TSPN Just the Facts: Affordable Housing, Homelessness, and Health

On March 22nd, TSPN hosted a discussion about Canada’s housing and healthcare crisis with three leading experts in the field. Moderated by Victoria Gibson, the Toronto Star’s affordable housing reporter, attendees learned about the significant health costs of housing instability and how implementing evidence-based solutions can help.

On the panel, we were fortunate to have:

• Mikaela Gabriel, a PhD Candidate in Clinical and Counselling Psychology from the Ontario Institute in Studies in Education at the University of Toronto. Supervised by Dr. Suzanne Stewart, she explores how Traditional Knowledge and Elder connections can support Indigenous Peoples’ mental health across life transitions, specifically for homeless and street-involved individuals.
• Dr. Stephen Hwang is a Professor of Medicine at the University of Toronto, Chair in Homelessness, Housing, and Health at St. Michael’s Hospital and the University of Toronto, and the Director of the MAP Centre for Urban Health Solutions at St. Michael’s Hospital, Toronto, Ontario. Dr. Hwang’s research program focuses on interventions to improve the health of people who are homeless and to interrupt chronic homelessness itself.
• Dr. Andrew Boozary is a primary care physician and Executive Director, Population Health and Social Medicine at the University Health Network and Assistant professor in the Department of Health Policy, Management and Evaluation (IHPME) at the University of Toronto; Adjunct faculty member at the Mailman School of Public Health at Columbia University; Visiting Scientist at the Harvard T.H. Chan School of Public Health; Senior Fellow at the Wellesley Institute.

To open the discussion, Gibson highlighted data from local studies that illustrates the extreme health costs of living through homelessness:

• On average, homeless men in Toronto live 20 years less than the overall population (Toronto Public Health)
• People experiencing homelessness are 20X more likely to have epilepsy, 5X more likely to have heart disease, and 4X more likely to have cancer than the overall population (The Street Health Report, 2007).

The good news is that decades of cross-disciplinary research has generated numerous evidence-based solutions to combat this crisis. To learn about these, Gibson asked each of the panelists to share one policy or research finding they would share if given three minutes with a decision maker.

Hwang spoke to the success of Housing First, which quickly and successfully moves people into stable housing that is not contingent upon them first addressing mental health and addiction issues. Speaking to its success, he says “research has shown that 85% of people who are chronically homeless can be permanently housed with this intervention, and they will stay housed for 7 years or longer”.

Gabriel emphasized that for Indigenous people experiencing homelessness, policies that support communities in self-governance and acknowledge the importance of traditional knowledge are a necessity. Such culturally appropriate policies must be used to address the disproportionately high rates of homelessness among Indigenous people which has been caused by Canada’s colonial history.

Finally, Boozary spoke to the human rights and economic failures of our current housing and healthcare policies. He emphasized that rising income inequality should worry policy makers about keeping such an irresponsible system in place.

On the topic of COVID-19, the panelists spoke to the failures of this broken system. Public health’s primary advice to stay home and social distance continues to be impossible for those living on the streets, in crowded shelters and other substandard arrangements. The economic stress of the pandemic coupled with Toronto’s skyrocketing living costs is pushing people out of their homes or forcing inhumane decisions between rent, food and medications. The resulting chronic stress becomes another factor eroding health, causing the cycle to continue. Whether the argument is economic or moral, investing in affordable housing is critical for pandemic recovery.

Gibson then led a moderated discussion on why housing is such a fundamental determinant of health, what barriers stand in the way of stable housing, and how evidence-based policies can improve Canada’s homelessness crisis and bring greater healthcare equality to all Canadians.

A recording of the panel can be viewed on our Youtube channel and at the end of the article. TSPN would like to thank all our speakers for sharing their expertise with the University of Toronto community and the general public. We would also like to thank the Hart House Good Ideas Fund for generously sponsoring our event. Finally, we would also like to thank everyone who attended and participated in this event.

— The TSPN Team