homeless migrants Carol Kauppi, PhD, School of Social Work Phyllis Montgomery, RN PhD, School of Nursing Henri Pallard, Doct. – PowerPoint PPT presentation

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Title: Health challenges for


1
  • Health challenges for
  • homeless migrants
  • Carol Kauppi, PhD, School of Social Work
  • Phyllis Montgomery, RN PhD, School of Nursing
  • Henri Pallard, Doct. Department of Law and
    Justice
  • Laurentian University, Sudbury, Ontario
  • 28 May 2014
  • Public Health 2014, Toronto
  • CPHAs Annual Conference

2
Background
  • Migration, a complex and dynamic social process.
  • Movement within regions, between provinces and
    across country borders.
  • Inter-regional, provincial, national,
    international.
  • Rural ? urban.
  • Physical, psychological, social, economic,
    cultural, racial, political, and religious
    reasons.

3
Background
  • Some evidence that people with poor mental health
    are more likely to migrate for a better life
    Stillman et al., 2009.
  • Persons with severe mental illness
  • 2 times as likely to move Lix et al., 2006.
  • 3 times the risk for developing schizophrenia
    Bhugra, 2000 Cantor-Graae Selten, 2005.
  • Having to migrate contributes to lower
    post-migration psychological health outcomes
    Gong et al. 2011.

4
Background
  • Experiences are influenced by
  • Pre-migration factors (e.g., reasons for
    migration)
  • Preparation for migration and process of moving
    (voluntary/forced vs. planned)
  • Post-migration factors (e.g., acceptance by host
    community).
  • Migration produces stress
  • Exacerbated by racism, discrimination, social
    disadvantages.
  • Contributing factors are poverty, poor housing
    and low SES.
  • Bhugra (2000) argued that severe social and
    economic disadvantages increase the incidence of
    mental illness.

5
Objectives of this presentation
  • 1) To compare the profile and migration patterns
    of northern and rural persons.
  • Compare 2 groups
  • Those who self-identify as living with mental
    health issues.
  • Those who do not self-identify self-report
    migration/mental illness.
  • 2) To describe migrants to northern Ontario
    cities
  • socio-demographic characteristics.
  • histories of homelessness.
  • physical illness

6
Northern Ontario CURA Poverty, Homelessness and
Migration (PHM)
  • A 5-year research project of the Centre for
    Research in Social Justice and Policy at
    Laurentian University.
  • Working with 11 communities in northeastern
    Ontario, from Sudbury and North Bay up to the
    James Bay.
  • Partner communities include 3 northern cities, 4
    towns and 4 First Nations.
  • PHM is bilingual and tri-cultural working with
    Anglophone, Francophone and First Nations
    communities in the vast area of northeastern
    Ontario.

7
(No Transcript)
8
Sample
  • Database collected using a survey.
  • Service providers in Sudbury, Timmins and North
    Bay invited homeless people to complete the
    questionnaire (2009 to 2011).
  • Sample 1528
  • Migration analysis draws on 468 participants who
    provided information about migration and mental
    health.
  • 118 participants who self-reported mental health
    issues Mental Health Sample
  • 350 who did not cite mental health issues
    Comparison Sample

9
Total sample MH vs. Comparison
  • Significant gender difference (.01)
  • More men in mental health group.
  • More women in comparison group.
  • Significant difference on marital status (.01)
  • More single/unattached people in mental health
    group.
  • More married/common law relationships in
    comparison group.
  • Significant difference on custody of children
    (.01)
  • Fewer people with custody of children in mental
    health group.

10
Total sample MH vs. Comparison
  • No significant differences with regard to
    socio-cultural backgrounds.
  • Similar proportions of people of Indigenous,
    Anglo-Euro, Franco-Euro origins and racialized
    others in both groups
  • Group
  • Anglo-Euro 53.4
  • Franco-Euro 15.9
  • Indigenous 29.6
  • Racialized others 2.1

11
FINDINGS ON MIGRANTS Physical health problems in
last year
(plt0.01)
12
Health problems
  • Mental health group of migrants self-identified
    health problems in year prior to the study
  • 5 main categories of problems
  • Category
  • Musculoskeletal 58
  • Circulatory 10
  • Respiratory 8
  • Substance use/abuse 7
  • Infections 6
  • Other 11

13
FINDINGS ON MIGRANTS Absolute homelessness in
lifetime
(plt0.01)
14
FINDINGS ON MIGRANTS Slept outdoors in last year
(plt0.01)
15
FINDINGS ON MIGRANTS Profile of migrants who
cited mental health reasons for homelessness
  • Male (55)
  • Anglo-Euro (48)
  • Single, divorced, separated or widowed (70)
  • Not accompanied by children (72)
  • No custody of children (67)
  • Physical health problems (68)
  • Has been absolutely homeless in lifetime (76)
  • Has been absolutely homeless in last year (50)
  • Main source of income was government (e.g. OW,
    ODSP) (81)

16
FINDINGS ON MIGRANTS Profile main reasons for
migration
  1. Housing/ poverty/unemployment/seeking work.
  2. Encouraged to go to destination community by
    family, friends or services.
  3. Illness or to access health services.
  4. Challenges with family, violence, divorce.
  5. Due to mental illness.
  6. Due to addictions/substance use.

17
Migration patterns
Migration from
Examples

A place near the study community Within 50 km of Sudbury, Timmins or North Bay 16
Northeastern Ontario Moose Factory, Kirkland Lake, Matagami FN 28
Northwestern Ontario Wawa, Thunder Bay  10
Eastern or western Ontario Cornwall, London 10
Southern Ontario Toronto, Barrie, Waterloo 21
Another province, territory BC, AB, QC, NB, PEI, NFLD  11
Another country USA 4
18
Discussion
  • The study has shown that migrant homeless persons
    who experience mental illness have
  • extensive histories of absolute homelessness
  • experience with sleeping rough and
  • problems with physical health.
  • Our qualitative studies also show that they
    experience impacts in various ways
  • emotional/mental (anxiety, fear, depression,
    mental illness),
  • physical (health impacts), and
  • social (e.g. through the loss of relationships).

19
Conclusion
  • Homeless migrants may lose both dwelling space
    and social ties.
  • Migration may occur by force as homeless people
    are sometimes encouraged to move or are given bus
    tickets to move to other cities. This practice
    has been referred to as greyhound therapy.
  • Absolutely homeless persons are often excluded
    from public places through laws pertaining to
    loitering, surveillance of inhabitants,
    regulations regarding access to certain public
    places (e.g., parks, malls) and the closure of
    shelters during the day time.
  • Exclusionary practices may erode the sense of
    self and cohesion among homeless people who rely
    often on public locations to conduct day to day
    life functions.

20
Future directions
  • The results indicate the complexity of migratory
    homelessness.
  • Services for homeless, migratory people
    experiencing mental health challenges must take
    into account varied needs
  • Must address anxiety and stress that results
    from loss of place and migration.
  • More research is needed to extend concepts of
    place to understand better the experiences of
    migrant, homeless persons with mental illness in
    Ontario and Canada.

21
Contact us Poverty, Homelessness and
Migration Laurentian University 935 Ramsey Lake
Road Sudbury, ON P3E 2C6 Tel. 705-675-1151, ext.
5156 homeless_at_laurentian.ca www.lul.ca/homeless
www.lul.ca/sansabri ckauppi_at_laurentian.ca
pmontgomery_at_laurentian.ca hpallard_at_laurentian.ca
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