Housing as Determinant of Health

Introduction

The topic of health for Indigenous people is one that is complex. There are many factors that take effect on their health and well-being, including education, housing, employment, social status, income status and social support systems being just a few. This paper will focus on housing as a social determinant of health.

Housing can include physical dwellings and their conditions, as well as lack of housing, and spiritual belonging. Having proper housing plays a pivotal role in the health of Indigenous men, women and children. The effects of having inadequate housing and homes can be vast and severe in nature, ranging from overcrowding, to physical dangers such as critical repairs needed and poor drinking water, to mental health consequences such as depression and suicide.

Spiritual Homes

The idea of a spiritual home was brought up by Memmot and Chambers (2008, as cited in Christensen, 2016). Spiritual homelessness was referred to as “the collective forms of dispossession and displacement” (Young, 1998, as cited in Christensen, 2016), and explained the disconnect between cultural knowledge, identity and spirituality. Colonization disrupted Indigenous home-making practices by removing children from their homes to attend residential schools, disrupting ancestral lands and forcing the assimilation of their people into the European western way of living.

Exclusionary measures taken by Europeans against Indigenous people had major effects on their health ranging from proximal determinants like housing and poverty to distal effects such as cultural continuity, self-determination and an Indigenous sense of home and belonging (Czyzewski, 2011; Greenwood and de Leeuw, 2012; Reading and Wein, 2009, as cited in Christenson, 2016). Christensen (2016) also adds that “home is not limited to four walls”, and that many Indigenous men, women and children have become “homeless in [their] homeland”.

The feeling of spiritual homelessness compounds the effects of literal homelessness on mental health, exacerbating the instances of depression and suicide among others which will be discussed further in this paper. Over CrowdingInadequate home life can cause a myriad of problems for Indigenous children, who then grow up and have children that they fail to care for, and the cycle of poor health is perpetuated through generations.

The importance of home is often forgotten, and homes become overcrowded due to the lack of housing opportunities in many areas. Often, this is the case because Indigenous people have a harder time finding work because they may be under educated, under qualified, and many face racism as the foremost hindrance. Some may believe that providing a place to stay for friends and family members is beneficial for Indigenous kinship (Christensen, 2016), however the overcrowding of homes often strains an already poor financial situation, causing a loss of home for all members. Mental health can be greatly impacted by these types of living conditions.

A feeling of not belonging, being unsafe, and lacking self-determination can be detrimental to children who may then seek attention elsewhere, become addicted to drugs and alcohol, and as is common in some reserve communities, are more inclined to commit suicide (Chandler and Lalonde, 2008 as cited in Loppie-Reading, 2013). Suicide ideation inflicted nearly 43% of Canada’s Inuit adolescents and young adults (Lehti et al. 2009 p. 1199). As well, the instances of communicable diseases are much higher in overcrowded homes for obvious reasons. Being in such close proximity with other people makes it difficult to avoid catching illnesses such as tuberculosis which is common in many communities (NCCAH, 2009).

According to NCCAH (2009), 26% of First Nations on reserves lived in crowded homes, while 36% of Inuit people did, and 40% of the Inuit in Nunavik lived in crowded dwellings. Homelessness in Northwest TerritoriesWhile Christensen (2016) examines the cases of homelessness in the Northwest Territories, the overall picture that is painted stretches across most, if not all of Canada. According to Julia Christensen (2016), homelessness was uncommon in the Northwest Territories before the late 1990’s, and by 2008, 5% of the population was homeless, with Indigenous people accounting for 90-95% of that statistic.

These numbers were based solely on reports from homeless shelters, and do not account for any individuals who did not seek shelter at a public facility but rather stayed in the street or sought shelter with friends or family. A staggering report also showed that 50% of all children in foster care were Indigenous, though Indigenous children only account for 5% of the child population in the area (Christensen, 2016). This shows that the trend of Indigenous homelessness begins in early childhood.

Physical Homes

Physical housing situations are dire in many reserve communities. According to the NCCAH (2009), 28% of Indigenous people live in homes requiring repairs, leaving obvious room to believe there is a physical danger to being in these homes. Many of these homes also do not have access to clean, safe drinking water, many are without electricity and many are infected with molds which can cause many health problems (NCCAH, 2009).

Chronic illness is common in such communities due to these conditions, including many breathing disorders and allergies due to the mold issues and are perpetuated by the fact that they are not within a close proximity to services such as health care, grocery stores with adequate and healthy foods or water and sewage facilities which create sanitation problems in the inner and outer home environments. A lack of funding and help from the government makes it quite difficult to try to improve these conditions.

Conclusion

There is a vast need for change in Indigenous communities on and off reserve when it comes to housing and home situations. The dire mental health effects are critical to the well being of the Indigenous people, but there seems to be no accessible services to help combat these issues. While attempting to create a plan to aid these communities, it is important to consider that Nelson (2017) stated “Much of the mental health research reviewed in this paper describes and advocates for the process of integrating Indigenous methods of healing into the system of mental health services”.

Indigenous people are best to take point on these types of issues as they are better able to see and understand the problems at hand and may better know how to go about dealing with them at their core. However, this also requires collaboration between the federal government and Indigenous communities (Loppie-Reading, C. 2013).

The NCCAH states that “Investing in sustainable housing and infrastructure is essential to reducing Aboriginal health disparities”. They also suggest that the funding should be in conjunction with the growth and costs of construction, and again that self-determination is vital, that Indigenous people should control the housing plans (NCCAH, 2009). There can be no solution to the ongoing problem of housing for Indigenous people, and the effects it has on the health of those affected unless the government and all communities can join and work together to solve them.