Policy-related Homelessness Discourses in Canada: Implications for Nursing Research, Practice, and Advocacy
DOI:
https://doi.org/10.25071/2291-5796.145Keywords:
Homelessness, Critical Political Economy, Critical discourse analysis, Human Rights-Based Approach to Housing, Nursing PracticeAbstract
Despite Canada’s commitment to several international human rights instruments recognizing the right to housing, homelessness remains widespread nationwide. Informed by critical political economy theory and critical discourse studies, we examined relevant literature focusing on homelessness policy-related documents in the Canadian context. The findings demonstrate interrelated homelessness policy discourses: 1) emergency shelters, 2) housing first, 3) social determinants of health, 4) human rights, and 5) political economy approach. We conclude that a critical political economy approach offers the most helpful way of understanding and responding to the homelessness crisis in Canada. Homelessness is a socioeconomic and political problem requiring nurses and health professionals to take sociopolitical actions. As nurses and health justice advocates, we stand in solidarity with labour movements to protect public health. This study can be adopted in local, national, and global settings.
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References
Adams R (2017) Michel Foucault: Discourse. Critical legal thinking. https://criticallegalthinking.com/2017/11/17/michel-foucault-discourse/ (accessed 16 October 2022).
Aldridge, R. W., Story, A., Hwang, S. W., Nordentoft, M., Luchenski, S. A., Hartwell, G., ... &
Hayward, A. C. (2018). Morbidity and mortality in homeless individuals, prisoners, sex workers, and individuals with substance use disorders in high-income countries: a systematic review and meta-analysis. The Lancet, 391(10117), 241-250. DOI: https://doi.org/10.1016/S0140-6736(17)31869-X
Armstrong, P., Armstrong, H., & Coburn, D. (2001). Unhealthy times: Political economy
perspectives on health and care. Toronto: Oxford University Press.
Bambra, C., Fox, D., & Scott-Samuel, A. (2005). Towards a politics of health. Health Promotion DOI: https://doi.org/10.1093/heapro/dah608
International, 20(2), 187-193.
Banting, K., Myles, J. (2013). Inequality and the fading of redistributive politics. (K. G. Banting
& J. Myles, Eds.). Vancouver: UBC Press.
Borras, A. M. (2021). Toward an intersectional approach to health justice. International Journal
of Health Services, 51(2), 206-225.
Bryant, T. (2016). Health policy in Canada. 2nd Edition. Toronto: Canadian Scholars’ Press Inc.
Bryant, T., & Raphael, D. (2020). The politics of health in the Canadian welfare state. Canadian
Scholars’ Press.
Bryant, T. & Shapcott (2016). Housing and Health. In D. Raphael (3rd ed.). Social determinants
of health: Canadian perspectives (pp. 343-359). Toronto: Canadian Scholar’s Inc.
Buch-Hansen, H. (2018). The prerequisites for a degrowth paradigm shift: Insights from critical DOI: https://doi.org/10.1016/j.ecolecon.2017.10.021
political economy. Ecological Economics, 146, 157-163.
Built for Zero Canada. (2019). Beginning the end of homelessness in Canada.
Carroll, W. K., & Sapinski, J. P. (2018). Organizing the 1%: How corporate power works.
Halifax & Winnipeg: Fernwood Publishing.
Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy advocacy and nursing organizations: A scoping review. Policy, Politics, & Nursing Practice, 22(4), 276-296. DOI: https://doi.org/10.1177/15271544211050611
Cohen, B. E., & Reutter, L. (2007). Development of the role of public health nurses in addressing child and family poverty: A framework for action. Journal of Advanced Nursing, 60(1), 96-107. DOI: https://doi.org/10.1111/j.1365-2648.2006.04154.x
Cook, G. & Crowe, C. (2022b). Displacement City: Fighting for Health and Homes in a Pandemic. Toronto: University of Toronto Press. DOI: https://doi.org/10.3138/9781487546519
Cowan, L., Hwang, S., Khandor, E., & Mason, K. (2007). The street health report 2007.
Toronto: Street Health.
Crowe, C., & Baker, N. (2007). Dying for a home: Homeless activists speak out. Between the Lines.
Crowe, C (2019). Knapsack Full of Dreams: Memoirs of a Street Nurse. Friesenpress.
Crowe, C. (2022a March 8). Canada’s housing strategy makes homelessness worse. Rabble.ca
https://rabble.ca/columnists/canadas-housing-strategy-makes-homelessness-worse/
Crowe, C. (2022b). Cathy Crowe, https://www.cathycrowe.ca/
Cusack, C., Schultz, A., Scruby, L., Dyck, N., Martin, D., Betker, C., & van Daalen-Smith, C.
(2022). Remembering Dr. Benita Cohen: A tribute to a life well-lived. Witness: The
Canadian Journal of Critical Nursing Discourse, 4(2), 1-4.
Duchesne, A., Rivier, J., Hunter, P., & Cooper, M. (2019). Highlights of the National Shelter
Study 2005-2016 – Emergency Shelter Use in Canada. ESDC: Canada.
Draaisma, M. & Ricci, T. (2022 April 9). More than 200 unhoused people died in Toronto last
year, city data shows. CBC News. https://www.cbc.ca/news/canada/toronto/people-experiencing-homelessness-deaths-toronto-2021-1.6414864
Falk-Rafael, A. (2005). Speaking truth to power: nursing's legacy and moral imperative. Advances in Nursing Science, 28(3), 212-223. DOI: https://doi.org/10.1097/00012272-200507000-00004
Falk-Rafael, A., & Betker, C. (2012). Witnessing social injustice downstream and advocating for health equity upstream: “The trombone slide” of nursing. Advances in Nursing Science, 35(2), 98-112. DOI: https://doi.org/10.1097/ANS.0b013e31824fe70f
Fairclough, N. (2013). Critical discourse analysis: The critical study of language. New York: Routledge. DOI: https://doi.org/10.4324/9781315834368
Flanagan, E. & Raphael, D. (2022). From personal responsibility to an eco-socialist state: political economy, popular discourses, and the climate crisis. Human Geography. DOI: https://doi.org/10.1177/19427786221138965
Forchuk, C., Reiss, J. P., Mitchell, B., Ewen, S., & Meier, A. (2015). Homelessness and housing
crises among individuals accessing services within a Canadian emergency department.
Journal of Psychiatric and Mental Health Nursing, 22(6), 354-359.
Gaetz, S. (2010). The struggle to end homelessness in Canada: How we created the crisis, and
how we can end it. The Open Health Services and Policy Journal, 3(21), 21-26.
Gaetz, S. (2013). The Debate is Over! Housing First Works! Retrieved on November 9, 2022
https://www.homelesshub.ca/blog/debate-over-housing-first-works
Gaetz, S., Barr, C., Frieson, A., Harris, B., Hill, C., Kovacs-Burns, K., Pauly, B., Pearce, B.,
Turner, A., and Marsolais, A. (2012). Canadian Definition of Homelessness. Toronto:
Canadian Observatory on Homelessness Press.
Gaetz, S., Dej, E., Richter, T. & Redman, M. (2016). The state of homelessness in Canada 2016.
Toronto: Canadian Observatory on Homelessness Press.
Gaetz, S., Scott, F., & Gulliver, T. (2013). Housing First in Canada: Supporting communities to
end homelessness. Canada Homelessness Research Network.
Goering, P., Veldhuizen, S., Watson, A., Adair, C., Kopp, B., Latimer, E., & Aubry, T. (2014).
National at home/Chez Soi final report. Ottawa: Mental Health Commission of Canada.
Guirguis-Younger, M., Hwang, S. W., & McNeil, R. (Eds.). (2014). Homelessness & health in Canada. Ottawa: University of Ottawa Press . DOI: https://doi.org/10.26530/OAPEN_515362
Hackworth, J., & Moriah, A. (2006). Neoliberalism, contingency and urban policy: The case of DOI: https://doi.org/10.1111/j.1468-2427.2006.00675.x
social housing in Ontario. International Journal of Urban and Regional Research, 30(3), 510-527.
Hulchanski, J. D., Campsie, P., Chau, S. B., Hwang, S. W., & Paradis, E. (2009). Homelessness:
What’s in a word. Finding Home: Policy Options for Addressing Homelessness in
Canada. Toronto: University of Toronto Press.
Hwang, S. Wilkins, R., Tjepkema, M., O’Campo, P., & Dunn, R. (2009). Mortality among residents of shelters, rooming houses, and hotels in Canada: 11-year follow up study. DOI: https://doi.org/10.1136/bmj.b4036
BMJ: British Medical Journal. 339. 1068-1070.
Hwang, S. W., Wilkins, E., Chambers, C., Estrabillo, E., Berends, J., & MacDonald, A. (2011). Chronic pain among homeless persons: characteristics, treatment, and barriers to DOI: https://doi.org/10.1186/1471-2296-12-73
management. BMC Family Practice, 12(1), 73.
Kalman-Lamb, G. (2017). The financialization of housing in Canada: intensifying contradictions DOI: https://doi.org/10.1080/07078552.2017.1393911
of neoliberal accumulation. Studies in Political Economy, 98(3), 298-323.
MacDonnell, J. A., & Buck-McFadyen, E. (2016). How activism features in the career lives of
four generations of Canadian nurses. Policy, Politics, & Nursing Practice, 17(4), 218-230. McBride, S. K., & Shields, J. M. (1997). Dismantling a nation: The transition to corporate rule
in Canada. Halifax & Winnipeg: Fernwood Publishing.
McDermott, S., Harding, A., & Randle, J. (2019). The characteristics of shelter residents.
Statistics Canada. Online Catalogue no. 75F0002M
McGibbon, E. (2021). The COVID-19 pandemic: On the everyday mechanisms of social DOI: https://doi.org/10.51357/cs.v16i1.148
murder. Critical Studies: An International and Interdisciplinary Journal, 16(1), 35-40.
McGibbon, E., & Lukeman, S. (2019). Critical social justice: The moral imperative for critical DOI: https://doi.org/10.25071/2291-5796.21
perspectives in nursing. Witness: The Canadian Journal of Critical Nursing Discourse, 1(1), 3-12.
McNeil, R., Guirguis‐Younger, M., B Dilley, L., Turnbull, J., & Hwang, S. W. (2013). Learning
to account for the social determinants of health affecting homeless persons. Medical Education, 47(5), 485-494. DOI: https://doi.org/10.1111/medu.12132
Mendly-Zambo, Z., & Raphael, D. (2018). Competing Discourses of Household Food Insecurity DOI: https://doi.org/10.1017/S1474746418000428
in Canada. Social Policy and Society, 18(4): 535-554.
Multiple Sclerosis Society of Canada (2006). Advocacy for people with MS. Retrieved on November 29, 2022, from https://mssociety.ca/library/document/TJaARhK1zOUX8kwMr745jY3LGupFDdbg/original.pdf
Norman, T., & Pauly, B. (2013). Including people who experience homelessness: a scoping DOI: https://doi.org/10.1108/01443331311308203
review of the literature. International Journal of Sociology and Social Policy, 33(3/4),
-151.
Norman, T., Pauly, B., Marks, H., & Palazzo, D. (2015). Taking a leap of faith: Meaningful
participation of people with experiences of homelessness in solutions to address
homelessness. Journal of Social Inclusion, 6(2).
Pauly, B., Cross, G., & Weiss, D. (2016). No vacancy: Affordability & homelessness in
Vancouver [R]. DOI: http://dx.doi.org/10.14288/1.0416187
Peters, J. (Ed.). (2012). Boom, bust and crisis: Labour, corporate power and politics in Canada.
Halifax & Winnipeg: Fernwood Publishing.
Perron, A. (2013). Nursing as ‘disobedient’ practice: Care of the nurse’s self, parrhesia, and the dismantling of a baseless paradox. Nursing Philosophy, 14(3), 154-167. DOI: https://doi.org/10.1111/nup.12015
Phillips, C.D. (2012). Nurses becoming political advocates. Journal of Emergency Nursing: JEN: Official publication of the Emergency Department Nurses Association, 38 (5), Epub DOI: https://doi.org/10.1016/j.jen.2012.05.022
Pomeroy, S. (2015). Built to last: Strengthening the foundations of housing in Canada.
Federation of Canadian Municipalities.
Poremski, D., Stergiopoulos, V., Braithwaite, E., Distasio, J., Nisenbaum, R., & Latimer, E.
(2016). Effects of Housing First on employment and income of homeless individuals: Results of a randomized trial. Psychiatric Services, 67(6), 603-609. DOI: https://doi.org/10.1176/appi.ps.201500002
Registered Nurses Association of Ontario (n.da.). Policy Statement on Homelessness.
Retrieved from https://rnao.ca/sites/rnao-ca/files/storage/related/2283_RNAO_Policy_Statement_Homelessness.pdf
Registered Nurses Association of Ontario (n.db.). Nurses Advocate for Affordable Housing.
Retrieved from https://rnao.ca/about/public-impact/affordable_housing
Raphael, D. (2011). A discourse analysis of the social determinants of health. Critical Public DOI: https://doi.org/10.1080/09581596.2010.485606
Health, 21(2), 221-236.
Raphael, D. (2015). The political economy of health: A research agenda for addressing health DOI: https://doi.org/10.3138/cpp.2014-084
inequalities in Canada. Canadian Public Policy, 41(Supplement 2), S17-S25.
Raphael, D., Bryant, T., & Curry-Stevens, A. (2004). Toronto charter outlines future health
policy directions for Canada and elsewhere. Health Promotion International, 19(2), 269-273.
Strobel, S., Burcul, I., Dai, J. H., Ma, Z., Jamani, S., & Hossain, R. (2021). Characterizing
people experiencing homelessness and trends in homelessness using population-level
emergency department visit data in Ontario, Canada. Health Reports, 32(1), 13-23.
The Salvation Army. (n.d). Housing and Shelter. Retrieved from https://salvationarmy.ca/what-
we-do/in-your-community/housing-and-shelters/
Tipple, G., & Speak, S. (2005). Definitions of homelessness in developing countries. Habitat DOI: https://doi.org/10.1016/j.habitatint.2003.11.002
International, 29(2), 337-352.
Tsemberis, S. (2011). Housing first: The pathways model to end homelessness for people with
mental illness and addiction manual. European Journal of Homelessness Volume, 5(2).
Tsemberis, S., & Eisenberg, R. F. (2000). Pathways to housing: Supported housing for street-
dwelling homeless individuals with psychiatric disabilities. Psychiatric Services, 51(4), 487-493. DOI: https://doi.org/10.1176/appi.ps.51.4.487
United Nations. (1948). Universal Declaration of Human Rights. United Nations.
United Nations. (1965). International Convention on the Elimination of All Forms of Racial
Discrimination. United Nations
United Nations. (1966). International Covenant on Economic, Social and Cultural Rights.
United Nations.
United Nations. (1979). Convention on the Elimination of All Forms of Discrimination Against
Women Concerned. United Nations.
United Nations. (1989). Convention on the Rights of the Child. United Nations.
United Nations. (1990). International Convention on the Protection of the Rights of All Migrant
Workers and Members of Their Families. United Nations.
United Nations. (1999). UN Human Rights Committee (HRC), UN Human Rights Committee:
Concluding Observations: Canada, 7 April 1999, CCPR/C/79/Add.105. United Nations.
United Nations. (2006). Convention on the Rights of Persons with Disabilities. United Nations.
United Nations. (2007). United nations Expert on Adequate Housing Calls for Immediate
Attention to Tackle National Housing Crisis in Canada. United Nations.
United Nations. (2014). UN-HABITAT. The Right to Adequate Housing. United Nations.
United Nations. (2016). Advance Unedited Version. Committee on Economic, Social and
Cultural Rights: Concluding observations on the sixth periodic report of Canada. United Nations.
United Nations. (2017). The New Urban Agenda: Habitat III. United Nations.
United Nations. (2018). A/HRC/37/53. United Nations.
Wodak, R., & Meyer, M. (Eds.). (2015). Methods of critical discourse studies. London: Sage.
WHO. (1986). The Ottawa charter for health promotion: First international conference on health
promotion. Prerequisites for Health. Geneva: WHO.
WHO. (2008). Closing the gap in a generation: health equity through action on the social
determinants of health. Final report of the Commission on Social Determinants of Health.
Geneva: WHO.
Young, M. G., & Joshua, M. (2013). Neoliberalism and homelessness in the Western Canadian DOI: https://doi.org/10.22230/cjnser.2013v4n2a147
Arctic. Canadian Journal of Non-profit and Social Economy Research, 4(2),7-22.
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