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By providing secure,
safe housing, we are also addressing persistent health problems
By
Danyaal Raza
and Ritika Goel EvidenceNetwork.ca
TORONTO,
Ont. / Troy Media/ - As family doctors, we see and know the powerful effect
proper housing has on the health of our patients.
When you
feel unwell, whether from a minor cold or a devastating terminal illness, the
feeling of home, the desire for a safe and comfortable place to rest and
recuperate is universal. But what if your home itself is a source of stress and
illness? Worse yet, what if you don't have a home at all?
On the
front lines of health care, family doctors have the rare opportunity to see a
person as a whole, in the context of their lives and social situations. As
practitioners of evidence-based medicine, we also seek the most effective
interventions to improve the conditions of our patients. And the evidence is
clear. Social factors, like housing, income and wealth, educational background
and race are more powerful determinants of health outcomes than our behaviours,
genes or even the health-care system.
And yet,
experts in health are often trained to focus on the provision of health-care
services, often sending patients back into the social and economic conditions
that made them sick. Nowhere is this more evident than for individuals
experiencing homelessness or living in unsafe, precarious housing.
We treat
chronic back pain and send people back to sleep on concrete streets. We treat
insomnia and send people back to chaotic shelters where they cannot sleep. We
treat asthma and send people back into mouldy homes where they labour to
breathe. We send patients back to the very places that create their
disease.
As
health-care providers, we know the actual prescription needed is safe, secure
and affordable housing. We are not alone.
Canada's
former chief public health officer, Dr. David Butler-Jones, agrees
that inadequate housing can have several negative repercussions on health
ranging from "respiratory disease and asthma due to moulds and poor ventilation,
to mental health impacts associated with overcrowding."
This is
not a small issue. An overwhelming 1.5
million households in Canada live in precarious housing that is inadequate,
unsuitable and unaffordable. In other words, 1.5 million families live in
housing that requires major repairs, does not have enough bedrooms for their
needs and pay more than 30 per cent of their household income for this unfit
housing.
This is
not a sustainable and it endangers the health of our communities. The 1.5
million in precarious housing does not even count the over 235,000
a year experiencing homelessness in Canada - those living in shelters, sleeping
outside or surfing friends' couches.
The recent
federal budget offered $2.3 billion for affordable housing - a step in the right
direction. We know some of the funds will be allocated to deal with
homelessness, First Nations housing and seniors. While these are positive steps,
there is as yet no timeline for promised consultations on allocating these
funds. The government's solution to our housing crisis cannot be about writing
cheques and walking away.
When
consultations are launched, as health providers who see the impact of these
policy decisions on the ground, we have suggestions.
First and
foremost, housing must be viewed as a health and social justice issue. Safe,
secure and affordable housing is crucial to maintaining and improving health and
well-being.
Secondly,
these conversations must include not just the health sector, community partners
and think-tanks but, most importantly, those who have experienced homelessness
and precarious housing.
Finally,
our approach to the housing crisis cannot be one-off policy changes but should
be part of a co-ordinated national housing strategy. This is the approach
recommended by the United
Nations Economic and Social Council in March. They raised red flags over our
insufficient funding for housing, our shortage of social housing units and
increased evictions related to rental arrears.
Tackling
these problems in a co-ordinated strategy - not just with short-term spending
promises but with meaningful long-term partnerships - isn't just good social
policy, it's good health policy.
It's time
to move from crisis to action, from precarious circumstances to security, and
towards improved housing and health for every Canadian.
Danyaal
Raza is an advisor with EvidenceNetwork.ca and Upstream, a family physician at
St. Michael's Hospital and assistant professor at the University of Toronto.
Ritika Goel is a family physician with the Inner City Health Associates working
with people experiencing homelessness, as well as a lecturer at the University
of Toronto.
© 2016 Distributed by Troy
Media
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