Chapter 29: Poverty, Homelessness & Food Insecurity

By utilizing lenses such as the social determinants of health, health equity, and critical social theory, community health nurses can move beyond downstream clinical treatments to address the upstream causes of systemic vulnerability. A significant focus is placed on the impact of neoliberalism, an ideology that has historically prioritized austerity and reduced social spending, often resulting in the individualization of systemic issues and a tendency toward victim-blaming for unhealthy choices that are actually constrained by financial limitations. The text details the realities of poverty in Canada, noting that marginalized populations—including those with disabilities, lone-parent families, racialized groups, and seniors—are disproportionately affected. It distinguishes between various measures of low income, such as the low-income cut-off and market basket measure, while highlighting the specific structural drivers behind Indigenous child poverty and the ongoing legacy of colonialism. Homelessness is analyzed as a spectrum ranging from unsheltered living to precarious "hidden" housing in rural areas, with a deep dive into the twelve dimensions of Indigenous homelessness that reflect displacement from traditional territories and governance. Furthermore, the discussion addresses food insecurity as a worsening public health crisis, particularly in Northern regions where exorbitant costs and disappearing traditional food sources lead to severe physical and mental health outcomes. Community health nursing practice is framed through a hierarchy of prevention—primordial, primary, secondary, tertiary, and quaternary—urging practitioners to engage in political advocacy and inclusion health models. By forging chains of trust and challenging discriminatory institutional mandates, nurses can advocate for structural reforms like affordable housing, increased social assistance, and equitable policy changes to prevent morbidity and mortality before they occur.