page_title: Downtown Eastside
section_title: Health and well-being
hierarchical_section_title: Downtown Eastside / Current issues / Health and well-being
caption_attribution_description: English: A person who is homeless sleeps on the public streets in Vancouver BC Canada; in the downtown eastside area.
context_page_description: The Downtown Eastside is a neighbourhood in Vancouver, British Columbia, Canada. The area, one of the city's oldest, is the site of a complex set of social issues including extremely high levels of drug use, homelessness, poverty, crime, mental illness, and prostitution. It is also known for its strong community resilience and history of social activism.
  Around the beginning of the 20th century, the DTES was the political, cultural, and retail centre of the city. Over several decades, the city centre gradually shifted westwards and the DTES became a poor, although relatively stable, neighbourhood. In the 1980s, the area began a rapid decline due to several factors including an influx of hard drugs, the release of mentally ill individuals, policies that pushed prostitution and drug-related activity out of nearby areas, and the cessation of federal funding for social housing. By 1997, an epidemic of HIV infection and drug overdoses in the DTES led to the declaration of a public health emergency.
context_section_description: A 2013 study of SRO residents in the greater DTES area found that 18.4% were HIV positive and 70.3% were positive for hepatitis C. Few of those infected with hepatitis C receive treatment. The DTES population also has higher rates of tuberculosis and syphilis than the rest of the province, and injection drug users are susceptible to other infections such as endocarditis.  Aboriginals are at the greatest risk from disease.
  Amongst the most vulnerable DTES residents, common issues with psychosocial well-being include low self-worth, lack of personal safety, lack of respect from others, social isolation, and low education levels. Many have lost custody of their children. A 2000 report from the Vancouver Native Health Society Medical Clinic said, "Many individuals are survivors of severe childhood trauma. Negative experiences such as family violence, parental substance abuse, sexual and emotional abuse, suicide, divorce, and residential school atrocities are the norm." Many DTES residents are too unstable to keep appointments or reliably take medication.
  Life expectancy in the greater DTES area is 79.9 years, a significant improvement since the mid-1990s. Some of the increase may, however, be explained by the migration of healthier residents to the neighbourhoods surrounding the DTES. A 2015 study of DTES SRO residents found that they were eight times more likely to die than the national average, mostly due to psychosis and hepatitis C-related liver dysfunction.
caption: Around half of the city's homeless people live in the greater DTES area. Street homelessness was relatively rare in Vancouver until the 1990s.
exif: {}