Opinion

Access to housing is not just a political issue. COVID-19 has made it a matter of life and death

The 35,000 Canadians who experience homelessness every night are at a crossroads as winter approaches, write Dr. Naheed Dosani and Dr. Trevor Morey.

The 35,000 Canadians who experience homelessness every night are at a crossroads as winter approaches

An ad-hoc tent city in Vancouver's Strathcona Park is seen in mid July. The city's mayor says the federal government must help with permanent housing solutions. (Ben Nelms/CBC)

This column is an opinion by Dr. Naheed Dosani and Dr. Trevor Morey of Toronto. Dr. Dosani is a palliative care physician & health justice activist who provides health care to people experiencing homelessness. Dr. Morey is a physician and health care advocate for people experiencing homelessness. For more information about CBC's Opinion section, please see the FAQ.

On a park bench in downtown Toronto recently, Rick was struggling to catch his breath as he tried to figure out where he would sleep that night. For the past two months, he had been bouncing between his local hospital and various shelters after starting chemotherapy for newly diagnosed lung cancer.

Rick, 62, is suffering, just trying to get through the day between feeling nauseous from chemotherapy and feeling short of breath from his lung cancer. As physicians who are part of a palliative care team for people experiencing homelessness, we've been working with Rick to find medications to alleviate his symptoms and improve his quality of life. Besides the medical care we can provide him, he had special hope for one particular prescription: a place to call home.

Rick's request is not an unusual one. But during the COVID-19 pandemic, this request has become more frequent as people struggle to find space in a shelter system that has less capacity than ever because of efforts to prevent further spread of the virus.

As a stopgap measure, many jurisdictions have set up COVID-19 programs to support people experiencing homelessness. Meanwhile, in cities across Canada our homelessness crisis is more visible than ever as people have fled in fear, preferring to be outside of these systems, some living in tents to maintain physical distancing.

This unprecedented time has shown us all that access to housing is not just a political issue, but a matter of life and death.

A man sits on the sidewalk near a mural of Minister of Health Patty Hajdu, painted on a boarded-up business in Vancouver’s Gastown neighbourhood. Homeless advocates say more safe housing is needed for homeless people during the COVID-19 pandemic. (Maggie MacPherson/CBC)

Fortunately, Rick recently got his wish. He's been given access to a hotel room that has been repurposed to provide housing during the pandemic. But a week into his stay in his new temporary home, where he has his own bathroom and a comfortable place to sleep, he asks our team, "When the pandemic is over, will I have to go back to the street?"

The truth is that unless there's action, he probably will end up back on the streets.

According to a recent nationwide Nanos poll, 36 per cent of Canadians say they have experienced homelessness or know someone who has.

Nearly 1.6 million Canadians have had to spend time in a shelter or on the streets in urban cities, suburban communities and even rural areas at some point in their life.

Prime Minister Justin Trudeau recently said COVID-19 has unmasked "fundamental gaps" in our society, and our housing gap is one that looms large. With that said, Canadians recognize the need for change. The same Nanos poll showed that eight out of 10 Canadians support investments in new affordable housing, and three out of four feel that finding an end to homelessness must be addressed urgently.

As the pandemic drags on and shelter capacity has been reduced, homeless encampments are popping up in Canadian cities and there are concerns they will only continue to grow as evicted renters are forced onto the streets. 2:07

So, how can we fill a prescription for the end of homelessness in Canada? A new framework released by the Canadian Alliance to End Homelessness, entitled Recovery for All, provides a six-step plan. It would offer Rick and thousands of other Canadians a better chance at living in the kind of home they deserve:

1. We need a federal commitment to end homelesness, with specific timelines and targets. This includes maintaining current federal emergency funding for the COVID-19 pandemic and transitioning to permanent funding that supports the end of homelessness. As not all people experience homelessness in the same way, a commitment to a national definition of homelessness that recognizes the unique needs of women, youth, and Black, Indigenous & People of Colour (BIPOC), is crucial.

2. Alleviate poverty by increasing people's capacity to pay through adequate income support programs. A compassionate approach should not stigmatize the poor, nor penalize those who wish to work but still need help to meet the income threshold. This strategy must be implemented alongside other efforts to end homelessness and provide an adequate income that meets the cost of living.

3. Expand the supply of affordable housing. More than 370,000 new permanently affordable housing units are needed to meet the current needs. Meanwhile, enhancements are needed to Canada's existing rental support programs for low-income people.

4. While the government of Canada has recognized housing as a right, it has yet to create an oversight structure to support and protect people who experience difficulties obtaining housing. For example, BIPOC who are facing discrimination, and children in child welfare services who face discharge to homelessness. The federal government should implement the promised National Housing Advocate and National Housing Council that would ensure human rights oversight and accountability in developing and implementing pandemic recovery plans. The collection of race-based and ethnicity data will also be vital to ensuring that those who need help receive it.

5. Prevent the erosion of our existing naturally affordable housing stock by limiting the ability of large capital funds (including Real Estate Income Trusts - REITs) to buy up rental housing. This phenomenon has been shown to deepen Canada's housing crisis by taking existing rental housing off the market or by increasing rent, thereby making it unaffordable.

6. Address the fact that Indigenous people are dramatically over-represented among people experiencing homelessness in Canada. This can be achieved by developing and implementing an adequately resourced and distinct housing strategy that is created by urban, rural and Northern Indigenous people.

The creation of new homeless shelters in Toronto has created tensions in one neighbourhood. Some residents say they don’t feel safe, while others say people in temporary housing are being discriminated against. 2:00

With a stable place to stay, Rick's symptoms have improved, he has access to his medications and his appointments are better coordinated. However, as Rick is "too well" for a hospice or a palliative care bed, he still stays up at night anxious and afraid that he may lose his housing and have to go back to the street.

There are 35,000 Canadians who experience homelessness every night, and they are at a crossroads as fall and winter quickly approach.

The COVID-19 pandemic proves that policy can change quickly in crisis. All levels of government have the ability to develop and implement a prescription for the end of homelessness in Canada.

The time to fill that prescription is now.


About the Author

Dr. Trevor Morey is a physician and health care advocate for people experiencing homelessness in Toronto. Dr. Naheed Dosani is a palliative care physician providing care for homeless & vulnerably housed populations in Toronto.

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