March 28, 2023
Presenters: Susan Snelling, NCCMT
Margaret Haworth-Brockman, NCCID
Adina Lakser, NCCID
The role of public health working with shelters
serving people experiencing houselessness

Welcome!
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• Participants panel

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4
National Collaborating Centres

Session Outline
• Introduction to the Shelters and Public Health Project
• Overview of a rapid scoping review on the role of public health
working with shelters serving people experiencing houselessness,
completed in 2022. https://www.nccmt.ca/rapid-evidence-service/48
• Overview of NCCID’s consultations & Institute that explored
opportunities to improve communications and programming that work
for shelter clients and shelter staff.
• Discussion: What are the possibilities for increased collaboration
among public health and shelters?

Thinking about people’s mobility has been a
“lens” for NCCID for some time
• Newcomers to Canada
• Mobility and movement of populations within
Canada
• Movement in and out of certain facilities
NCCID, Shelters, and Public Health

We intend this to be a multi-year exploration
Our guiding principles are intended to ensure that we
put people first:
• Our primary interest is in the people who make use of shelters and the staff and
volunteers who provide services
• Shelters may not agree that public health is a suitable partner. We take our lead
from staff at shelters about where public health may be able to contribute.
• Public health personnel may already have good relationships in the community,
and can share knowledge and practices with each other
• Activities will explicitly include learning from and working with First Nations,
Métis and Inuit community experts and leaders
• Systems and structures (political, economic and governance) can be changed to
improve health equity for shelter clients, staff and volunteers.
NCCID, Shelters and Public Health

Focus of the Rapid Scoping Review
What is known about the role of public health
in working with shelters serving people
experiencing homelessness?

Search Strategy
Sources: Medline, OVID Emcare, Sociological Abstracts and grey
literature
___
Population: People experiencing homelessness who use shelters;
People involved in shelters, including staff, medical
personnel, volunteers
Concept: Partnerships and relationships between shelter staff or
organizations and public health personnel or organizations.
Context: Shelters; Shelter programs run outside of shelters, e.g.,
through street outreach

Search Results
Found n=52; 11 syntheses and 41 single studies.
Major Topic # Syntheses # Single Studies
Model of care for public
health/shelter partnership
4 7
Dental health 3 6
COVID-19 1 8
STBBIs 1 5
Tuberculosis 1 5
Other infectious diseases 1 3
Mental health and
substance use
0 5
Health promotion 0 2
TOTAL 11 41

Findings: Public Health Topics
Dental
Infectious diseases
• COVID-19
• STBBIs
• Tuberculosis
• Other
Mental health and substance use
• Tobacco
• Working with shelter staff
Health Promotion

Findings: Public Health Approaches
Prevention
Screening and Testing
Health promotion and education
Harm reduction
Infection prevention and control
Outbreak management
Immunization
Treatment
Capacity building; Policy development

Findings: Partnerships
Multi-partner
collaborations
to
One-offs

Limitations
What’s
missing?

Scoping Review Take-aways
• Variety of:
• Topics
• Approaches
• Models of care/ways of partnering between shelters and public health
• Collaborative models follow good public health engagement practices
• Opportunity for more intentionality about equity

Engagement with Shelters:
• Reached out to shelters in Fall 2022
• Identified 35 shelters in region to contact
• 20 shelter leaders participated in 6 panel
discussions
• Panel discussions included questions about
connection to public health, key health
issues, and suggestions for working together
Planetware.com

Engagement with Public Health:
• Conversations with 17 public health professionals
(Medical Officers of Health, Program Managers,
Public Health Nurses, etc.) in the region
• Discussed experiences working with shelters, gaps
and opportunities for further partnerships, topics of
interest for Institute

Objectives:
v To explore the possibilities of partnerships between shelters and public health.
v To learn about building successful, respectful partnerships
v To understand some of the public health and healthcare needs of shelter clients.
v To spark discussions towards essential elements for shelter and public health
collaborations that can improve the health of shelter clients.
Winter Institute 2023
Format was a mixture of plenary sessions, concurrent sessions and facilitated small
group discussions.
We based our event on the many topics that emerged from the consultations.
• February 7-9, 2023 in Winnipeg
• 114 registrants including shelter leadership and staff, public health personnel,
policy makers, and staff from government and community organizations from
Manitoba, Saskatchewan, Northern Alberta and Northwestern Ontario.

NCCHPP
PATHS
SASKATCHEWAN HEALTH AUTHORITY
SHELTER HOUSE
THUNDER BAY DISTRICT
HEALTH UNIT
ISLAND HEALTH
Shelters and Public Health 2023
NCCEH
MAIN STREET PROJECT
SILOAM MISSION
MANITOBA HARM REDUCTION
MIMO PIMATISIWIN
KA NI KANICHIHK
FIRST NATION HEALING CENTRE
MB HEALTH
FIRST NATIONS HEALTH & SOCIAL SECRETARIAT
1JUST CITY
NORTHERN INTER-TRIBAL HEALTH
SASKATCHEWAN HEALTH AUTHORITY
MANITOBA HARM REDUCTION
NORTHEN HEALTH REGION
NCCDH
STREEET CULTURE PROJECT
SK MINISTRY OF HEALTH
NCCIH
PEACE RIVER REGIONAL WOMENʼS SHELTER
GRAND PRAIRIE YOUTH EMERGENCY SHELTER SOCIETY
WAPITI COMMUNITY SUPPORT ASSOCIATION
ALBERTA HEALTH SERVICES
UNIVERSITY OF ALBERTA
BOYLE STREET COMMUNITY SERVICES
EDMONTON SOUTHSIDE PRIMARY CARE
RED LAKE EMERGENCY SHELTER
KENORA HEALTH DISTRICT
CDN MENTAL HEALTH
NORTHWESTERN HEALTH UNIT
NʼDINAWEMAK
ASSEMBY OF MANITOBA CHIEFS
KATRIME INTEGRATED HEALTH
FNIHB
MB HEALTH
WPG REGIONAL HEALTH AUTHORITY,
U OF MANITOBA
PHAC, NCCID
NCCMT

Winter Institute highlighted:
• Still many gaps in health care for people who use shelters: oral care, foot
care, mental health, dental, safer drug use
• Shared approaches to care (cultural safety, trauma-informed, harm reduction)
is a strong foundation for partnerships
• Staff burnout and turnover is an issue both in shelters and in public health
• Attendees at Institute expressed strong interest to keep the conversations
and connections going
• Exploring options for future meetings (Regionally? Online? By sector? Cross-
sector?)

Q&A; Discussion
What are the possibilities for increased collaboration
among public health and shelters?

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Thank You!
For more information:
NCCMT website: www.nccmt.ca
Contact: nccmt@mcmaster.ca
NCCID website: www.nccid.ca
Contact: nccid@umanitoba.ca