Housing crisis a public health emergency

Some physicians have gone so far as to label homelessness a palliative diagnosis. Not having a home can be lethal. Homelessness causes premature death, poor health and is a significant burden on our health care system.

by Tim Richter and Ryan Meili

One of the biggest factors that determine whether people will stay healthy or wind up needing emergency or chronic medical care is where they live. People without access to stable housing are at higher risk of illness, and their likelihood of recovering well from that illness is greatly diminished.

How bad is Canada’s housing crisis? According to the newly released National Shelter Study, Canada’s emergency shelters are packed to the rafters. People are languishing in homelessness longer, and their ranks increasingly include seniors, veterans and families with children. Shamefully, Indigenous Canadians are over 10 times more likely than non-Indigenous people to end up in emergency shelter.

This report paints only a partial picture of homelessness in Canada, including only emergency shelters. The sad reality is that over 35,000 Canadians are homeless on a given night with more than 235,000 Canadians experiencing homelessness at some point every year, whether they sleep in shelters, on the street, couch surf, wait unnecessarily in hospital or other temporary accommodation.

Beyond a crisis of housing and poverty, homelessness is a public health emergency. The longer people are homeless, the worse their health becomes. A recent report from British Columbia suggests life expectancy for people experiencing homelessness in that province is half that of other British Columbians.

Some physicians have gone so far as to label homelessness a palliative diagnosis. Not having a home can be lethal. Homelessness causes premature death, poor health and is a significant burden on our health care system.

Today, more than 1.5 million Canadian households live in core housing need, with over half of those households living in extreme core housing need (living in poverty and spending over 50 percent of their income on housing).

The crisis stands to get worse before it gets better as federal operating agreements for older social housing expire and over 300,000 more households risk losing the subsidies that keep their housing affordable.

In the last 20 years, as Canada’s population has grown, federal funding for affordable housing has dropped more than 46 percent. This has meant at least 100,000 units of affordable housing were not built. Canada’s homelessness crisis is the direct result of this federal withdrawal from housing investment. The new federal government has promised a National Housing Strategy, and has begun consultations.

The most pressing problem – finding stable housing for those who are currently homeless or at risk for homelessness – is one that, fortunately, can be solved. We need to start by collecting real-time, person-specific data on homelessness and expanding the application of the Housing First model of supportive housing for individuals with greater challenges. Housing First (www.homelesshub.ca) is an evidence-based approach to ending homelessness that provides direct access to permanent housing and support.

Tim Richter is the president and CEO of the Canadian Alliance to End Homelessness (www.caeh.ca), a national movement of individuals, organizations and communities working together to end homelessness in Canada. Ryan Meili is a Family Physician in Saskatoon, an expert advisor with Evidence Network and founder of Upstream.

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