All Albertans need emergency healthcare
sometimes, but homeless and low-income people are prone to using
emergency departments again and again.
That’s because living in poverty makes
people sick, says Dr. Gabriel Fabreau,
an internal medicine physician and
researcher at the University of Calgary
funded by Alberta Innovates (previously
Alberta Innovates – Health Solutions).
People who live in poverty face greater
challenges to afford healthy food and
may have unstable housing or be
homeless. They often don’t have social
support, a job or stable relationships.
Fabreau adds they also have a higher risk
of addiction and mental illness.
Emergency departments are designed
for delivering short-term acute care,
rather than long-term health and social
support. So patients living in poverty
are regularly discharged without getting
the full care they need and can become
Calgary’s CUPS Coordinated Care
Team helps homeless and low-income
people become healthier
WRITTEN BY CAITLIN CRAWSHAW
PHOTOGRAPHED BY MICHAEL INTERISANO
sicker and need emergency help again.
The cycle can be difficult to break, plus
it erodes the health of people living in
poverty and adds costs to the healthcare
system, Fabreau says.
A pilot project in Calgary hopes to
break this cycle. Launched in 2015 by
Dr. Van Nguyen, a family physician
and health director of the Calgary
Urban Project Society (CUPS), the CUPS
Coordinated Care Team supports people
living at or below the poverty line who
have visited the emergency department.
A team of nurses and community health
workers from Alpha House (a Calgary
organization that cares for people with
drug and alcohol addictions), visits
people anywhere in the city and connects
them to social supports (such as housing
and employment services) and health
services (such as mental illness and
“It’s a coordinated response—a
collaboration,” Nguyen says. She says
team members also act as advocates for
their clients and bridge gaps between
health, social and justice agencies so they
can become well again.
The program is expanding, and
Fabreau and Nguyen are working with
Drs. Kerry McBrien and Eddy Lang to
study its results. They are collaborating
with a similar team in Edmonton—the
Addiction Recovery and Community
Health team—to evaluate the strengths
and weaknesses of both pilot projects
and take successful elements to other
Alberta communities. Both teams want to
know if their projects reduce healthcare
costs, and more importantly, if patients
are becoming healthier.
“These are citizens and people who
live in our communities,” Fabreau says.
“People can recover and get back on
their feet and participate meaningfully in
society. It’s a win for everybody.” |a
The CUPS Coordinated Care Team is working to reduce homeless
people’s emergency visits while improving their healthcare.