Grant: Operating Grant: Data Analysis - Healthy Cities Intervention Research

People who inject drugs (PWID) often face profound socio-economic disadvantage and are one of the most vulnerable groups in society, with a global mortality rate nearly 15 times that of the general population. Largely concentrated in cities, PWID are disproportionately exposed to housing vulnerability, with up to 60% of those living in large North American cities reporting recent unstable housing. Access to safe and stable housing is a well-established determinant of health and has gained renewed focus as a structural target for intervention following the limited success of conventional public health approaches to reducing morbidity and mortality in PWID. Data on mortality rates and trends among PWID are particularly scarce in Canada. Further, despite evidence for a broadly deleterious impact on PWID health, relationships between unstable housing and mortality are not well understood. This study seeks to examine mortality rates and refine our understanding of the relationship between these aspects living context and mortality, and ultimately guide policies and interventions that address inequalities related to housing stability and service distribution within our cities. This study will capitalize on data collected as part of St. Luc/HEPCO, one of the largest prospective cohort studies of PWID, having recruited more than 4000 participants since 1992, with detailed assessment of behavioral and service use data, as well as geospatial and laboratory data. Mortality and causes of death among cohort participants will be obtained via record linkage with the Institut de la Statistique du Québec. This project will improve our understanding of how housing contexts influence this ultimate health outcome. Findings will be relevant to city planners and community organisations seeking to allocate housing solutions and services in a manner that supports our most vulnerable citizens.