Home Coordinator Dave Jansen, right, and outreach worker Aaron Ostafie, in back, work in the Health Outreach Mobile Engagement (H.O.M.E) bus parked behind Ark Aid Mission, in London, Ont. on Aug. 29. The program provides a mobile response to provide care to marginalized individuals in London.Lindsay Lauckner Gundlock/The Globe and Mail
When a community member who doesn’t have a permanent place to live was diagnosed with cancer, a support worker at the London InterCommunity Health Centre in London, Ont., went to the hospital with them to walk through the facility in preparation for an upcoming chemotherapy appointment. When their treatment begins in the coming weeks, the support worker will be there as an advocate and to help navigate the process.
Now, LIHC staff are working directly with the hospital to help ensure systems are in place to assist other vulnerable patients in accessing the care they need.
And as the number of people living in encampments has grown in recent years, LIHC staff responded by converting an old bus into a mobile clinic to provide health care to some of society’s most marginalized individuals.
These examples give a glimpse into the breadth of services offered by LIHC, one of many community health centres in Ontario that are dedicated to offering health care and other vital services to people experiencing homelessness, refugees, low-income individuals and others who need help.
At a time when millions lack access to primary care and the housing and affordability crises send more people onto the street, advocates and experts say that community health centres can and should be playing a more pivotal role in delivering health solutions.
“We serve people that are largely invisible to lots of people in our community. We quietly go about our work of supporting marginalized communities,” said Scott Courtice, LIHC’s executive director. “We improve people’s health who have access to us and we also save the overall health system a lot of money.”
Ostafie, middle, and Jansen, right, speak with a client outside of the bus.Lindsay Lauckner Gundlock/The Globe and Mail
Community health centres, or CHCs, have been around for decades, providing primary care and other supports, such as counselling for new parents or programs for newcomers to Canada. But the work they do is often overlooked, in large part because many of the people they serve are marginalized individuals, said Shelley Craig, Canada Research Chair in Sexual and Gender Minority Youth at the University of Toronto.
But considering the fallout from the pandemic, which sent many people into poverty and homelessness and also pushed the health care system into crisis, governments should be looking to CHCs to help address some of those problems, she said.
“Those cracks are getting wider,” Dr. Craig said. “This is a time when we actually need CHCs more and we need to help think about ways they can increase their reach.”
Community health workers in Peterborough, Ont., have launched a campaign to bring a CHC there, arguing it would serve 6,000 marginalized individuals who currently lack access to a primary care provider.
Nurse Janelle Calhoun, left, speaks with a client inside the Health Outreach Mobile Engagement bus.Lindsay Lauckner Gundlock/The Globe and Mail
Mr. Courtice said that his organization and others like it have received marginal funding increases in recent years and that the operating budgets have remained largely unchanged for about a decade. He attributes that, in part, to the nature of the work being done by CHCs.
“We stand up for people that are traditionally ignored and marginalized and feared. We do that unapologetically,” he said.
Maxine Stata is one of the individuals who could have fallen through the cracks, if not for her local CHC. Ms. Stata, a 75-year-old low-income individual who lives in Ottawa, was struggling to find a family doctor in the 1990s when she came across the primary care services being offered by the Somerset West Community Health Centre.
While her family doctor has changed a few times over the years, Ms. Stata continues to get health care from Somerset West CHC. And as her needs have become more complex – she has diabetes, is nearly blind and has limited mobility – the team at the CHC has adapted to those changes, offering her in-home visits and access to a specialty diabetes clinic. She even had her income tax prepared for free at the CHC, underscoring that a person’s health is tied to their housing status and financial stability.
“My experience has been that they try to look after the whole person,” Ms. Stata said. “They try to shine a light on the community that they’re serving.”
Maxine Stata stands on her front porch with her dog Edward on Aug. 26, in Ottawa. She has been getting primary care at a community health centre in Ottawa for 30 years.Dave Chan/The Globe and Mail
Suzanne Obiorah, executive director of the Somerset West CHC, said community health centres perform a unique role, focusing on prevention and delivering health care to at-risk individuals where they are. Research shows that CHCs help reduce emergency department visits and save the system tens of millions every year, she said.
Ms. Obiorah said six of Ottawa’s CHCs say an expanded reach would result in improved health for many people in the community. They are advocating for more government funding so they can hire more health care professionals and increase their operating hours to, among other things, serve thousands of additional patients. They also say that a new investment could help them do more outreach work, such as providing health care in shelters.
Jennifer Rayner, director of research and evaluation at the Alliance for Healthier Communities, which represents CHCs, said it’s difficult for community health teams to meet the growing need without more money.
“We keep taking on more and more and the funding just doesn’t keep up with it,” she said.