Social issues

Homelessness and health barriers

People who find themselves living on the street face many barriers to obtaining health care and medications prescribed for them. In a survey of 156 residents of the two largest men's shelters in Toronto, researchers found that residents of the shelter which did not automatically pay for drugs, were significantly less likely to fill prescriptions than residents of another shelter which did provide automatic coverage.

Of those who did not fill their prescriptions, 73% cited cost or the lack of drug benefit coverage as the reason. The fact that prescriptions for psychiatric conditions, more common among the homeless, were more likely to go unfilled than those for all other conditions (26% v. 9%) raises further concern about the seriousness of this problem. The authors conclude that automatic drug benefit coverage administered through a shelter could reduce the rate of unfilled prescriptions among homeless people. [CMAJ 1999;160(7):1021-4]

Senior squalor

Although London, Ont. is a wealthy university town, local public health staff and other service providers were so disturbed to find some seniors living in filth that the municipality allocated $25,000 for a two-year Task Force on Senior Squalor. Public health staff have found reclusive seniors living in homes overflowing with garbage amid huge stacks of debris and papers, surrounded by human and animal feces, urine on the floor, soiled bedding and decomposing waste. [CMAJ 1999;161(10):1307]