Saskatoon’s housing crisis is a health emergency

Recently, a disturbing photo of five people sleeping in a Saskatoon bank lobby became headline news and filled social media feeds.

An earlier photo had contrasted the lush yards on the east side of the riverbank with tents in the bushes on the west side. A few days later, homelessness was back in the news, with the fire department discovering a makeshift living space under the closed Traffic Bridge. This spring, the Saskatoon Health Region closed numerous units in a downtown hotel due to conditions unfit for habitation.

These disturbing images and events each are part of a larger narrative: despite a strong economy, Saskatchewan has a deficit in access to safe and affordable housing.

Such stories put a human face on the state of housing and homelessness in the city. This summer, the Saskatoon Housing Initiatives Partnership performed a "point-in-time" count of people without a home on a given night and found 405 people. The number from these counts has steadily increased, with 260 people without a home identified in 2008 and 379 homeless in 2012.

What's especially disturbing is that 45 of the homeless individuals in this year's count were children. Across Canada, an estimated 235,000 people will experience homelessness in the course of a year, with 35,000 homeless on any given night.

Beyond those who are homeless, many Canadians struggle to maintain the housing they have. The Canadian Mortgage and Housing Corporation defines core housing need as paying more than 30 per cent of household income for housing. In 2014, one in four Canadians were in that situation, with the cost of their dwellings squeezing out the ability to pay for other essentials.

The health impacts of homelessness and inadequate housing are well known. A 2007 Wellesley Institute study showed that homeless people in Toronto were 29 times more likely than the general population to have hepatitis C, 20 times more likely to have epilepsy and twice as likely to have diabetes.

These conditions are related to an interplay between the social and personal factors leading to homelessness and the hardships of living in inadequate housing. Lack of shelter means exposure not only to the elements, with risk of heat stroke in summer and hypothermia in winter, but also to violence and other risks.

Accessing safe food and clean water becomes a challenge, and healthy social and family dynamics all but impossible. Managing mental health issues, addictions and other illnesses is improbable without a stable living situation.

As a result, hospitalization for unmanaged chronic medical conditions rises, as do ambulance pickups to address emergencies. The cumulative effect of these challenges has untold impact on individuals, and costs the Canadian economy more than $7 billion a year.

As one of the major upstream determinants of health, if housing is properly addressed we can avoid preventable illness and costs, and promote good health in our communities.

In Saskatoon, a "Housing First" pilot program spearheaded by the United Way provided housing to 10 local residents who have challenging health issues and social circumstances. In only six months, the program saved nearly $700,000 through decreased ambulance trips, hospital visits, police calls and detentions.

Along with these compelling immediate benefits, safe, stable housing allows people an opportunity to manage health issues, pursue education and employment, as well as develop supportive family environments. The Saskatchewan government's advisory group on poverty reduction recently released recommendations for a provincial strategy.

Reflecting the role of housing in both preventing and alleviating poverty, its recommendations include establishing a province-wide Housing First model and strategies to increase affordable housing. All levels of government have a role to play in making safe and affordable housing available to all. As well as the direct development of affordable housing, cities have a variety of tools available to encourage and maintain such housing options in their neighbourhoods.

Federally, there is potential for leadership on this issue and practical initiatives such as earmarked funding for affordable housing. Canada remains the only G-8 country without a national housing strategy.

The people of Saskatoon have been rightly upset by recent pictures of homelessness. Now is the time for us to demand action from political leaders so that we can instead become the picture of health.

Ryan Meili is an expert advisor with EvidenceNetwork.ca, a practicing family physician in Saskatoon and founder of Upstream: Institute for A Healthy Society and Chair of Canadian Doctors for Medicare.

Michael Schwandt is a Public health physician and Assistant Professor, Department of Community Health and Epidemiology, University of Saskatchewan.