Inadequate housing complicates TB treatment. (Nathan Denette/Canadian Press)

The head of the Canadian Medical Association said cities need to do a better job providing sustainable housing if they want to lower mortality rates among homeless people with tuberculosis.

Last week a study published in the journal Emerging Infectious Diseases found that 20 per cent of homeless people with tuberculosis die within a year of diagnosis.

The problem was identified ten years ago, say the study's Toronto-based authors, but the high mortality rate still hasn't changed.

An inquest into the death of Joseph Teigesser, a homeless man who died of tuberculosis in Toronto in 2001, had made 13 formal recommendations, including provincial funding for a centralized clinic system to provide specialized care for people with TB and improvements to shelter ventilation.

But the study's authors said those are two areas where the province and cities have fallen short.

CMA president Dr. Jeff Turnbull, who also serves as chief of staff for the Ottawa Hospital and co-founded the Ottawa Inner City Health program, said the study's bleak picture should push cities to spend more on sustainable and supportive housing.

Shelter improvements not enough: MD

He said improvements to shelters, however, wouldn't be enough to counter the underlying barriers to proper treatment of the disease, which primarily targets the lungs.

"Improving conditions in a shelter doesn't make a lot of sense to me," said Turnbull.

"I'd rather move people from a shelter into a much more appropriate setting where we can bring in better health services. Another part of it is improved education, screening and better management of tuberculosis when we do identify it in our homeless community," he said.

Turnbull said tuberculosis claimed Inuit artist Normee Ekoomiak in Ottawa two years ago.

Turnbull said Ekoomiak, who had been living in and out of homeless shelters for two decades, was "a perfect example of somebody who had tuberculosis and ... didn't get the treatment he deserved because he was homeless," he said.

"We shouldn't have people living in emergency shelters for the better part of their life. That's not best for anyone," said Turnbull.

Worldwide, tuberculosis claimed the lives of 1.7 million people in 2009, according to the World Health Organization.