Tuesday, August 09, 2022

Report shows poisoning behind 25 per cent of unhoused people's ER visits in Alberta

Madeline Smith - Yesterday - EDMONTON JOURNAL

A new report from the University of Alberta’s Injury Prevention Centre is crunching the numbers behind injuries that land people experiencing homelessness in emergency rooms.



© Provided by Edmonton Journal
Laurence Braun-Woodbury poses for a photo near homeless encampments in downtown Edmonton, Friday Aug. 5, 2022. A new report from the University of Alberta's Injury Prevention Centre breaks down what kinds of injuries most often bring unhoused people to emergency rooms across the province.

The analysis of Alberta Health Services data looks at more than 11,600 instances in 2019 and 2020 where unhoused people went to an Alberta ER with an injury. Researchers broke down the causes of those injuries, including poisoning, violence, falls, environmental factors and self-harm.

The leading cause of injury was poisoning, accounting for one-quarter of all ER visits. Those injuries are broadly defined as a case when a substance is taken “incorrectly,” whether that means in combination with another drug that could be dangerous or at a dose that’s too high.

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Opioid poisonings would be included in this category, reflecting the ongoing overdose crisis that kills thousands of Albertans each year, and which street outreach workers have stressed is a serious danger for unhoused people struggling with addictions.

Nearly three-quarters of unhoused people who came to the ER due to poisoning were men, averaging 1,035 visits per year.

Over the time period studied in the report, violence accounted for 19 per cent of the injuries that brought unhoused people to emergency departments, fall-related injuries made up 13 per cent and environmental injuries — like insect stings and exposure to extreme weather — added up to seven per cent of the total.

Injury Prevention Centre associate director Kathy Belton said people living on the streets or in shelters are more at risk for many health issues, and to her knowledge, a specific analysis of their ER visits has never been done in Alberta before.


“Understanding what’s actually happening in this population is the first step in coming up with initiative to address it,” she said.

Belton said the results also raise more questions, like what happened in more than 2,000 documented instances of a patient leaving the ER before their treatment was completed. That category accounts for 17 per cent of the way ER visits ended.

“We don’t know why they left. Was it the fact that they faced stigma? Was it too long in accessing health care? … If they’re leaving in that high of a percentage, then something must be wrong in our ERs that we’re not addressing,” Belton said.


© David Bloom
A homeless man sits in a wheelchair in downtown Edmonton, Friday Aug. 5, 2022. A new report from the University of Alberta’s Injury Prevention Centre breaks down what kinds of injuries most often bring unhoused people to emergency rooms across the province.

The Bissell Centre was also consulted for the injury report, and Laurence Braun-Woodbury, the organization’s director of service integration and advocacy called the results “validating.”

“It confirmed so much of what we see year in and year out as service providers,” he said.

He added stigma and trauma play a role in the difficulty many unhoused people have accessing medical care, and that’s likely a factor for many people who leave an emergency department before their treatment is finished.

But he also has questions about the 61 per cent of ER visits that were recorded as ending with the patient being discharged, and whether those people felt they got adequate care.

Both Braun-Woodbury and Belton underlined the finding that the vast majority of environmental-related injuries were due to cold exposure, resulting in issues like frostbite. Most injuries at a broad scale are preventable, and in this case, Braun-Woodbury said if people had options for safe housing and didn’t feel compelled to sleep rough during the winter, those injuries could be avoided.

“People don’t have to live lives that are vulnerable to these sorts of health crises,” he said.

“This human cost, all this suffering, and systemic cost associated with accessing health services at this scale is ultimately preventable, and can be prevented through tools like housing first policies and supportive housing units.”

masmith@postmedia.com
@meksmith

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