The Oxford dictionary defines ”home” as a place where one lives permanently. However, it can be argued that a home is much more than that. For example, when you have a cold or a severe illness, you are bound to think about the comfort and rest you could receive at home. But what happens when your home is the cause for your sickness? What if you don’t have a home? This is the reality for one and a half million Canadian households who are insecurely housed, and approximately 235,000 Canadians who experienced homelessness in 2014.
Zooming into the municipal level, we find that housing affordability has been a growing concern in the Canadian city of Toronto for many years. In 2017, housing affordability in Canada was at its worst in 27 years, with Toronto taking the hardest hit: house prices increased by an average of 23 percent while annual family income rates remained the same. This has left Torontonians with limited housing options and put their health at risk.
As family budgets become more constrained and rent continues to makeup a large portion of people’s spending, many experience a lower quality of life. The relationship between adequate housing and health is multi-faceted. For example, living in a poorly ventilated house can result in the spread of air-borne diseases such as tuberculosis. As well, families living in damp and moldy housing conditions have significantly higher chances of developing respiratory conditions. Many of these houses also don’t have a proper heating system, which could prevent one from catching the cold, flu, or pneumonia. This is particularly a concern in Canada, which has long and harsh winter months. Many low-income families and individuals have even opted to live in overcrowded housing, where they experience increased risk of contracting communal diseases, such as acute respiratory infections and meningitis. Furthermore, these individuals are affected by illnesses for a longer period of time, as some skip meals or do not purchase the medications needed in order to pay for their rent.
Unfortunately, it is often young children, immigrants, the Indigenous, and older adults who are at greatest risk of experiencing a mental illness due to their housing conditions. Over 15 percent of Canadian children under the age of 9 live in families that are insecurely housed, and 40 percent of all Aboriginal children grow up in poverty. Inadequate housing conditions have proven to be linked to increased stress, tension, depression, disturbed sleeping patterns, and can significantly impair a child’s cognitive development. For example, living in a moldy and damp area can cause children 14 years old and under to fall into depression or anxiety, whereas excess cold can result in slower physical growth and cognitive development.
While finding affordable rent in Toronto becomes increasingly difficult, social housing agencies are facing a crisis themselves. In 2017 alone, 92, 452 applicants were waitlisted for subsidized housing, but only 3 percent were provided with a home. Thus, it is no surprise that, after waiting an average of 9-years, waitlisted individuals have no other option but to gravitate towards run-down homes. Even homeless shelters in Toronto operate at a 95% occupancy rate. The homeless population experiences a greater burden of health conditions, as they are 5 times more likely to have heart disease, 4 times as likely to have cancer, 3.5 times more likely to have asthma, and twice as likely to have diabetes. The homeless are also unable to afford medication or are refused health services, and so they return to the shelters or the streets where their health problem originated. In this situation, how are they expected to get better?
Toronto has taken notice of this issue, and in 2015 the City Council approved The Toronto Poverty Reduction Strategy. A few key components of this 20-year plan include the improving the quality of affordable housing, assisting individuals to secure and maintain affordable housing, and creating more affordable homes. Homelessness cost the Canadian economy $7.05 billion dollars in 2013, as the average cost of a homeless individual in Toronto is approximated to be $59 000 per year. By placing individuals in social housing instead of shelter beds, provincial jails, and hospitals, the city could save $1732-$10700 per person.
A possible solution to housing is the Housing First Model. The idea is simple: provide individuals with a home first, so that the other issues they face can be addressed once they are stabilized. A prime example of the success of this program is in Finland, which is the only European country to see a decrease in homelessness over the years. In order to do this, a national homelessness policy was implemented and it took collaboration between state authorities, municipalities, and NGO’s in order to be successful. The Housing First model could reduce more than half of the current costs of a homeless individual in Canada. In fact, a one-year trial program in Canada held a lot of promise, showing great improvements in housing stability and quality of life for individuals who took part in it. The model has yet to be implemented nation-wide, and Toronto is still a long way from establishing these partnerships and the adequate housing needed.
Although there has been talk to provide more safe, affordable, and adequate housing in Toronto, more needs to be done. Not having a safe home can have serious physical and mental health implications for children, individuals and families. In 2017 alone, Toronto Public Health estimated that 94 homeless individuals died on the streets. This number is both troubling and alarming. The social service industry needs to learn from its international counterparts and act in a more impactful way, either by funding more shelter beds or improving the quality and quantity of affordable housing. There’s no denial that housing is a social determinant of health, and once it has been addressed, the people of the city will prosper, and so too will the city itself.