Shelters and Public Health: A Winter Institute Final Report

Publication Summary

Hosted by the National Collaborating Centre for Infectious Diseases (NCCID), Shelters and Public Health: A Winter Institute (the Winter Institute) brought together over 100 community experts, policy makers and public health personnel from Northern Alberta, Saskatchewan, Manitoba and Northwestern Ontario, to explore the potential for partnerships between shelters and public health.

NCCID designated this region for the project because this part of Canada is not represented widely in national literature around houselessness and because the region shares relevant characteristics, such as climate, geography and dispersed communities. The event was held in Winnipeg and started at noon on Tuesday, February 7 and concluded at mid-day on Thursday, February 9, 2023. The event included plenary presentations, concurrent sessions and facilitated small group discussion groups to encourage information sharing, relationship building, and applying the presentations to participants’ work contexts.

The agenda for the gathering was informed by the engagement process NCCID held over the fall months leading up to the Winter Institute (more below). Shelter leaders raised some key issues and themes to address, and these were reflected in plenary presentations for the whole group. The concurrent sessions were around more specific topics that came up during the consultations. Participants brought high energy to the event; they were very engaged in discussion, in meeting others, and sharing information and working towards finding ways to better serve their communities. Given that the participants represented many different sectors and geographical locations and that many did not know each other beforehand, the buzz of conversation was notable during breaks and discussion groups.

Some of the key highlights:

  • 100% of the participants indicated that this is the first time they have participated in a meeting like this, to discuss connections between public health and shelters.
  • Public health could and should be “on the ground” more, spending more time in shelters and speaking with staff and directors to learn what is needed. At the same time, public health is not funded adequately, faces staffing shortages, and is often prioritized after acute health care units.
  • Partnerships between shelters and public health do happen, often with results that have improved the health of people who use shelters, and we can learn from these examples. In particular, the response to the COVID-19 pandemic often led to increased connections and conversations between shelters and public health.
  • Cross-sector and jurisdictional collaboration are essential to dismantle the “silos” of health and social services to better meet the needs of people who use shelters. Entrenched systemic inequities, stigma, discrimination and racism, and general health care shortages all contribute to barriers to care and shelters “stepping in” to provide care “on the frontlines”.
  • The demands and stress on shelter staff, who often work for low pay without benefits, to meet the needs of people who use shelters must be recognized and planning must take into consideration the wage disparities between shelter and public health staff.
  • Participants reiterated the need for continued conversations and connections between shelter staff and leadership and public health policy makers and personnel. Some suggestions identified to move this process forward were to develop a regional network, with shelters and public health, as well as offer opportunities for the groups to meet separately, and platforms on which to share information and network.
  • Culturally safe, trauma-informed and harm reduction-oriented health care are all foundational to create services that welcome people who use shelters and provide care rooted in respect, dignity and to dismantle systemic inequities and violence.