Report #3 Factors Influencing Poverty and Homelessness in Dartmouth-Cole Harbour Summary of Dartmouth North Studies (Attached Tables for Dartmouth South and Dartmouth East) 1. Harm Reduction in Dartmouth North: planning for addiction 2. Housing Trilogy, Dartmouth North Report, November 2017 3. The Highfield/Pinecrest Neighbourhood Housing Initiative: A Working Proposal, September 2016 • PDF attachment, Dartmouth South and Dartmouth East 1. Harm Reduction in Dartmouth North: planning for addiction Juniper Littlefield Undergraduate Honours Thesis Proposal Advised by Ren Thomas April 9th, 2018 Bachelors of Community Design, Honours Urban Design Dalhousie University School of Planning Halifax, NS Dartmouth North stands out as having no focused mental health or addictions supports available to everyone. There are no public health locations in the area, and only one private practitioner—resulting in poor health care access. Drug-related charges (accessed through police records) and community consultation (Between the Bridges, 2015), indicate that alcohol, cocaine, and opiate dependencies are likely major concerns for the Dartmouth North community. Cannabis related charges are also frequent through each of these neighbourhoods, which based on literature, may indicate the presence of other mental health and addiction issues (Rhodes et al., 2006). Dartmouth North, located just inside the circumferential highway (Figure 1), has some of the lowest incomes and shelter costs in the Halifax Regional Municipality (HRM). 43% of households spend 30% or more of their income on shelter, signaling income-induced housing poverty (Statistics Canada, 2011). At 33.6%, this area has the highest neighbourhood rate of individual poverty in HRM, according to 2015 data included in United Way’s Poverty Solutions report (2018). According to Capital Health research, Dartmouth North also has the highest rate of utilization for addiction and mental health1 services in HRM (Capital Health, 2014). Drug users are an especially vulnerable group and likely to experience the effects of poverty and social deprivation in unique ways (Linton et al., 2013). Drug strategies have historically focused on enforcement, aiming to rid communities of users, and ‘clean up’ public spaces (de Montigny et al., 2011). This approach tends to displace addicts and associated criminal behavior, disrupting social connections and creating new issues with housing (Rhodes et al., 2006). In my thesis I intend to form a spatial analysis of addiction and mental health in Dartmouth North, and investigate the ways in which social and land-use planning can use harm reduction to support mental health. Harm reduction has proven successful in reducing the open drug scene, minimizing overdose deaths and the spread of diseases such as HIV/AIDS and hepatitis. This approach is now commonly used as a way to foster safe and healthy communities (City of Vancouver, 2017). 2 According to a 2014 report by Capital Health, Dartmouth North had 53.2 adults and 41.5 children per population of 1000 accessing community mental health services. IWK reproductive mental health services saw a utilization rate of 4.67 per 1,000 women within this community. All of the above numbers represent the highest rates within the HRM. This neighbourhood has the highest rate of utilization for Addictions Community Based Services in the HRM, with an average of 22 visits per client (Capital Health, 2014). Incomes in Dartmouth North are also the lowest among the three communities, with a median household income of $22,816 after-tax (compared with a municipal median of $59,240), and 43% of households living in housing poverty, almost identical to Gottingen levels (though this community had wider variation in income and shelter costs). For context, shelter costs in Downtown Dartmouth average at $997, with a median income of $49,109, and 30% in housing poverty. Gottingen area has average rents of $889, with a median income of $34,532. As mentioned in Capital Health’s 2014 report, and Between the Bridges 2015 consultation, 41% of households in Dartmouth North have at least one person living with limitations to daily activity (this includes a wide variety of disability), while Gottingen comes in at the regional average of 36%, and Downtown Dartmouth has a total of 27%. Downtown Dartmouth has quite a low population of visible minorities, totaling 7%, while the marginalized Gottingen area and Dartmouth North neighbourhoods feature 29% and 17% respectively. 3 Downtown Dartmouth North Dartmouth (CT HRM (CMA 205) (CT 0114.00) 0102.00) Population 2016 6,569 4,623 403,390 Population change (5 yrs) 7.60% 3.30% -2.50% Median household income after tax $22,816 $49,109 $59,240 Average rent $751 $997 $1,035 Renters 88% 62% 40% Moved in last 5 yrs 57% 52% 40% Spending over 30% of income on 43% 25% 30% shelter Household with activity limitations* 41% 27% 36% 17% 11% Visible minority 7% Aboriginal identity 4% 7% 4% Table 1: Demographic neighbourhood comparison. Statistics taken from the 2016 Census, *Activity limitation info pulled from CMHC's Housing Portal (2011) Bozinoff et al. (2017) cite the issue of service centralization, which can be problematic for addicts attempting to avoid trigger areas and seeking quality housing outside the zone of drug-related services. This common thread carries into Dartmouth North, where residents must travel to health care located largely in Halifax’s hospital system… As with many issues in planning, NIMBYism is a common barrier in siting harm reduction services. Bernstein and Bennett (2013) completed a policy review of land use bylaws in British Columbia, revealing that several BC (and Ontario) towns have amended zoning codes in order to prohibit harm reduction facilities. Municipalities have expanded, narrowed, or added definitions to their index of health care uses in order to limit or altogether ban provision of harm reduction facilities. Dartmouth North needs our focus, and planning as a profession has yet to take seriously its role in mental health and addiction. Poverty as a social determinant of health has 4 important effects on health and crime, and mitigating these inequities can only be achieved by working collectively to shape our environments. This community is experiencing effects of many interconnected factors, and the segregation and isolation of this neighbourhood only perpetuates the issue. Public Consultation Public consultation in the Dartmouth North area, pulled from consultation by Sperry/MacLellan (1991)17, and Between the Bridges (2015), showed the following themes: Safety Between the Bridges cited this as a main concern, with residents raising the issue of unsafe parks, negative relationships with police, and high crime rates (2015). Pride Residents responding to Between the Bridges outreach give examples of broken street lamps, roads and buildings in need of repairs, a lack of outdoor public spaces, and issues with trash and pollution (2015). Consultation by Sperry MacLennan in 1991 suggested similar concerns around property maintenance, to which the city responded by planning for enforcement of minimum standards. They did note however that many of the area’s apartment buildings were too small to afford a full-time superintendent, suggesting that a rental education program may be useful in this area18 (1991). Concerns around public open space and streetscapes have been around since Sperry and MacLennan’s 1991 plan, with little change seen since. Youth Residents suggests that programs run by outsiders aren’t reflecting their community’s needs, and families cannot afford extracurricular programs in their area, and children need more help with schoolwork and job searches. One outcome suggested by residents was addiction specific supports for youth, as well as general supports and programming, and emotional learning in schools (2015). 17 Sperry/MacLellan’s review is included in the Dartmouth MPS (2010) Secondary Municipal Planning Strategy (SMPS) for the Highfield/Pinecrest area. 18 Almost two decades later, the Affordable Housing Association of Nova Scotia and Metro Works Employment Association have just launched a new Nova Scotia chapter of the RentersEd program (Personal Communication, AHANS, 2018). Community supports In addition to the need for affordable programming and addiction services, residents also reference discrimination based on location, race, and mental illness. A need 5 was identified for services that are delivered in a way that fits the community and culture, stable funding programs, as well as affordable daycare (something also brought up in 1991 consultation for Dartmouth’s Highfield Pinecrest Secondary Municipal Planning Strategy or SMPS), a diversity in social services, a walk-in medical clinic, and food banks (2015). 1991 consultation from Sperry MacLennan suggested the lack of long-term residents as a barrier to social capital. Income Income concerns about social assistance revolved around the difficulties of moving into employment, the lack of financial literacy and local job opportunities (2015). Residents described difficulty accessing the nearest grocery store, choosing instead to shop at the drug store for unhealthy and expensive food. Affordable housing as well as access to shelters and living wage are mentioned in this Between the Bridges report (2015). The Dartmouth SMPS suggests zoning supports for cooperative housing, subdivision, and density as some solutions to the affordable housing issue (2010). However, Littlefield’s 2017 housing report for the area