#Research participants drivers#

These knowledge gaps are due to a dearth of data that adequately characterizes economic engagement and employment in inner-city residents. Still, the precise nature of employment and economic engagement in these populations, and their impact on the health and social well-being of inner-city populations, remain relatively less well understood. More targeted studies, meanwhile, link suboptimal labour market engagement among inner-city PWUDs to higher disease morbidity and mortality, demonstrating that poverty and socioeconomic disadvantage are both causes and consequences of severe health harms in this population. However, most of this evidence has been drawn from representative or administrative data which may mask experiences of employment and economic engagement that are specific to disadvantaged populations. This paper describes the objectives, design, and characteristics of the Assessing Economic Transitions (ASSET) study cohort which aims to provide data on gaps and opportunities for addressing economic engagement in an inner-city drug-using population in Vancouver, Canada.Įxisting population health research supports a bi-directional relationship between employment, work, and health, showing that both the availability of employment and quality of work influence wide-ranging health outcomes, and that health selects individuals out of employment or into specific kinds of employment. Upstream strategies to enhance the economic engagement and employment-related determinants of health inequity in drug-using populations are urgently needed.

The consequences of labour market exclusion are of considerable concern in the context of the COVID-19 pandemic, given the exacerbation of the ongoing and unprecedented overdose epidemic amongst other health and social challenges facing PWUDs. Due in part to a lack of accessible and viable formal employment opportunities, inner-city PWUDs are commonly relegated to informal, prohibited, or illegal income generation activities (e.g., informal recycling, sex work, drug dealing) that carry further risk of harm, including high-risk drug use, violence, criminal justice system involvement, disruption, or the discontinuation of substance use disorder treatment and overdose. Labour market exclusion and employment instability are common experiences of socioeconomic marginalization in these populations, as indicated by high levels of volatility in accessing or having regular formal employment, particularly in the case of persistent, poly-substance or high-intensity substance use.

#Research participants drivers#

A growing body of evidence identifies staggering individual, economic and community costs of unemployment, poverty, and material insecurity (e.g., food or housing insecurity) as key drivers of health harm among inner-city people who use drugs (PWUD), including non-fatal and fatal drug poisoning. The resulting evidence will inform policy and programmatic initiatives to address socioeconomic drivers of health and well-being.Īmidst the interrelated public health emergencies of the drug toxicity crisis and the COVID-19 pandemic, the health equity impacts of the socioeconomic marginalization of vulnerable populations have emerged as a central concern. Nested qualitative studies will focus on how inner-city populations experience economic engagement. Employed participants largely had casual jobs (42%) or jobs with part-time/varied hours (35%). In the three months prior to baseline, more participants undertook informal income generation (75%) than formal employment (50%). At baseline, all participants reported past daily drug use, with 27% currently using opioids daily, and 20% currently using stimulants daily. Between April 2019 and May 2022, the study enrolled 257 participants ages 19 years or older (median age: 51 40% Indigenous, 11.6% non-Indigenous people of colour 39% cis-gender women, 3.9% transgender, genderqueer, or two-spirit) and 41 qualitative participants. A subset of participants complete nested semi-structured qualitative interviews semi-annually. Participants complete interviewer-administered surveys quarterly. This paper describes the objectives, design, and characteristics of the ASSET study cohort, an open prospective cohort which aims to provide data on opportunities for addressing economic engagement in an inner-city drug-using population in Vancouver, Canada. The Assessing Economic Transitions (ASSET) study was established to identify relationships between economic engagement, health and well-being in inner-city populations given that research in this area is currently underdeveloped.