Ontario’s housing crisis is also a health crisis

Whether we’ve managed to buy our dream home or are simply dreaming of having a home, few things matter to us more than where we live. Our homes can be a large part of our identity. But they’re much more than that. Research demonstrates that decent housing is fundamental to our health.

If home is one of the most important things to both our health and well-being, you would imagine it would be at the top of every political platform. But in Toronto, where we have just completed a provincial campaign, are in the midst of a municipal campaign, and have a federal campaign on the way, housing has not emerged as a campaign theme.

This is a surprising omission in a city where close to 78,000 households are waiting for social housing, with almost 160,000 waiting Ontario-wide (that’s 3 per cent of all households). And these figures do not capture the fact that women list lack of affordable housing as a barrier to leaving violent situations, or that, in Toronto alone, more than 70,000 households are living at risk of homelessness and around 4,000 individuals and families use city shelters on any given night. Nor do they capture the barriers to getting housing such as racism, homophobia and other forms of discrimination.

All of this is taking a huge and well-documented toll on our health. In 2009, researchers followed 1,200 people in Toronto, Ottawa and Vancouver who were homeless or at risk of homelessness. It was found that they experience a high burden of serious health problems like asthma, high blood pressure and chronic obstructive pulmonary disease. They are also at high risk for conditions like depression and anxiety, and of going hungry.

There’s more. We know that housing in disrepair can lead to accidents, fires and infestations. That overcrowding can lead to infections. We also know that, if you develop an illness, it is more difficult to get better if you are homeless or live in a substandard home.

Finally, we know the cost of housing deeply affects our health. When it takes up a large percentage of our income, it can cause profound stress and crowd out things that are important for health like recreational activities, nutritious food and prescription medication.

The housing crisis is affecting health care use, too. Researchers looked at health care records for 1,165 adults using homeless shelters and meal programs in Toronto and found much higher than average rates of emergency department use and hospitalization. For people experiencing homelessness or housing vulnerability in Toronto, Ottawa and Vancouver, researchers found that 55 per cent had visited the emergency department and 25 per cent had been hospitalized at least once in the past year.

Ontarians recognize the connection. A recent study demonstrated that many see a strong link between social factors like housing and health. Forthcoming related research demonstrates that Ontario residents support strong government action on basics like recreation and, yes, housing.

This is consistent with the rest of Canada. Last year a national survey by the Federation of Canadian Municipalities confirmed that nearly three-quarters of Canadians want a national long-term affordable housing plan and more than two-thirds want increased government funding for housing and homelessness.

Ontario has a housing crisis. And a housing crisis is a health crisis. The public knows it, and wants change. Now it’s time for the new provincial government — along with incoming municipal and federal governments — to engage in an urgent and long-overdue conversation about housing and how to reverse these negative trends through good policy and action on affordable housing.

When Ontario’s new provincial government gave its speech from the throne on Thursday, it included a commitment to housing and homelessness funding and programs. Now is a very good time to turn high-level promises into brick-and-mortar realities

We have international and Canadian research demonstrating the way forward. And if further help is needed, we are here along with many others, ready and able to work to implement solutions. The ingredients are all there. Now it’s time to demonstrate the vision and political leadership to make sure every single one of us has a decent place to call home.


Dr. Stephen Hwang is a practising physician in general internal medicine at St. Michael’s Hospital and a research scientist at the Centre for Research on Inner City Health (@CRICH_StMikes) in Toronto. @StephenHwang.



Dr. Kwame McKenzie is CEO of the Wellesley Institute and a medical director responsible for Dual Diagnosis, Child Youth and Family and Geriatric services and Director Health Equity at CAMH.

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