Housing inequities as social injustice for tenants on low income in Ontario
Good morning. My name is Erica Phipps and I am a PhD student in health promotion here at Queen’s. My story this morning includes some glimpses into my serendipitous journey towards becoming a mid-career PhD student, and some reflections on the value of bringing the worlds of academia and practice into closer connection. It is also about housing, and health equity, and trying to improve the ways in which we work together on issues of societal concern.
The work I want to share with you today starts with the living conditions of people in low-income rental housing in rural and urban communities across Ontario. Each day, thousands of kids go to bed at night in housing with serious pest and mould…
…infestations, lead hazards, structural disrepair, inadequate heating or cooling and any number of other unsafe and unhealthy conditions. The effects of unfit housing on the physical, mental and social well-being of children, individuals and families is staggering, with the burden greatest on those living in poverty and those enduring the effects of colonization, racialization, gender-based violence and other forms of discrimination.
Looking around the room, I would imagine that many of you are parents, perhaps grandparents. I ask you to stop and think for a moment. What would you do if the chips had fallen differently and you were trying to raise your children under these types of conditions? Where would you turn for help?
You might first go to the landlord or building manager. Perhaps you would try the legal aid clinic, or the municipal by-law enforcement officer. Maybe you’d reach out to the public health department, or your social worker or, if you were a newcomer, your settlement worker. Or see if you could get the support of a health care professional. There are lots of doors to be knocked on, but what are the prospects for an effective and timely response?
These are the questions that motivated us, as part of a collaborative initiative called RentSafe, to convene focus groups with tenants to hear about their experiences in seeking support and to conduct surveys with various types of agencies and service providers to find out what capacity they have to respond to tenant concerns. In short, we wanted to find out: Is the “system” working effectively to respond to and prevent unhealthy rental housing conditions for people on low income?
Well, one of the tenant focus group participants pretty much nailed it by saying this: “Multiple levels of people to deal with – there’s so much bureaucracy, it will never get solved.”
Or, in the words of another participant “I just keep my mouth shut.”
The story of my PhD research is taking place, real-time, within this Ontario-wide RentSafe initiative, a project that I and colleagues created out of concern for the lifelong health implications of starting out young lives in conditions that are known to exacerbate asthma, impair brain development, cause mental stress and contribute to various chronic diseases. In my longtime role as director of the Canadian Partnership for Children’s Health and Environment – or CPCHE — I saw a need to not just raise awareness and concern about housing conditions, but to seek to improve the systems that are (or should be) in place to enable tenants to realize their right to healthy housing. The approach that we took – with an emphasis on healthy equity, explicit recognition of upstream drivers such as poverty, and a commitment to directly engaging with a wide range of sectors and perspectives — was very much influenced by the work of Dr. Jeff Masuda and the concept of Equity-focused Knowledge Translation.
I began working with Jeff Masuda and his colleagues back in 2010 around this concept of EqKT. Representing CPCHE, I was a community partner on the research team. It was a game-changer for me. I began to reorient my thinking about what our collaborative could – or should – be doing in the name of children’s environmental health equity. This intersection of our practical work with the critical theoretical constructs of our new academic partners significantly influenced the design of RentSafe, and ultimately led to my decision to pursue a PhD.
I won’t go into a long description of EqKT, but I will say two things. As a concept that is inherently equity-focused, it has challenged me to look at myself and my own practice critically and with humility, and to start to recognize my own blind spots. EqKT practice requires that each of us to stop and ask ourselves questions such as, “Whose voices do I listen to? What types of knowledge do I value (or discount)? What circumstances give me the authority to speak?” Secondly, EqKT has resonated with me because it affirms what I have learned, organically, through my work in leading collaborative, multi-stakeholder work over the years: People matter. Relationships matter. Achieving robust intersectoral collaboration is not just a matter of aligning bureaucracies and signing memoranda of understanding. It is about people at all levels understanding each others’ roles, capacities and motivators, overcoming barriers to effective communication, and perceiving value in working together.
So this nexus between practice and theory is what started me on my PhD journey, and will continue to be the substrate on which I hope to build greater understanding of how we can do better in addressing the potent causes of health inequities, including unfit housing.
RentSafe provides an opportunity to field-test EqKT within a real-world intersectoral initiative, in which we are already working with public health, legal aid, social services, tenants, landlords and others. As the fortunate recipients of a CIHR Knowledge-to-Action grant that will start to roll out next year, we will be able to field-test the “essential ingredients” of EqKT practice that emerged from our earlier work in the Knowledge Leaders immersive training program.
Our research is about moving beyond the science of knowing into the science of doing.
What do we hope to learn from this research? We want to understand whether investing in relationship-building among diverse players, using the principles of EqKT in an immersive and experiential setting, will contribute to more effective intersectoral practice.
Will this novel approach help to create the conditions for mutual understanding, the breaking down of hierarchies, silos and sterotypes? Will bringing people together, in all of their diversity, and nudging them outside of their comfort zones, help to generate the types of creativity and courage that are needed to tackle the unacceptable disparities in health and well-being that exist in Canada today?
I certainly hope so.