Human Resources Committee on March 7th, 2017

[The Chair, Liberal, Bryan May]

Good morning, everyone. Pursuant to Standing Order 108(2), we're going to move forward with our study on poverty reduction strategies.

We are very pleased to have members of the Kuujjuaq contingent join us here in Ottawa today. As many of you know, we did our best to get to Kuujjuaq as part of the travel component of our study. It wasn't the weather in Kuujjuaq that held us up, but the weather here. We were about to leave and the charter was frozen solid. We were very disappointed not to be able to get up there. I know we're going to do our best to do that in the future. Maybe there are other studies we can pursue that will afford us the opportunity to visit that part of the country.

However, I am very pleased, as a consolation, to have you here today to meet with us.

I want to recognize that we have, representing the NDP, Madame Boutin-Sweet, who is stepping in once again.

Thank you and welcome.

We have a first-timer to the committee, MP Nicola Di Iorio.

I would like to welcome the communications officer, Marie-Christine Vanier, and the administrative technician, Linda Roy Makiuk, from the Kativik Municipal Housing Bureau. From the Nunavik Regional Board of Health and Social Services, we have Françoise Bouchard, director of public health.

We have only the two groups here today, so I will allow a 10-minute opening. We're going to start with the Kativik Municipal Housing Bureau.

The next 10 minutes is yours.

[Marie-Christine Vanier, Communications Officer, Kativik Municipal Housing Bureau]

Thank you.

Thank you for the invitation.

Ullaakkut. Good morning.

My name is Marie-Christine Vanier, and I am the communications officer for the Kativik Municipal Housing Bureau, KMHB.

I want to begin by thanking you for the opportunity to give you an overview of an important organization in northern Quebec, the Kativik Municipal Housing Bureau, a key organization that provides housing for almost all Nunavik citizens, Inuit.

We were expecting you and we were very happy to welcome you to Kuujjuaq. We even prepared bannock, which we ate to your health.

When we talk about housing in Nunavik, you will understand that we are talking about social housing.

The KMHB is a non-profit organization whose main objective is to acquire and administer housing for low to moderate income individuals or families. It manages and administers a social housing stock of 3,144 units in 14 Nunavik communities. In each of those communities, we have a local housing office, a housing manager, and a maintenance and repair team.

[Linda Roy Makiuk, Administrative Technician, Kativik Municipal Housing Bureau]

Hi. My name is Linda Roy Makiuk. I work as an administrative technician for the client services of the KMHB office. I'm also the ambassador for the Pivallianiq program.

The Inuit of Nunavik were nomadic for thousands of years, living in tents and igloos. The people survived one of the harshest climates on the planet by being ingenious with their hunting, fishing, and trapping skills and through strong leadership. They did what they had to do to survive and to take care of their families.

In 1998 the Kativik Regional Government and the Quebec government signed a framework agreement concerning the Kativik region, which included the establishment of a housing management structure that was to reflect the reality of the region. This was to be named the “Kativik Municipal Housing Bureau”. The KMHB's 2015 housing needs survey determined that there were 3,912 individuals or families who lived in 2,884 social housing units. According to Statistics Canada, Nunavik suffers from the worst overcrowding situations in Canada.

The KMHB was the first out of the more than 500 housing bureaus in Quebec to operate at the regional level. The KMHB's board of directors is composed of up to seven members chosen from the region to represent the concerns of the municipalities, the tenants, and the socio-economic groups. The SHQ wanted the KMHB to function like any other housing bureau in Quebec, but it soon became apparent that in almost all aspects the KMHB had to be different, because social housing in Nunavik was different.

The KMHB has about 150 employees, of which more than 75% are Inuit.

Since 2000, the KMHB has added over 1,400 units to its stock due to various housing agreements with Canada and Quebec, for a total of 3,144 housing units in Nunavik.

[Marie-Christine Vanier]

As Ms. Roy Makiuk said, Nunavik is a special region with unique realities that are very different from those in the rest of Quebec. We have to constantly take them into account in our operations.

I will give you a series of figures.

Nunavik's total population is about 12,000 people, 90% of whom are Inuit. The region's demographics are very different from those in the rest of Quebec. The population is increasing faster than elsewhere. From 2006 to 2011, the number of households increased by 11.8%, while that increase was 4.7% elsewhere in Quebec. As a result, even if homes are added every year, we cannot even catch up with the population growth.

The number of children in Nunavik is 3.2 per woman, while elsewhere in Quebec, it is 1.6. Moreover, 70% of the population is under 35 years of age.

In closing, the cost of life in Nunavik is 148% higher than in the rest of Quebec.

[Linda Roy Makiuk]

Among the conclusions of the report on the cost of living, which Gérard Duhaime of Université Laval studied, here are some interesting statistics.

For the households with the lowest incomes, more than 70% of their incomes go to food and housing expenses. Also, the grocery basket is 48% more expensive in Nunavik. As well, current expenses are 43% higher in Nunavik, including 37% more for beverages and tobacco. Also, for recreation, it's 32% more.

Only housing has a lower cost index in Nunavik. These differences are observed despite the cost-of-living measures already in place in the region. Although housing rents are lower in Nunavik than in Quebec City, housing drains between 22.1% and 27% of household spending. According to the survey, social housing is an important cost-of-living measure for Nunavik households.

[Marie-Christine Vanier]

The housing issue in Nunavik concerns everyone. Everyone is affected. The KMHB is facing significant challenges. I will mention a few of them.

We are currently 1,030 homes short of meeting housing needs. So we are facing an issue of overcrowded housing, along with the social problems that can cause.

The housing access system is no longer adapted to the needs of tenants or to their reality. Of course, the system supports the less fortunate, while young people who work and live orderly lives are at a disadvantage. That is a problem and a criticism we hear every day from people we see on the street.

There are no roads between the south and the north or between communities. The only way to travel between communities is by plane at the whim of Mother Nature.

We hope to conclude longer-term agreements with governments over the next few years. Some of the benefits would be our ability to ensure better planning for construction projects and reduce costs thanks to a higher purchase volume. We could start building homes earlier in the season, prepare surfaces—pads, as we call the plots on which homes are built—a year in advance. That would give the pads time to stabilize after a winter.

Ground warming and permafrost thaw are becoming more significant every year and are increasingly influencing the stability of the ground and, in turn, existing and future builds. So longer-term planning would help us reduce expenses related to home renovations, since the pads would be more stable and would cause less damage. Longer-term planning would also help us further develop, with our partners, community urbanization, and conceive and design homes that are better adapted to the Inuit way of life.

Let's talk about the coming years. With the arrival of our new executive director, Marie-France Brisson, the KMHB is reinvigorated and is turning the corner. The KMHB's main objectives for the next few years are focused on the same theme—communication.

We want to improve the lines of communication with our tenants, and develop a stronger and more reliable connection in order to create a relationship of mutual trust, but also give them a say in the matter.

Client service will be our priority. We also want to create lasting connections and rebuild a trusting relationship with the tenants. We will work on improving information flow between various departments of the KMHB in order to provide an improved service.

We are developing a housing allocation grid project to better meet the needs of the people and accommodate them.

The more human aspect of housing will be among our concerns, so that we can build while taking into account Inuit cultural identity.

We also intend to develop a strategic plan to define our action plan for the coming years.

Those are the major objectives that will guide the KMHB over the next few years.

Thank you.

[Linda Roy Makiuk]

The Pivallianiq program has been ongoing for five years now. It is a unique initiative for a better-living pact with the communities of Nunavik. The Pivallianiq program means a change towards better living. Families are invited to participate in a major offensive to make our homes and communities better and more orderly places to live, thrive, and grow healthy.

You will find a summary of the program activities in your package. There are three parts to the program. The first part is the makeover team, which helps the tenants in their homes. The second part is the Nanuk tour that is given to the students from grades four to six in English and in French. Part three is the campaign, Say No to Vandalism. Street workers go into the communities to talk about vandalism and to find ways for the youth to express themselves other than through vandalism.

Thank you.

[The Chair, Liberal, Bryan May]

You're very welcome. Thank you very much.

Now, from Nunavik Regional Board of Health and Social Services, we have Françoise Bouchard, director of public health.

The next 10 minutes are yours.

[Dr. Françoise Bouchard, Director, Public Health, Nunavik Regional Board of Health and Social Services]

Thank you, Mr. Chair.

Mr. Chair, members of the committee, thank you for having us here to talk to you today about an important issue for us from the health perspective. This issue has been a preoccupation of the Nunavik Regional Board of Health and Social Services for many years. My objective today is to relate to you a decision in regard to health issues that we are facing in Nunavik.

The Nunavik Regional Board of Health and Social Services was created following the James Bay and Northern Quebec Agreement. Our board of directors is made up of 14 representatives from the 14 communities of Nunavik region.

I am the director of public health. As the medical officer of health, I am responsible for all the programs related to promotion, protection, and prevention. As well, the board is responsible for all the planning of health and social services for the region. We also have two hospitals in Nunavik, one on the Hudson Bay coast and one on the Ungava Bay coast. Each village has a community health clinic providing 24-hour services.

Today my statement will include the remarks of Mr. Watt, who is not able to be present today. For us, the housing crisis in Nunavik has been an issue. It's reflected in the overcrowding of many houses and the poor shape of the existing housing and the need for major repairs.

This housing crisis has consequences for all age groups: children, youth, adults, and elders in Nunavik. Considering it from the children's perspective, the Nunavik population, as was mentioned to you, is a very young population. Roughly 40% of our population is under 19 years of age.

Acknowledging that, more than half of them are growing up in overcrowded houses; yet children are among the most vulnerable to inappropriate housing conditions. They are particularly vulnerable to infectious disease. We have some of the highest rates of infectious disease hospitalization rates in Quebec for children under two years old, and we can't escape talking about the psychosocial problems that some adults may demonstrate at home and that have repercussions for our children.

As for our youth, many young Inuit today have moved south to study or work, but they have a hard time when trying to come back. There is no housing available for them. This is a huge loss for Nunavik workplaces, because we can't benefit from their education and experience. Our objective is always to be able to develop Inuit competencies in health care, so that one day my job will not have to be filled by a white halunak from the south. This situation prevents other youth from also pursuing their education down south, because they're not encouraged that way.

In contrast, many adults try to escape the situation. Many move to Montreal, growing the itinerant population of Montreal homeless. Some, sadly, in fact end up on the streets, as they're poorly prepared for urban life.

The elders in Nunavik are the official tenants of their house, and the housing shortage often leads them to share their house, willingly or not, with some of their adult children or grandchildren who have nowhere else to go. Sadly, sometimes this leads to elder abuse situations.

There is a very well-documented body of evidence that housing circumstances affect the health and well-being of both family and individuals. I think you all have the brief that we have prepared and summarized. I will talk briefly about it today.

Increased humidity leads to increased mould growth and exposure, which could lead, we know, to asthma and other respiratory conditions. Household quality and density have well-documented implications for the spread of infectious disease.

Overcrowding, however, can also have an impact on mental health, with the possible health outcomes including depression, sleep deprivation, and family problems. In a situation in which individuals are already vulnerable, the situation only fuels psychosocial problems.

There's also a negative association between crowded living conditions and educational outcomes. How can a child do homework and concentrate in an overcrowded household?

Women, children, and elders who need alternative housing arrangements are often victims of family violence.

I want to talk specifically about an issue that has kept me and my team really busy in the last years and that is the recurrence of tuberculosis in the north. There is a strong resurgence right now of tuberculosis in Nunavik and the correlation between the housing situation and this resurgence is getting clearer.

First, there is a growing evidence base to substantiate the strong pathways between the incidence of TB and various social and economic determinants, including malnutrition, crowded housing, inadequate ventilation, low levels of sanitation, low socio-economic status, poverty, alcohol and drug abuse, high levels of stress, and poor access to health care.

Transmission of tuberculosis occurs most frequently as a result of prolonged contact and sharing a close environment with an infectious person. Persons who are at the greatest risk of exposure to tuberculosis are those who live and sleep in the same household as an infected person.

Since the beginning of 2000, the incidence of tuberculosis has been rising steadily in Nunavik after decades of decline. We see a strong relationship between the housing crisis we face and the tuberculosis resurgence in Nunavik. It has quickly overwhelmed our health care system.

The health board efforts to contain the recent TB outbreaks will not suffice if the social conditions that contribute to the transmission of the disease are not changed. We are in an endemic situation where each community right now is vulnerable to tuberculosis outbreaks.

In conclusion, for over a century public health in our country has targeted poor sanitation, overcrowding, and inadequate ventilation to reduce infectious disease transmission. While today most Canadians benefit from adequate housing and living conditions, and infectious diseases such as tuberculosis has almost disappeared in our southern parts, the housing situation remains critical in Nunavik, along with the situation with tuberculosis right now.

Thank you.

[The Chair, Liberal, Bryan May]

Thank you both for making the trip here today to share this with us.

We are going to get started with questions.

MP Warawa, you have six minutes. Welcome back, by the way. We're glad to have you back, sir.

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

Thank you. It's good to be back.

I want to thank the witnesses for being with us today on this important subject of poverty reduction.

My focus and responsibility is to represent Canadian seniors both in the general population and the north. Because you represent the north and the issues there, I'll be focusing my questions on the challenges that seniors face in the north.

I found it interesting that in 2008, the life expectancy of a male in the north was 68 and that it has now been reduced to 64. Life expectancy of the total population of Canada is 79, but in the north it's 15 years less. In the general population right now, one in six people is a senior. In six years it will one in five, and in 13 years it will be one in four. Yet in the north both men and women are living much shorter lifespans—they are expected to, and are—and there is a real concern that as a country we are not prepared for the aging population.

What are the challenges that seniors face in the north? We have heard about elder abuse, and I would like some more comments on that. How does access to housing and the housing shortage affect Canadian seniors?

Canadian seniors need to have their accommodation a little warmer than most of us do because they are not as mobile and physical, so the cost associated with keeping their housing warm is huge. We heard about tuberculosis and the other challenges of access and the need for social interaction. If that interaction includes elder abuse or is heading in that direction, it is very concerning.

Could you share with the committee how poverty reduction and housing affect seniors in the north? What are the challenges facing Canadian seniors in the north? How can the federal government help?

I will open it up to all the witnesses.

[Marie-Christine Vanier]

Maybe Madame Bouchard could best answer that.

[Dr. Françoise Bouchard]

I can try. I wish my colleague were here.

[Voices]

Oh, oh!

[Marie-Christine Vanier]

It's not an easy question.

[Dr. Françoise Bouchard]

You're right when you say that life expectancy in the north is still lower than it is in the south. We have to look at life expectancy being dependent on a lot of the issues facing our young children, because we still have a high mortality rate among children. We still have a lot of gains to make there.

With the change in lifestyle that has occurred in the last, I would say, 50 years in Nunavik, we're seeing more and more chronic diseases appearing in our regions that were not there before. The lifestyle changes that have occurred from la sédentarisation have resulted in issues for the Inuit accessing country food, all those elements that were very much present in the lifestyles of Inuit years ago and today are challenging for them to access.

For example, if elders don't have a family that hunts and brings them country food, they are losing all of the elements that they grew up with. The change in lifestyle is impacting the quality of life of the elders, and they are often very dependent on being in a family where their sons can keep hunting.

It's hard to talk about all of this without having all the context of living in the north. Take hunting, for example. Access to traditional food right now is very much challenged. Programs to support hunters are very expensive, and not all communities are able to access this capacity. So when we look at quality of life of our elders, we should consider all of these programs that can enhance their quality of life, the things that are dear to them.

The loss of the traditional ways brings a lot of challenges—for example, alcohol. We've talked about the problems we have. Living in a household where the young today have difficulty finding jobs or the capacity to bring their own value into the household has an impact on the members of the household, and elders are often pressured to use the little revenue they have to support the large family that's in the house.

These are the different issues that I can bring to you. I don't know if my colleague would want to add to that.

[The Chair, Liberal, Bryan May]

Be very quick, if you have anything to add, because we're up to the six minutes.

[Marie-Christine Vanier]

No. She summed up the situation very well.

[Dr. Françoise Bouchard]

I don't know if I answered your questions.

Certainly, right now one of our departments in the Nunavik Regional Board of Health and Social Services, the flying services, has looked at the development of services specifically addressing elders. If you're interested, I can ask them to forward to you the review of that strategy that's been done. I didn't bring it with me today.

[Mark Warawa, Conservative, Langley—Aldergrove, BC]

Thank you.

[The Chair, Liberal, Bryan May]

If you could forward it to the clerk, that would be fantastic.

Thank you.

Mr. Long, for six minutes, please.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Thank you, Mr. Chair, and thank you to our presenters this morning.

I'd like to start with Marie-Christine and Linda on housing and how important affordable housing is to breaking the cycle of poverty.

In budget 2016 our government did come forth with extra monies—hundreds of millions of dollars was made available for affordable housing. There was an announcement in my riding of Saint John—Rothesay of an additional $60 million investment in affordable housing for the province of New Brunswick. I think it was a very positive step.

There's no doubt that a national housing strategy is needed to help communities right across the country with poverty reduction. How would you see a national housing strategy roll out? What would it look like, coming from our government?

[Marie-Christine Vanier]

I would begin by consulting the population. I would ask the people what they want in terms of homes and lifestyles. So far, we have been developing plots, clearing them, preparing pads and building homes on them. I am telling you this because I have an idea in mind.

We are collaborating with the Université Laval, which is carrying out a major five-year study on architecture that should be more in harmony with Inuit culture and way of life.

I think that strategy should include research groups and consultations with Inuit to find out what they want in terms of housing and development. Urbanization is not developed, is not thought out, in the north. Homes are designed to reduce costs. They are built close together. You may not know this, but perhaps you do. Waste water is collected and clean water is put back into the tanks attached to homes. To reduce municipalities' costs, houses are closer together and neighbourhoods are very dense.

I have heard Inuit say that they would like to have a better connection with nature, have views of the land, see the sun when they get up in the morning. Those are the aspects that are brought up when we talk about housing development. They miss the land.

[Wayne Long, Liberal, Saint John—Rothesay, NB]

Françoise.

[Dr. Françoise Bouchard]

In the context of the consultation for the national housing strategy of the Government of Canada, the Institut national de santé publique du Québec has discussed our situation not only in Nunavik but also in regard to first nations. It's part of the written statement that I brought with me today. There are suggestions in there that address housing specifically. I can leave you my copy, Mr. Chair.

I think there are two main aspects they felt should be dealt with. First, the federal government urgently needs to invest massively to deal with the current backlog we have. We'll never get ahead if we don't deal with that damned backlog; I'm sorry to express my words like that, but we've been saying it and repeating it every year. We have a backlog that needs to be dealt with.