Homelessness and its impact on health - Interview with Isolde Daiski

Isolde Daiski was a hospital staff nurse for many years. Today she is a full-time faculty member at the School of Nursing at York University. Isolde also volunteers as a nurse with an outreach program for homeless people, called the ‘Health Bus’. In this Q&A, she shares her insights on homelessness and its impact on health.

What is the focus of your research?

My research is qualitative; I want to hear about the life experiences of people who have experienced homelessness. I believe that they are the experts of their lives and by getting to know their lives and their ideas, you get a better understanding of homelessness as an issue.

What makes this research area important?

I think it's very important because the people who experience homelessness know what it’s like and they also understand their needs, they are the experts. I cannot come from my own middle class environment and know what it is like to be homeless. So I think it's most important to actually hear from them and hear their stories.

What are the key issues?

I not only do research, I also practice. I work as a nurse on the Health Bus, which is an outreach program for people who are experiencing homelessness. I work as a nurse on the Bus and see people regarding their health care needs. In my opinion, the most important issue is to have safe housing that is clean and shelters people from the environment, the elements, as well as keeps them safe from infectious diseases. For instance, [unlike being in] overcrowded shelters. And they also need adequate income so they can afford proper nutrition, proper clothing and all the necessities in life that people need in order to stay healthy.

What is the key policy priority?

Housing should be a right, there should be standards, there should be housing policy on all levels of government. It should be a right to have safe and clean housing that is livable. The second policy is that we should have adequate income; everybody should have an adequate income so that they can live and afford the necessities of life.

What is the most controversial issue today?

Well I that think the most controversial question is about harm reduction right now. The notion is that harm reduction breaks everything else loose so you are just facilitating addictions, which is not true because people also get counseling on that. We have to start somewhere and getting people to trust [is the first step]. I think everything starts with trust, so when you work with harm reduction you get the trust of people. People change when they are ready to change and when they have the possibility to change. So long as their living conditions are really poor, they cannot change. It is a vicious cycle; there is nothing else to do. Self medication, taking drugs or alcohol is very common and until we provide an alternative, how are people going to get out of it? It is like being in a hole and not being able to get out of it. Housing should be first. I hope there is enough support for people when they are in housing because it is a big change in their life, after being homeless for so long. They need support and I hope the supports are there for them.

What barriers do homeless people face in obtaining health care?

One barrier is that many homeless people don't have IDs, which includes the OHIP card. IDs get lost and stolen when you are homeless. Just imagine: you always have to carry everything with you, whatever your belongings are, and sometimes you may have to [put it down] for a few minutes and it's gone.

Another barrier is the attitude of health care providers. I think it is slowly getting better but people seem to feel that, “it's your fault that you are homeless” and, “why can't you get out of it?" We seem to blame the individual and that gives them the right to treat people in a disrespectful manner. That's what I learned from my own research, that's what [homeless] people told me, that they often get treated very badly.

Why should a preventative approach be implemented on a large scale?

If [homeless] people are comfortable accessing health care when they need it, it would probably prevent a lot of the costs [associated with health care] later on. If you start with this issue as a small problem and you treat it in the preventative phase, so as long as it is small, then it does not become a full blown issue later. Later, [homeless patients] will need a lot more medication and treatments and it will cost the health care system a lot more.

Publication Date: 
2011
Location: 
Toronto, ON, Canada