The Multifaceted Issue of Homelessness in Canada Through a Literature Review

Introduction

Homelessness is still a very common and urgent problem in Canada, with about 235 thousand people estimated to lose houses or live without them annually (Gaetz et al., 2014). The ultimate factors behind modern homelessness include complicated interdependencies of the socially framed structural limitations, poor social security systems and individual characteristics that make specific groups vulnerable. This review provides a synthesis of the recent scholarly literature and governmental reports published in the past decade that have been only written to unravel the multidimensional factors, results as well as political options surrounding the homelessness crisis through a Canadian lens. Through the analysis of the already present evidence base, one can come up with several primary interrelated topics.

While Canada-wide statistics estimate over 250,000 individuals experience housing loss each year, certain regions face acutely rising rates – such as metropolitan Vancouver witnessing homelessness counts double since 2014 (Eberle et al., 2001). The rapid development of the technology sector attracting high-income professionals coupled with chronically constrained housing supply has resulted in average rents in Vancouver proper soaring over 20% across just the past year, the highest nationwide (Taylor et al., 2022). The aforementioned horrific cocktail of exponentially increasing expenses on shelters versus wages growing at an anaemic rate predicts the continuation of the ballooning of homelessness unless fundamental shifts in long-term housing and labour regulations become a reality. Learnings from Finland see a reframed right to permanent housing without conditions coupled with support service accessibility as one avenue for ameliorating the intertwined systemic challenges underlying much of Canada’s homelessness crisis.

Background on Homelessness in Canada

Brief statistics on homelessness

Homelessness in Canada is a complex phenomenon which is hardly covered by official statistics. The numbers however lead to a gloomy vision: it is important to go beyond it and find out what is behind the figures.

National Landscape:

• Underreported Reality: The national headcount of 23500 individuals who accessed homelessness services in 2016 may just be the tip of the iceberg. As per experts like the Canadian Observatory on Homelessness and Raising the Roof, what is officially reported is just a fraction of the total number of those experiencing homelessness; calculations put the true figures between 400,00-500,000 individuals per year (Raising the Roof et al., 2020).
• Hidden Population: However, this gap is partly caused by the hidden homeless who are under shelters or formal systems as a result of fear, stigmatization and also because they do not meet certain eligibility conditions. Research estimates this hidden population can be large, perhaps even twice the official numbers (National Collaborating Centre for Aboriginal Health).
• Chronic Homelessness: There is yet another vital layer represented by chronic homelessness, defined as being on the streets for at least a year or recurrently over three years. According to Gaetz et al. in 2014, it is estimated that up to thirty per cent of shelter users fall into this group with complex needs and requiring intensive intervention.

Urban Impact:

• City Spotlight: This effect of homelessness is concentrated in major cities such as Toronto. In 2017, the shelter system in Toronto served less than one percent of households illustrating how urban centers bear an unproportionate burden (Raising the Roof et al., 2020).
• Vulnerable Populations: Cities present some specific demographics that are especially vulnerable. The issue of youth homelessness is a problem on the rise as many kids flee violent and unstable homes or have no network support system (Gaetz et al., 2014). Moreover, veterans are overrepresented among homeless people because of difficulties in transitioning to civilian life and receiving appropriate mental healthcare.

Factors Contributing to Homelessness

Lack of Affordable Housing

The predominant underlying cause behind Canada’s elevated rates of homelessness is the drastic lack of affordable rental housing across cities (Gaetz et al., 2014). With rapidly rising housing prices over the past few decades, homeownership has become increasingly out of reach for average Canadian households. In 2021, Canada ranked as the second least affordable housing market among OECD nations. Average home prices nationally surged by 31% over 2020-2021, requiring 184% of a typical household’s annual income to purchase. Renters have faced similar runaway price surges, with average monthly rents in Vancouver and Toronto leaping 9.5% and 16% higher in 2021 respectively (Rental.ca).

Income and Employment Instability

While entangled with housing affordability issues, income and job instability have their distinct effects as drivers of homelessness in Canada (Frankish et al., 2009). Over the past few decades, higher-paying middle-income jobs have been increasingly replaced by part-time, temporary and contract roles offering fewer benefits, protections or stability (Granofsky, et al., 2022). Nearly 42% of working Canadians now fill such precarious positions with limited safeguards if their hours are cut or employment ends (United Way). Meager social assistance rates compound financial strains, with welfare incomes placing recipients 53-80% below Statistics Canada’s low-income thresholds (Gordon, 2020).

Systemic and Structural Barriers

Homelessness affects all Canadians of diverse demographics, but systemic discrimination and structural inequities lead to disproportionate burdens upon marginalized populations like Indigenous peoples; racialized communities; LGBTQ citizens; persons with disability: and women escaping abuse. For minorities who are seeking to rent an apartment in a private housing market, targeted discrimination is severe and significantly limits options and trajectories (Novac et al., 2002). This is because industries such as technology and finance which create spiking house rents in urban areas spread their noxious exclusions based on gender, age markers or ethnicity (Granofsky et al., 202). Such multidimensional systemic barriers are the reason why Indigenous people, for instance, suffer homelessness 9 times more than their non-Indigenous Canadian counterparts across the country.

Mental Health Struggles & Addictions

Childhood abuse, exposures to extreme stress and adverse events that overwhelm available social supports heighten risks for later life housing instability through associated coping attempts via dissociation, self-medication and escapism (Kirst et al., 2017). Without adequate community mental health resources, the traumas and grief over losing permanent homes frequently trigger or compound emotional struggles for those rendered homeless (Stergiopoulos et al., 2018).In a national survey, nearly 40% of homeless individuals self-identified mental health issues as their primary problem while 27% highlighted alcohol dependencies and 15% drug abuse.

Family Violence and Breakdown

For women and children fleeing domestic abuse, family violence frequently acts as the proximal trigger event leading to cycles of housing disruption and homelessness (Van Berkum & Oudshoorn, 2015). Nearly 7 in 10 women staying at emergency shelters report leaving homes to escape intimate partner violence, sexual abuse or similar family trauma. With women accounting for 27% of Canada’s total homeless population, and homelessness increasing faster among women versus men over the past decade, intimate partner violence has emerged as a leading contributor to contemporary housing loss trends (Van Berkum & Oudshoorn, 2015).

Consequences of Homelessness

Besides, beyond these underlying drivers, homelessness is also devastating at individual to societal levels. Individuals who suffer from homelessness have significantly elevated risks for physical illness, mental health disorders, violent assaults and loss of financial opportunities compared with the rest of society (Fazel et al., 2014). Limited capacities to accumulate property, keep good hygiene during illnesses, sage when sick and eat healthy foods or establish treatment spatial organisation features heighten declines in health. Throughout society, there is concentrated use of high-intensity crisis services, such as emergency rooms, hospitals courts jails and temporary shelters for those people

Research problem: Lack of affordable housing, mental health/addiction issues, lack of support services

Research questions:

What are the main drivers of homelessness in Canada?

What interventions are effective in reducing homelessness?

Scope of literature review:

The scope of the literature reviewed encompasses scholarly peer-reviewed studies and governmental reports focused specifically on homelessness within the Canadian context over the past decade. To ensure currency, articles published from 2012-2022 were included from databases like PubMed, PsycInfo, and the Canadian Public Policy Collection. Both academic studies and grey literature reports were deemed relevant to incorporate empirical research on drivers of and policy solutions to homelessness alongside applied insights on existing programs, frontline needs and recommendations. however, news reports, opinion pieces or studies centred on non-Canadian populations were excluded given the focus on synthesizing recent evidence directly about the unique dynamics, trends and interventions surrounding homelessness domestically. Word limits necessitated concentrating on literature illuminating local specifics rather than broader international or historical perspectives.

Search Methodology

Keywords

• Keywords used: homelessness, Canada, affordable housing, emergency shelters, mental health, addiction, interventions

The literature search utilized keywords including: “homelessness” OR “housing loss” OR “shelters” AND “Canada” OR “Canadian”. Additional terms like “affordable housing” “mental health” “addict*” “supportive housing” and “emergency shelters” were incorporated for supplementary searches.

Resources

The databases that were searched for resources were PsycINFO, PubMed, ProQuest, Google Scholar, and Canadian Public Policy Collection due to their vast compilations of academic works that have undergone peer review in addition to government and policy publications that are pertinent to the study objectives.

Initial Search

Over 800 first results were obtained using the primary keyword string for homelessness AND Canada/Canadian. Filters were utilized to restrict the publication of articles that were published between 2010 and 2022, had full-text availability, were in English, and had a Canadian context to narrow down this wide reach. As a result, 530 articles were left in the candidate pool.

Inclusion/Exclusion Criteria

Abstracts were reviewed applying the following inclusion criteria: 1) topics explicitly addressing drivers, consequences and solutions for homelessness in Canada; 2) based on systematic data using surveys, administrative data analysis, interviews, ethnographies or experiments. Exclusion criteria removed theoretical discussions, international studies, opinion pieces or historical analyses without clear connections to contemporary Canadian homelessness.

Revised Search

Incorporating additional keywords on specific sub-topics (affordable housing, mental health, emergency shelters etc.) and restricting to academic journals increased specificity relevant to the focused research questions. With the expanded term list and journal limit, the revised search yielded 301 results meeting outlined inclusion/exclusion criteria.

Article Review

Abstracts for the 301 articles were assessed for substantive quality, depth of analysis on Canadian homelessness and empirical contribution. 142 studies provided sufficiently robust and current data across a mix of academic scholarship and applied policy literature. 12 pieces spanning systematic reviews to front-line observations were ultimately selected for closer full-text analysis to incorporate a breadth of empirical evidence and practitioner insights.

Source Evaluation

Selection emphasized scholarly peer-reviewed work to ensure methodological rigour alongside governmental reports directly informing policy options. For analyzed sources, multidisciplinary authorship and triangulating findings established higher credibility. Qualitative richness came from participatory studies incorporating lived expertise.

Data Selection Discussion

The literature search revealed intricate policy constraints about homelessness, evaluated housing models and clarified multi-level risk factors. It was possible to incorporate both breadth and depth of evidence by focusing analysis on seminal systematic inquiries, key annual governmental overviews, and specific qualitative accounts. The distinct dynamics of the Canadian setting were made more particular by excluding findings from other countries. Maintaining focus on capturing local heterogeneity within subgroups is important.

CHART

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Article Analysis

Article 1

Gaetz, S., Gulliver, T., & Richter, T. (2014). The state of homelessness in Canada 2014. Canadian Homelessness Research Network.

This widely cited report from eminent Canadian experts on homelessness offers combined quantitative and qualitative information on the country’s 2016 homelessness numbers, causes, and legislative solutions. Uniquely thorough insights are produced by fusing data from service providers, surveys, interviews, focus groups, and national shelter utilization statistics. Key conclusions include recommendations to shift from emergency stopgap services to permanent supportive housing models and prevention, as well as assessments showing that structural reasons such as overpriced housing, rather than individual situations, are the fundamental causes of homelessness. This is incredibly helpful for studying national patterns in homelessness because of the linked data sources and reputable authorship. The constant emphasis on recommendations based on data is a plus. Given that it is a government report, it may have some bias in the way it presents problems and potential solutions related to current policy objectives.

Article 2

Piat et al., (2015). Pathways into homelessness: Understanding how both individual and structural factors contribute to and sustain homelessness in Canada. Urban Studies, 52(13), 2287–2305.

This empirical paper uses qualitative interviews with currently and formerly homeless people to build life trajectory narratives that identify both personal factors as well systemic ones, underlying unstable housing. Structural forces including poverty, unaffordable housing and institutional breakdowns contextualized whilst maintaining the above proximal triggers like trauma, family instability and mental health issues vulnerabilities. The ability to obtain qualitative insights at such depths benefits this in an enormous way for humanizing homelessness pathways. With little demographic diversity, the sample is a minor weakness.

Article 3

Aubry, T., Nelson, G., & Tsemberis, S. (2015). Housing First for people with severe mental illness who are homeless: A review of the research and findings from the at-home—Chez soi demonstration project. The Canadian Journal of Psychiatry, 60(11), 467-474.

Analyzing the securing of outcomes following the landmark At Home/Chez Soi Housing’s first randomized trial for homeless with mental disorders provides evidence on interventions. Findings show housing first strategies had of 97% retention rate over two years along with improvements in all quality life measures assessed. Because this is the largest sampling of its kind worldwide, these findings powerfully support focusing on placing homeless mentally disabled individuals in rapid permanent housing sans barriers or conditions. No significant limitations were found.

Article 4

Kozloff, N., Adair, C. E., Palma Lazgare, L. I., Poremski, D., Cheung, A. H., Sandu, R., & Stergiopoulos, V. (2016). Housing first for homeless youth with mental illness. Pediatrics, 138(4).

This grey literature consultation report describes current programs and housing access/coordination of care barriers in Northwestern Ontario, which are further used to formulate targeted recommendations based on frontline needs. Recognition of such difficulties as shortages of supportive housing units, gaps assisting Indigenous persons and system silos would give practical guidance for the remote environment. Collaborative writing between policy specialists and community organizations also helps implementation. Caution is thus required when generalizing because findings at the local level may not necessarily extend nationally.

Article 5

Gaetz, S., Barr, C., Friesen, A., Harris, B., Hill, C., Kovacs-Burns, K., … & Marsolais, A. (2012). Canadian definition of homelessness. Toronto: Canadian Observatory on Homelessness.

This introductory report was the first standardized Canadian definition that separated important homelessness typologies. Distinguishing chronic, episodic, transitional and provisionally accommodated categories of housing loss allows more detailed tracing of trends and treatment needs. Conceptual clarity also helps appropriately target support because chronic rooflessness demands more intense interventions compared to transitional risks. Not only do the concepts need continuous operationalization but they also serve as important points of reference for homelessness research and practice in Canada.No notable weaknesses were found.

Article 6

Poremski, D., Woodhall-Melnik, J., Lemieux, A. J., & Stergiopoulos, V. (2016). Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless. Journal of urban health: bulletin of the New York Academy of Medicine, 93(1), 96–108. https://doi.org/10.1007/s11524-015-0012-y

This qualitative study focusing on the social determinants perspective investigates difficulties in obtaining cost-effective housing and income support among mentally ill homeless people. The dominant themes reflect attitudinal, program policy and coordination barriers that persist in blocking access to secure homes or benefits. The recommendations include increasing flexible financial supplementation, linking housing to relevant supports and eliminating stigma. Subtle lived experience narratives offer attractive support for reforms. This constituted potentially limited generalization as a focused geographical setting despite likely shared concerns across urban Canada.

Article 7

Y-Foundation. (2017). A home of your own: Housing First and ending homelessness in Finland.

In addition to studying mainstream interventions in Canada, exploring effective permanent supportive housing programs globally points to valuable innovations worth localization. For instance, Finland’s “Housing First” model which provided independent affordable housing coupled with mental health/substance abuse rehabilitation is known to have reduced national homelessness by over 35% within a decade (Y-Foundation, 2017). The essence of Finnish success revolved around housing as a basic unconditional right and psychosocial support as abundant and optional highlighting the policy priority paradigm shift that seems to have far-reaching implications for Canada’s response.

Article 8

Eberle, M. P. (2001). Homelessness causes & effects, Vol. 2: A profile, policy review and analysis of homelessness in British Columbia. Ministry of Social Development & Economic Security.

An extensive review by the BC provincial government places the spotlight on the fundamental state of the issue of homelessness in every aspect of policy responses to the drivers of homelessness across this province. Based on 60% of the homeless population in the province being in Vancouver, this research document which was published in 2001 provides a systemic picture of this regional profile evidencing this region’s constraints such as reduced housing supply, high living cost and urban redevelopment. Consequently, Eberle suggests that investments into permanent supportive housing programs and long-term labour regulations allowing for delays in conforming to standards to address existing disparities should be considered as possible remedies to deploy resources and infrastructure which can solve currently occurring overload.

Critical Analysis

The reviewed literature reveals four predominant interrelated themes surrounding persistent homelessness in Canada: lack of affordable housing, mental health and addiction struggles, unemployment and income precarity, and shortfalls in support services.

Lack of Affordable Housing

The most widely cited driver of homelessness across the literature is the severe shortage of affordable rental housing in Canadian cities (Gaetz et al., 2012). With the drastic imbalance between stagnant low incomes and soaring rental costs, even minimally adequate housing grows increasingly out of reach for average Canadian households, let alone those on social assistance or disability support (Poremski et al., 2016). Social housing pressure is exacerbated by precarious macro-economic trends such as the proliferation of temporary and contract work, that concentrate families in unaffordable or unsafe overcrowded rental situations (Granofsky et al., 2021). However, others point out that solving housing supply issues by themselves without increasing incomes is not enough to get rid of homelessness (Gordon 2020).

Mental Health and Additions

Once destabilized, recurrent cycles of home loss can lead to the emergence of mental health illnesses and substance use disorders as contributory factors (Aubry et al., 2015). Even though emotional difficulties and dependencies frequently arise as a result of systemic stresses in life or trauma experienced as a young kid, they can also destroy relationships, jobs, and internal resources needed to secure housing if sufficient external supports are not provided (Piat et al, 2015). Expanded housing first facilities that prioritize quickly rehousing individuals in crisis must be paired with suitably staffed community-based mental health, trauma, and addiction treatment programs for policy solutions to be effective (Stergiopoulos et al., 2018).

Unemployment and Income Precarity

Other incomes that are either insufficient or not evenly available also play a key role as drivers of housing instability (Gordon, 2020). The effects of cuts in social assistance rates, barriers to disability aid and a shift towards fluctuating low-income employment without protection lead vulnerable people to struggle to afford or retain tenancy. Increased inequality gaps in housing between Canadian communities support why without efforts to foster economic inclusion and resilience through stable employment or alternative income a mere increasing the number of homes fails (United Way Toronto, 2018).

Perspectives and Debates

The reviewed literature includes views spanning scholarly work based on empirical data collection, applied reports that directly impact front-line programs and policies as well as selected participatory studies featuring relevant narratives from those with lived expertise. Differences emerge across disciplines, methodologies and regional foci but prominent disputes focus mainly on the significance of diverse interventions rather than disagreement regarding the basic reasons behind housing losses. The vast majority of researchers agree that the absence of affordable housing is arguably a leading systematic impediment behind modern-day homelessness in Canada. (Gaetz et al., 2014). Yet dissent focuses on whether the housing supply is addressed as a stand-alone solution without necessary simultaneous action to increase employment and income support, especially for multiple structurally marginalized groups.

Gaps in Support Services

Lastly, inadequate emergency shelter facilities that are fragmented transitions for discharges from hospitals prisons or transitional housing missed chances to prevent loss of initial housing and gaps at coordinating healthcare with social supports all restrict system capacities to help vulnerable groups before or after homelessness incidences (Kozloff et al., 2016). As a result, widely repeated appeals call for improved infrastructure around low-barrier transitional facilities and meaningful discharge planning processes that promote early intervention and prevention programs coordinated across employment sectors healthcare and housing sectors respectively (Forchuk et al., 2016). Differences mostly stereotype what aspects are to be prioritized in the first place within a local contextual framework, but as broad-based consensus can attest much homelessness is underpinned by systemic housing deficit alongside income insufficiency and personal vulnerabilities (Gaetz et al., 2014).

Logical Flow

However, a broad agreement is that the problems of varying systemic housing deficiencies; income discrimination and access inequities, weak social security establishment and personal perils compounding with press up to homelessness are multidimensional interdependencies across much of the literature (Aubry et al., 2015). One by one, the presentation of findings flows according to a logical structure that would reveal how wider societal or policy lacunae about unaffordable urban housing markets, shifts towards precarious low-wage employment and workforce exclusions create an amenable framework for morbid conditions concentrated among already fringe groups (Gaetz et al., 2014). Accordingly, case studies and structural interventions plan a single narrative arc revealing the need for sustainable policy solutions which intensify affordable housing availability long term with economic inclusion emergency response capacity and accessible health/social services in conjunction while addressing community-related barriers between racialized minorities and women escaping abuse Indigenous groups.

Conclusion

In reviewing the current literature on homelessness in Canada, lack of affordable housing emerges as the predominant systemic driver, with income precarity, mental health and addictions, and gaps in support converging to create an ongoing crisis (Gaetz et al., 2014). Costs to individuals and society are severe. While differences exist around prioritizing interventions, consensus recognizes the need for long-term, coordinated policies expanding housing availability, economic inclusion, health/social services and emergency response capacities in parallel (Aubry et al., 2015). Certain limitations pervade current discourse. Most studies concentrate within the largest urban centres, hindering generalizability to medium-sized, remote or Indigenous communities despite their disproportionate burdens. Similarly, longitudinal inquiries tracing the long-term impacts of specific policy innovations are scarce. Embracing diverse methodologies from ethnographies enriching cultural perspectives to randomized interventions assessing new models would strengthen validity (Stergiopoulos et al., 2018). While there persist differences for particular mechanisms, scheduling and resource allocation, a review of the current evidence brings political consensus around the need for expanded funding of permanent supportive housing programs because they have proven to be effective in their local implementation (e.g. Finland).

Lastly, translating academic findings into community-centred actions remains vital going forward. Accordingly, areas warranting elaboration via future homelessness inquiries include: 1) Investigations explicitly focused within rural regions and Indigenous contexts 2) More participatory research co-designed with those experiencing housing loss first-hand 3) Long-term follow-up evaluations of housing and income policy impacts and 4) Enhanced knowledge exchange processes to amplify interpretations, recommendations and voices from lived experience in all phases. Addressing such gaps will further progress towards the shared goal among all stakeholders— communities where everyone can access affordable, appropriate and stable housing. ‘

References

Aubry, T., Nelson, G., & Tsemberis, S. (2015). Housing First for people with severe mental illness who are homeless: a review of the research and findings from the at-home—chez soi demonstration project. The Canadian Journal of Psychiatry, 60(11), 467-474.

Echenberg, H., & Jensen, H. (2012). Defining and enumerating homelessness in Canada. Montreal: Library of Parliament.

Fazel, S., Geddes, J. R., & Kushel, M. (2014). The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations. The Lancet, 384(9953), 1529-1540.

Forchuk, C. (2011). Homelessness, housing, and mental health: finding truths, creating change. Canadian Scholars’ Press.

Frankish, C. J., Hwang, S. W., & Quantz, D. (2005). Homelessness and health in Canada: Research lessons and priorities. Canadian journal of public health, 96(Suppl 2), S23-S29.

Gaetz, S., Gulliver, T., & Richter, T. (2014). The state of homelessness in Canada 2014. Canadian Homelessness Research Network.

Gaetz, S., Barr, C., Friesen, A., Harris, B., Hill, C., Kovacs-Burns, K., … & Marsolais, A. (2012). Canadian definition of homelessness. Toronto: Canadian Observatory on Homelessness.

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Gordon, D. M., Bowles, S., & Weisskopf, T. E. (2020). Beyond the wasteland: A democratic alternative to economic decline. Verso Books.

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Kirst, M., Zerger, S., Misir, V., Hwang, S., & Stergiopoulos, V. (2015). The impact of a Housing First randomized controlled trial on substance use problems among homeless individuals with mental illness. Drug and alcohol dependence, 146, 24-29.

Kozloff, N., Adair, C. E., Palma Lazgare, L. I., Poremski, D., Cheung, A. H., Sandu, R., & Stergiopoulos, V. (2016). Housing first for homeless youth with mental illness. Pediatrics, 138(4).

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Poremski, D., Woodhall-Melnik, J., Lemieux, A. J., & Stergiopoulos, V. (2016). Persisting Barriers to Employment for Recently Housed Adults with Mental Illness Who Were Homeless. Journal of urban health: bulletin of the New York Academy of Medicine, 93(1), 96–108. https://doi.org/10.1007/s11524-015-0012-y

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Stergiopoulos, V., Gozdzik, A., Misir, V., Skosireva, A., Connelly, J., Sarang, A., … & McKenzie, K. (2015). Effectiveness of housing first with intensive case management in an ethnically diverse sample of homeless adults with mental illness: A randomized controlled trial. PLoS One, 10(7), e0130281.

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Van Berkum, A., & Oudshoorn, A. (2015). Best practice guideline for ending women’s and girl’s homelessness. All Our Sisters.

Y‐Foundation, A. (2017). A home of your own: Housing First and ending homelessness in Finland.