173499 Homelessness and immigration in Toronto: A comparison of the health of homeless recent immigrants, non-recent immigrants, and Canadian-born individuals

Tuesday, October 28, 2008: 8:50 AM

Stephen W. Hwang, MD, MPH , Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada
Shirley Chiu, MA , Centre for Research on Inner City Health, St. Michael's Hospital, Toronto, ON, Canada
George Tolomiczenko, PhD, MPH, MBA , Crohn's & Colitis Foundation of Canada, Toronto, ON, Canada
Alex Kiss, PhD , Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Laura Cowan, BScN , Street Health, Toronto, ON, Canada
Don Redelmeier, MD, MSHSR , Sunnybrook Health Sciences Centre, Toronto, ON, Canada
Wendy Levinson, MD , Department of Medicine, University of Toronto, Toronto, ON, Canada
Methods: A stratified random sample of homeless people (603 single men, 304 single women, and 284 adults with dependent children) was enrolled at 60 shelters and 18 meal programs in Toronto in 2005. Participants were classified as recent immigrants to Canada (£ 10 years since immigration), non-recent immigrants (>10 years since immigration), or Canadian-born. Physical health was assessed using the SF-12. Prevalence of mental health, alcohol, and drug problems during the current month were assessed using the Addiction Severity Index.

Results: 116 study participants (10%) were recent immigrants, 261 (22%) were non-recent immigrants, and 812 (68%) were Canadian-born individuals. These three groups differed significantly in mean age (28, 40, and 36 years, respectively), sex (67%, 53%, and 41% female), race (81%, 78%, and 27% non-white), family status (48%, 31%, and 18% accompanied by dependent children), and mean duration of current episode of homelessness (6, 14, and 18 months). Recent immigrants had significantly better SF-12 physical health scores (49.5, 45.5, and 45.8) and significantly lower rates of mental health problems (23%, 35%, and 40%), alcohol problems (5%, 23%, and 35%), and drug problems (10%, 27%, and 48%).

Conclusions: In Toronto, homeless immigrants have a very different demographic profile than homeless Canadian-born individuals. Homeless immigrants, especially those who immigrated within the last 10 years, are healthier and much less likely to suffer from substance use problems than other homeless people. Mental health problems, however, are relatively common among homeless immigrants. Programs to assist homeless immigrants should take these findings into account.

Learning Objectives:
1. To compare the demographic characteristics and health status of homeless recent immigrants, homeless non-recent immigrants, and homeless Canadian-born individuals. 2. To determine the prevalence of mental health problems, alcohol problems, and drug problems in these three groups.

Keywords: Homeless Health Care, Immigrants

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversaw the study data collection, carried out the statistical analysis and interpretation of data, and prepared the abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.