Author: Emily Holton

Think the Philippines and Russia. Now think Portugal and Mexico.

The former two have made headlines for their violent, often extrajudicial anti-drug user regimes, while the latter pair have been praised for their forward-thinking policies. But there are many more countries in the world whose approaches toward people who use drugs have not been scrutinized so publicly or thoroughly.

On March 27, the Centre on Drug Policy Evaluation (CDPE), based in Toronto, Canada, launched an interactive map to promote this further scrutiny.

Using data from the United Nations Office on Drugs and Crime on 44 countries (so far), the Drug Policy Metrics Map breaks down how governments around the world manage, police and support people who use drugs. The wealth of data on many metrics—organized in broader categories including Health, Peace & Security, Development, Human Rights, Demand Reduction, Supply Reduction and International Cooperation—allows readers to compares governments’ policies with their outcomes.

When Jason Smith found himself at Toronto’s Good Shepherd Ministries in 2016, he was just looking for a place to stay. Instead, he found a program that would help get his gambling under control—and his life back on track

Led by Dr. Flora Matheson, a scientist at MAP Centre for Urban Health Solutions at St. Michael’s Hospital who researches socially marginalized groups, the shelter’s Gambling Addictions Program is one-of-a-kind. The pilot project offers individual counselling, client-centred case management and a life-skills group that focuses on issues related to gambling. For some, the goal is to stop gambling altogether, and for others, it’s to reduce their behaviour and manage their spending.

For Smith, the program worked. He’s now living in a sober living house and has a job. He’s getting his G2 driver’s license in a few weeks, and moving into his own place with his sister in the fall. The Gambling Addictions Program helped him take his life back.

Dr. Flora Matheson was looking into the link between gambling and homelessness but there were no Canadian data, except one study out of Quebec.

“There wasn’t a lot of (research) out there, but to me it intuitively made sense there would be a link,” she says. “I thought, ‘This looks like a hidden population and we’re not talking about it.’”

So in 2013 she reached out to Good Shepherd Ministries on Queen St. E., which provides services to the homeless, to ask about their clients’ experiences with gambling. Staff had no idea how widespread the problem was because they didn’t ask about gambling. Like most shelters, the focus was on drug and alcohol addiction.

That led to a joint study by St. Mike’s and Good Shepherd. Researchers and staff interviewed 264 people at the shelter, mostly men, and discovered that 35 per cent had a problem with gambling, compared with 0.6 to 4 per cent in the general population. 

“I was shocked,” says Aklilu Wendaferew, assistant executive director of Good Shepherd Ministries. “I was surprised the problem was so wide within the population we serve…. (It) was an emerging need that needed to be addressed.”

Jonathon Maguire is the new Lawson Chair in Patient Engagement in Child Nutrition at the University of Toronto.

Maguire, an associate professor of paediatrics and nutritional sciences at U of T and a staff pediatrician and scientist with St. Michael’s Hospital at Unity Health Toronto, will hold the chair over a five-year term through the Joannah & Brian Lawson Centre for Child Nutrition.

“I’m very grateful to the university and the Lawson Centre for choosing to support patient engagement in the research process,” says Maguire. “It’s forward-thinking because it will enable children and families to co-design research with us and help us produce results that are most meaningful to them.”

The longest running study of its kind on the “Housing First” model has found that it significantly reduces homelessness over the long term compared to treatment as usual, according to a study published in The Lancet Psychiatry by scientists at the Centre for Addiction and Mental Health (CAMH) and St. Michael’s Hospital.

“The Housing First model results in a lasting and significant increase in the rate of days stably housed per year,” said lead author CAMH Physician-in-Chief Dr. Vicky Stergiopoulos. “We now have evidence that we can offer to policy makers, clinicians and other stakeholders about solutions to chronic homelessness for people with mental illness.”

Housing First provides immediate access to rent supplements and mental health support services to people who are homeless and have a mental illness. Traditional models require homeless people to stop using substances or receive psychiatric treatment before being eligible for housing support services.

This study published in The Lancet Psychiatry, which followed participants over a six-year period, is the first to show that Housing First continues to be significantly more effective than treatment as usual in the longer term, especially for those with high needs for mental health support services. After 6 years, that group had stable housing an average of 85% of the time in the previous year compared to 60% for the treatment as usual group.

“These results show that if we choose to do so, we can end chronic homelessness in a way that is life-changing for individuals and enormously beneficial for all of society,” said Dr. Stephen Hwang, Director of the MAP Centre for Urban Health Solutions at St. Michael’s Hospital, where the study was conducted.

Over the last 20 years, James Dunn’s research has revealed clear relationships between inequality in cities and people’s health. Working with communities in southern Ontario and beyond, he has explored how housing, economic inequality and attributes of neighbourhoods affect residents’ mental and physical health.

“People’s income and other socio-economic conditions are incredibly important to their health — and way more actionable than we’d like to believe,” says Dunn, whose background in urban geography and social epidemiology is well-suited to the study of urban health equity.

One in six women in fracture clinics around the world has experienced intimate partner violence, but screening for such abuse remains scarce.

MAP Centre for Urban Health Solutions has partnered with the Fracture Clinic at St. Michael’s Hospital to design and implement an electronic screening application for intimate partner violence that can be used within and beyond the hospital.

“We talked to women who had either lived with or were living with partner violence and we kept hearing them say that they realized too late in their relationship that they were living with unsafe behaviours,” said Dr. Patricia O’Campo, scientist at MAP, and co-lead on the development of the app.

“They wished they had known earlier that there were red flags. That’s where the initial idea to put screening into women’s hands came from.”

Eight researchers at MAP Centre for Urban Health Solutions have received more than $18 million in federal funding from recent Canada Research Chair allocations and Canadian Institutes of Health Research (CIHR) and Collaborative Health Research Projects (CHRP) grant competitions.

Dr. Stephen Hwang, the director of MAP Centre for Urban Health Solutions, was one of 28 researchers to receive support in the most recent round of CIHR Foundation Grant competition. CIHR Foundation Grants provide long-term support for leading health researchers in the pursuit of innovative, high-impact research programs. This year’s competition was the final round of the Foundation Grants program.

Dr. Hwang, whose research focuses on improving the health of homeless or vulnerably housed people, received a seven-year year Foundation Grant to continue his interventions research in homelessness, housing and health.

Dr. Janet Smylie, the director of the Well Living House, a specialized Indigenous health research unit housed in MAP, was also successful in the Foundation Grant competition…

Dr. Patricia O’Campo has been named a fellow of the Royal Society of Canada, joining 2,000 Canadian artists, scientists and scholars in this prestigious group.

“It’s thrilling to be recognized by a group of outstanding scientists who are among the best scientists in Canada. Being recognized for the body of your research, not just one paper or study, just feels great,” said Dr. O’Campo.

With 30 years under her belt, O’Campo is a pioneer in epidemiology. When she began her training, traditional epidemiology focused on clinical care, epidemics and patient factors that determined major health problems like cancer and cardiovascular health. Her early research helped shape what is now known as social epidemiology.

Two MAP scientists were appointed Canada Research Chairs earlier today, in an announcement made by Science and Sport Minister Kirsty Duncan at the University of Victoria.

Drs. Patricia O’Campo and Nav Persaud are joining eight other current Canada Research Chair holders at St. Michael’s Hospital. Learn more about their work below.