When we first met Mr. K, he was tucked underneath the crisp white sheets of his hospital bed. As medical students, we were sent to Mr. K’s room to practise gathering patient information. We worked down our mental checklist of questions. Mr. K patiently let us know that he was brought to hospital for severe abdominal pain. He was in his mid-50s, had a history of lung disease and recently underwent aggressive treatment for colon cancer.
It didn’t take a medical expert to recognize that his health was unstable. His long-term partner had recently passed away, and he had no family nearby. He was unsure how to manage his medications and follow-up appointments after discharge, so we asked if he had any neighbours who could help. He said he didn’t because he was living on the street.
In the health care system, we often encounter these stories, which make it abundantly clear how fundamental housing is to health – from a clean personal space for daily activities, privacy to manage one’s affairs and an address to use on job applications.
Toronto is seeing increasing levels of homelessness, presenting a dire public health crisis. Some 9,000 Torontonians are currently homeless, and about half are chronically homeless, defined as six or more consecutive months of homelessness. This is one consequence of decades of economic and social policies that have created unprecedented levels of inequality, forcing more individuals into precarious living conditions.
When we speak with people experiencing homelessness, we see how a few unfortunate life events or traumatic experiences can trigger a downward spiral of insecurity, poverty and poor physical and mental health. Many emphasize housing as the unequivocal first step toward reclaiming control over their lives.
People experiencing homelessness often face higher rates of chronic illness, mental health challenges, and substance use issues. Moreover, women, LGBTQ+, racialized and Indigenous people may experience homelessness differently.
Supportive housing is a model that addresses homelessness by combining secure, affordable housing with programs, including counselling, case management and medical assistance. This empowers people to live independently in communities while accessing health services they need to succeed.
Supportive housing pays, too.
Finland’s supportive housing program for homeless people saves the government $23,000 per individual per year. The 100,000 Homes Campaign in the U.S., which provided supportive housing to those at greatest health risk, demonstrated similar success with 85 per cent of individuals remaining in housing after one year. Not only does supportive housing have proven social outcomes, it also reduces costs in the hospital, shelter and criminal justice systems.
We need more supportive housing in Toronto. Of the 4,000 Torontonians who applied in the past two years, only 600 have been accommodated. Furthermore, wait times range anywhere from two to four or more years, forcing many to turn to couch surfing, shelters or the streets.
The city has committed to building 18,000 supportive housing units by 2028 but is not on track to meet that target. And Mayor John Tory’s Housing Now Initiative does not include a strong commitment to supportive housing. That’s why a group of 30 medical students from the University of Toronto are headed to City Hall today to press municipal leaders on committing to more supportive housing units.
As future health care providers, we want to be able to send patients like Mr. K into living conditions that promote good health rather than back into the streets or other precarious situations that keep people sick.
Chloe Brown, Nikisha Khare and Amita Mall are medical students at the University of Toronto and members of the Toronto Political Advocacy Committee.