Caring for vulnerable children starts with caring for parents

Posted on July 9, 2017 in Social Security Delivery System – Opinion/Editorials – Ontario’s health ministry should acknowledge, and act on, more accurate data on homeless births.
July 9, 2017.   By

Ensuring that pregnant women receive the care they need should be a priority of any health care system.

But some of the most vulnerable pregnant women in Toronto, those who are homeless, do not disclose the extent of their challenges because of stigma and fear of losing custody. The result is that births by homeless women are vastly underestimated in the provincial health ministry’s official data.

The Star’s Ainslie Cruickshank reported this past week that an estimated 300 babies were born to homeless mothers in the city of Toronto each year between 2012 and 2014, according to experts.

By comparison, the numbers collected by the Canadian Institute for Health Information for Ontario’s Ministry of Health and Long-Term Care, which are based on self-reporting of homelessness in hospital births only, show fewer than eight such births each year.

The size of this discrepancy is enough to sound the alarm. Dr. Ashley Vandermorris, one of the authors of a journal commentary calling for better statistics on homeless births, told Cruickshank that “understanding the magnitude of this issue is the first step” toward finding solutions.

Vandermorris is right. The health ministry cannot hope to provide adequate supports and services to pregnant, homeless women while using data that reaches only a very small portion of this group to inform their efforts.

A ministry spokesperson even acknowledged that the data is flawed due to bias in self-reporting on homelessness, but still defended using the numbers. It is unacceptable for the province to remain willfully ignorant of the extent of this issue, especially when external agencies have offered such divergent numbers.

Part of the solution is for the ministry to pursue more thorough data collection. It should include reports of births by women in shelters, detention facilities and residences — not just hospitals.

But the government’s flawed information on homeless births is not only a problem of inadequate data collection. It is also a symptom of a greater issue: the stigma attached to homelessness which impedes pregnant, homeless women from disclosing their status and seeking support.

Joyce Bernstein, an epidemiologist, told the Star that it’s common for homeless people to attempt to hide their status due to stigma. The fear of losing custody makes the prospect of disclosure even more daunting for pregnant women.

To address the root of this issue the province should make access to housing support more readily available to pregnant women and integrate such services within the health care system to encourage women to reach out rather than conceal their challenges.

There is reason to believe such a strategy will yield good results. Cruickshank reported that a pregnant, homeless woman who received help through a housing support worker was able to find an apartment before her child was born, a positive outcome to a challenging problem.

The province may also look to other programs for vulnerable parents as models for how different kinds of services can be integrated. Programs are available in Toronto and Hamilton, for instance, to expectant parents who are drug users.

A recent series of articles in the Hamilton Spectator found that combining medical appointments related to pregnancy with treatment for addiction made it more likely that the pregnant women would access the right care.

Such programs seem to benefit parents and babies alike. Babies with Neonatal Abstinence Syndrome, which results from exposure to drugs during pregnancy, tend to do well with the right medical attention. A Hamilton hospital with a program for substance using moms reported that about 60 per cent of NAS babies went home with their birth parents in 2014.

The province should aim to better support all vulnerable parents-to-be. To do that, it must first understand the true extent of the issues they face.

Tags: , , , , ,

This entry was posted on Sunday, July 9th, 2017 at 11:00 am and is filed under Social Security Delivery System. You can follow any responses to this entry through the RSS 2.0 feed. You can skip to the end and leave a response. Pinging is currently not allowed.

Leave a Reply