Stepping in, stepping up: Community Health Centres address inequity as pandemic supports roll-back

For those made vulnerable

Before the pandemic hit Vancouver’s Downtown Eastside, Atira Women’s Resource Society was already busy providing a range of services to local women including trans, two spirit and intersex women and or those who identify with a femme of centre non-binary gender. Now, as governments phase out programs created in response to COVID-10, many Atira clients are among the 2.1 million people who will be cut off from financial supports. According to a new report by Canadian Centre for Policy Alternatives, fifty-seven per cent of Canadians currently at risk of being cut off when the CERB system transitions to EI identify as women.

“Because of who we serve and how vulnerable they are made, the need is always high,” says Janice Abbott, Chief Executive Officer at Atira Women’s Resource Society, “and we’ve had to come up with interesting and creative ways to deliver services.”

The Atira team takes a holistic approach, embedding health services for pregnant women at risk through the Maxxine Wright Community Health Centre. Patients and clients who visit Atira can access frontline health services in addition to housing, groceries, social support programs, and other resources.

Managing the pressure on systems

Since March, Atira has had to switch gears and change the way they deliver these supports. The coronavirus pandemic created an unprecedented pressure on health providers as well as a new landscape of practical restrictions and regulations to keep the virus from spreading.

“One of the most important aspects of our work is that we do a daily hot meal for women and kids who access the Community Health Centre, and it’s quite a busy lunch. We can’t have a bunch of people inside because of the gathering restrictions, so we are also delivering food,” says Abbott. “Everyone is hustling as much as they can to continue to meet that very basic need.”

The coronavirus pandemic shed light on the way BC’s existing health and social systems leave behind those with complex needs. Women who lack access to safe and affordable housing, who lack adequate food for their families come to Atira for a trusted source of judgement-free care.

“We know that for women who are struggling with substance use while they’re pregnant, nutrition is one of the best ways that you can ensure a healthy baby, even more than stopping substance use,” says Abbott.

While COVID-19 has exacerbated challenges for groups made vulnerable, Abbott makes it clear that the root causes do not stem directly from the pandemic itself:

“The real issue is not the pandemic, it’s ongoing inequity. It’s rooted in racism, misogyny and sexism, reproductive rights and access to medications, and poverty.”

Getting to the root causes

The support offered by provincial and federal governments to Canadians over the last six months reflects an awareness that in the face of overwhelming challenges, policy choices can make a difference on systemic barriers to health. Collectively, decisions can be made to create conditions to improve the well-being of those with complex needs.

“It shouldn’t take a pandemic to do the right thing,” says Abbott. The pandemic response represents the societal choice to “do the things we should have always done” for people in need.”

Unfortunately, when it comes to vulnerable women in BC’s poorest neighbourhoods, the same calls for support have gone largely unanswered, and centres like Atira struggle to keep the doors open year after year. Income supports such as CERB are set to expire at the end of September 2020, and Abbott worries that the women who access services at Atira will be among the worst hit by the roll-back:

“I’m really concerned about the impact it’s going to have on women. If we don’t do anything to ensure security, it’s going to be really difficult.”

Community Health Centres around the province are adapting their service delivery in light of COVID-19, stepping in to address the root causes of inequity, and creating innovative programs to improve access to the social determinants of health. This model of care is proven to be effective, but many of BC’s Community Health Centres are persistently underfunded and under-supported by existing policies.

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