The true scale of homelessness is being grossly undercounted in the official estimates, experts say, leading to a chronic underfunding of programs designed to help unhoused people.
The most recent statistics of unhoused people nationwide are from 2016 in a Canadian Observatory on Homelessness report, which states more than 250,000 people in Canada experience homelessness in any given year.
According to a 2018 federal government report,on any given night across the country, 25,000 to 30,000 people do not have a place to call home.
But these numbers don’t tell the whole story because not every person experiencing homelessness gets counted.
"Homelessness is an increasingly visible humanitarian crisis and easy solutions have defied policymakers for decades," Howard Koh, a professor of the practice of public health from Harvard University told CTVNews.ca in an interview. "We need a more unified and urgent collaboration in response to this crisis, and academia must be included among all sectors (must) step up and do more."
Koh was the 14th assistant secretary for health for the U.S department of health and human services after being nominated by then-U.S. president Barack Obama. Through his heath-care research, he noticed researchers would overlook people dealing with homelessness.
"We know that there are a lot of people on the edge who are at risk (of homelessness), he said. "If we identify those better, particularly through academic work, and then partner with leaders in the community, and at the state and federal level, maybe we can prevent the suffering going forward."
BUILDING TRUST WITH COMMUNITIES
To ensure funding is being streamlined into programs that will actually help people who are homeless, researchers need to conduct counts or surveys with this population, a feat that is made difficult by the transient nature of the unhoused population.
Hidden homelessness is one factor as to why researchers find it difficult to develop methods of research capturing all unhoused people in Canada. The term refers to people who may be couch surfing or sleeping in cars, abandoned buildings and other precarious housing situations, but may not be visible out on the street.
People dealing with homelessness also tend to be in vulnerable positions. Many have mental illnesses, substance abuse problems and have suffered traumatic events due to homelessness, making it a challenge for surveyors and researchers to form relationships with them.
"Historically research has definitely taken a lot from populations that they may be studying, particularly ones that are experiencing disadvantages," John Ecker, director of research & evaluation at the Canadian Observatory on Homelessness told CTVNews.ca in an interview over the phone. "People are not always reporting back to the communities that they have engaged with, and also not involving people in some of those research practices. It takes time, you can't just swoop in."
Before any sort of survey research takes place, Ecker says consultation with the community and building rapport must take place. Understanding who they are as a person rather than a number on a list, has the potential the person would participate in research again.
"It's important to provide some form of honoraria for people as well, to respect a person's time and their thoughts," Ecker said.
Currently, most government agencies rely on point-in-time (PiT) counts to capture a picture of how many people are dealing with homelessness. This method relies on communities and volunteers to count on a single night every two years the number of people experiencing homelessness on the streets.
Advocates say although the PiT count is helpful, it is merely a snapshot of the true number especially because it is geographically sensitive and only happens one night.
"I think there are some pretty valid criticisms of point time counts," Ecker said. "I know there have been efforts to try to enumerate hidden homelessness as part of some of these PiT counts, but that's incredibly challenging, and definitely not getting the number of people at risk of homelessness in the community."
When fewer unhoused people take part in PiT counts, the less accurate numbers are. Ecker says building trust with communities is incredibly important and can increase the chances of participation.
"That's contingent upon if your community has an emergency shelter," Ecker said. "We know with rural, remote and northern communities, they often aren't emergency shelters. So that (PiT count) won't be feasible in those smaller communities."
Without standardization for PiT counts, the results will showcase different snapshots and not be comparable, allowing some people to never be counted, further adding to the underestimate.
Some municipalities take a step further and develop questionnaires to ask unhoused people their history, background and needs. Ecker says surveys allow policymakers to understand specifically what programs are working or not through the lived experiences of people dealing with homelessness.
"We also often speak with staff members who might be providing those supports, as well as managerial staff who are kind of overseeing to get that full, all-encompassing understanding of a program or the current situation," Ecker said. "Other times you want to get people together with the same experience in a focus group where they can come together, and then bounce ideas off one another."
ANOTHER WAY OF ESTIMATING
In 2019, British Columbia changed the way the province counted homelessness. Rather than relying on PiT counts, B.C. began using data from several provincial ministries, including the Ministry of Social Development and Poverty Reduction, BC Housing and the Ministry of Health. The key data taken from shelters, income assistance programs and the Medical Services Plan client registry helped the government pinpoint which communities were suffering from a lack of housing using up-to-date information.
The 2019 report showcased rural communities with a high per capita number of people suffering from homelessness, signalling to the government that preventative measures are needed.
This method of counting homelessness is one that public health researcher Stephenson Strobel and his team have tested in Ontario. He and his colleagues outlined their findings in a report published by StatCan in January 2021.
"One of the concerns that we had is, this population is so transient and so hard to track, that if we were doing this, we were going to have a hard time following up on them," Strobel explained.
This method relied on hospital emergency room data from the Clinical Evaluative Sciences (ICES), an independent institution funded by the Ontario Ministry of Health and Long-Term Care. People without a home address who enter an emergency department are given "XX" in replace of their postcode. This allowed researchers to see when a specific person would move from one hospital to another.
Being able to take data from all hospitals across a province, including rural and remote communities, allows the estimate to be more accurate than if volunteers went out one day during the year to a select few municipalities for a PiT count, Strobel said.
"If you need, like, really rapid data, need some idea of where is homelessness becoming a problem in the next month or two, this is how you would do it," he explained.
Strobel says the entire project to quantify the number of people who are homeless in Ontario took less than $10,000, which he says was mostly the cost of obtaining the data from the government.
"This can be done at a Canada-wide level…You could get an estimate of the level of homelessness in Canada, tomorrow, if you wanted it, you just need to do it," Strobel said.
However, Strobel's method isn’t without its limitations. It requires unhoused people to present at a hospital, otherwise, they won’t be counted.
"The emergency department is one of the last places these people want to come to because they spent six hours there and the practitioners are short with them," Strobel said of the stigma on people dealing with homelessness in a healthcare setting.
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Edited by Tom Yun
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