The health of residents of single-room occupancy hotels in Vancouver’s Downtown Eastside is far worse than that of most Canadians, with high rates of substance abuse, mental illness and infectious diseases, according to a new study by UBC researchers.

The study found the death rate among the residents is five times as high as that of the general population. The vast majority, 95 per cent, deal with drug addictions.

SROs are often the only option for low-income Vancouverites as they tend to be far more affordable, but also far smaller, than apartments. They house 3,000 people on the Downtown Eastside, if not even more. Two thirds of the residents surveyed had once been homeless.

Most SRO residents have a mental illness

Mental illness is particularly common in SROs, affecting three quarters of tenants. Almost half of tenants suffer from psychosis, which can be defined as losing connection with reality. Just as many residents deal with neurological disorders such as movement problems or restlessness.

Researcher William Honer, head of UBC’s department of psychiatry, said the high rate of psychosis was one of the most surprising findings of the study, and that the information could be useful in guiding mental health initiatives in the area. He was concerned about the high rates of mental illness generally, and speculated that mental illness rates might even be rising in SROs.

Almost two thirds of residents surveyed take injection drugs, which partly accounts for the high rate of HIV infection, almost 100 times higher than that of the general population, as 18 per cent of the residents are living with HIV. Hepatitis C is even more common, affecting half of the study participants.

The researchers found SRO residents suffer from an average of three of the serious illnesses they looked at.

He said SRO residents live in rooms as small as three by three metres, typically with a hot plate and a shared bathroom down the hall.

Poor housing a big problem: advocate

Downtown Eastside housing advocate Wendy Pedersen said she thinks the health of the residents could be improved by providing social housing instead of SROs.

“The hotels are part of the worst housing in Canada and need to be replaced,” she said.

She said sleep deprivation is common in the cramped buildings, while resident health is sometimes further damaged by pest infestations and stressful environments. Pedersen said getting approved for social housing can be one of the most important things to happen to an SRO resident.

“They talk about it like winning the lottery,” she said.

Poverty and poor health a chicken and egg issue

Honer and Pedersen both believed the poor health outcomes and poverty are interrelated, and contribute to each other.

“It’s a chicken and egg issue,” said Pedersen, explaining that many people wind up needing to live in SROs because of struggles with mental and physical illness and addiction, and living in poverty often causes or exacerbates such ailments.

Honer said one of the most striking findings was the diversity of the residents in terms of their challenges and capabilities, which he said highlighted the challenge of designing community interventions that benefit everyone. “We need to understand them as individuals,” he said.

He said he is optimistic the data can help improve access to health care by informing local health care providers. “Care should be based on evidence, and now we’re providing the evidence,” he said.

The researchers checked up on 293 SRO residents for roughly two years. Only one quarter were female, which is typical in the neighbourhood, and 28 per cent were First Nations, speaking a total of 20 different Aboriginal languages. The large majority of the residents were born in Canada, but only 13 per cent were from Vancouver.