Grant: IPPH Travel Awards - CPHA Annual Conference

Homelessness is a critical social determinant of health and public health equity issue. People experiencing homelessness have high rates of morbidity and mortality, resulting in a life expectancy of 42 years for men, and 52 years for women. Stigma, trauma and discrimination contribute to marginalization of people who are homeless, particularly indigenous peoples, women, LGBTQI2S and racialized groups. The Evidence Based Clinical Guidelines for Homeless, Vulnerably Housed and People with Lived Homelessness Experience provide broad recommendations to support people experiencing homelessness with access to healthcare and housing. Because homelessness is a key health equity issue for the public health community, we utilize a prominent framework to examine public health roles as they pertain to the recent Evidence-Based Guidelines. Using the National Collaborating Center for Determinants of Health (NCCDH) framework "Public Health Roles for Improving Health Equity", we examine ways that public health is already and can further respond to homelessness including (1) assessing and reporting on inequities relating to homelessness, (2) modifying and orienting interventions to better serve this population, (3) partnering with other sectors and (4) participating in policy development. We use familiar public health examples including tuberculosis management, opioid strategy and adverse childhood experiences, to explore in detail how homelessness can be more effectively addressed by public health organizations. Application of these guidelines through this framework demonstrates how public health can act on this preventable cause of morbidity and mortality. We discuss how existing activities in public health are relevant to meeting this population's needs, and identify opportunities for public health to reduce barriers for homeless populations, and address determinants of poor health related to homelessness through program, organizational, and policy-level interventions.