People living in single-room-occupancy hotels in Vancouver’s Downtown Eastside died at eight times the national average over a nearly four-year period, says a new study by University of British Columbia researchers.
And contrary to researchers’ expectations, HIV/AIDS or drug overdoses were not the biggest factors driving the higher mortality rate.
“We thought it would be the HIV/AIDS and maybe the opioids … but it turned out the two significant, statistically meaningful risk factors were the psychosis and the damage to the liver related to hepatitis C,” study co-auther William Honer said on Thursday.
For Dr. Honer, who is head of UBC’s department of psychiatry, the results underscore the complex health challenges facing many people living in the Downtown Eastside and the need for better ways of tackling them.
The current system can be difficult to navigate for people with, for example, hepatitis C and a mental illness.
“They don’t only have addiction, they don’t only have schizophrenia, they don’t only have HIV/AIDS. … People have multiple kinds of illnesses and those together lead to this unfortunately high mortality,” he said.
The researchers followed 371 people living in single-room-occupancy (SRO) hotels or recruited from the Downtown Community Court for nearly four years.
The study was launched in 2008 in an attempt to link the court process with health and social services.
Over the course of the study, 31 participants died – a mortality rate eight times the average for Canadians of the same age and sex. For younger participants, between the ages of 20 and 59, mortality was 10 times the national rate.
Participants had monthly interviews and tests and, when necessary, were referred for medical treatment.
The study, published Thursday in British Medical Journal Open, is a follow-up to a 2013 report by UBC researchers that found two-thirds of SRO tenants in Vancouver were previously homeless and had, on average, three illnesses simultaneously.
Nearly every participant in the newly published study was dealing with more than one illness or condition at a time, said lead author Andrea Jones, who is studying medicine and addictions research at UBC.
Like Dr. Honer, she said the study highlights the need for more integrated services.
“The treatment is possible. I think what some of the barriers are is that individuals are living with three, four illnesses and you have to choose what to treat,” Ms. Jones said. “They’re not getting the support for all the challenges they are facing.”
Vancouver Mayor Gregor Robertson said the study highlights the need for higher levels of government to “step up” to improve mental-health services and housing.
“This situation is primarily a crisis with health and a lack of affordable housing,” Mr. Robertson said when asked about the matter at an unrelated event on Thursday.
“We’ve been doing everything we can as a city right now, but we’re seeing this pattern across the country where we need more support for health and housing in Canada’s cities,” he said. “In Vancouver, we have a real crisis with this.”
Vancouver Coastal Health is currently unrolling what it calls its Second Generation Strategy, a plan to revamp services in the Downtown Eastside, where the health authority and community groups run more than 50 programs and clinics in a six-block radius at a cost of about $55-million a year.
The strategy includes new drop-in and counselling services and expanded morning hours for Insite, the city’s supervised injection site.
With a report from Andrea Woo