This document summarizes a presentation by Michael Shapcott from the Wellesley Institute on the relationship between health and housing. It discusses how housing insecurity and poverty have negative health impacts, but also how good housing can promote health. It notes that federal housing investments in Canada have been declining, leading to a loss of over 130,000 affordable housing units. The document calls for increased and sustained federal investments in affordable housing to improve health outcomes and reduce social costs.

1. Health
and
your
home
Michael Shapcott
The Wellesley Institute
CFMS, February 2014

2. Research and
policy institute???

4. Toronto 1911:
Founding of
Wellesley Hospital

5. “The health of Toronto must necessarily mean the health of
its citizens. It must mean, too, the continued progress and
development of Toronto along desirable lines. ...but I fear,
in all candour one must confess that this city, in common
with every large city, has acquired inevitable ‘slum
districts’... You will probably say: “But Toronto
has few such areas and they are not of
great extent!” I say, and I think you will
agree with me, that Toronto wants
none of them, and that the Toronto
of the future which we like to
contemplate will have none of them.”
!
Dr. H.A. Bruce
Lieutenant-Governor of Ontario
1934

6. s
um o g
sl nt
to d i
o n e es
or rm m
T fo o
ns h
ra
t
od
o

7. Equity, access, income and
social determinants of health

8. ity
al
qu
Ine

9. “After 20 years of continuous decline, both inequality and
poverty rates have increased rapidly in the past 10 years,
now reaching levels above the OECD average.”
OECD (2008), Growing Unequal? : Income Distribution and
Poverty in OECD Countries

11. Selected policy recommendations for OECD
countries from Divided We Stand
• Reforming tax and benefit policies is
the most direct instrument for increasing
redistributive effects. Large and
persistent losses in low-income groups
following recessions underline the
importance of government transfers and
well-conceived income-support policies.
• The growing share of income going to
top earners means that this group now
has a greater capacity to pay taxes. In
this context governments may reexamine the redistributive role of
taxation to ensure that wealthier
individuals contribute their fair share of
the tax burden.

12. OECD social
expenditures
Canada
32nd out of 34
Toronto 1911:
Founding of
Wellesley Hospital

13. From poor to rich:
Key household spending categories
Survey of Household Spending 2011

14. Systems thinking:
How interconnections
in complex, dynamic
world impact our lives
and our health

15. Wellesley Urban
Health Model

16. Practical
proposals:
The Mexico
City Charter

18. Four observations:
!
!
1.Housing insecurity deep / persistent
2.Costly to people, communities,
economy, government
3.Federal housing / homelessness
investments eroding
4.No comprehensive national plan

19. Most
housing
needs
invisible
!

20. For renters, average market rents are
outpacing renter household incomes
Canada Mortgage and Housing Corporation 2010

21. Bad housing makes you sick!
Homelessness:
Increased morbidity
Increased premature mortality
Contextual:
Individual / neighbourhood deprivation
networks / friends / crime
Socio-economic:
Affordability / energy
Transportation / income / jobs
Mental health:
Alarming rates... especially
Clinical depression and anxiety
Control / meaning
Collective efficacy
Biological / physical:
Chemicals, gases, pollutants
Design (accidents) / crowding

22. Good housing good for health!
Physical and mental health:
Better health outcomes /
decreased health care utilization
Environment / physical infrastructure:
New housing, repairs, heating, noise,
indoor + outdoor environmental issues,
allergens, water + sanitation
Community safety:
Reduced recidivism among
people leaving incarceration
Affordability interventions:
Income-based housing subsidies

23. Federal housing investments as a
percentage of GDP)
1.20%
1.10%
1.00%
0.90%
0.80%
0.70%
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
0.50%
1989
0.60%
Government Revenues and Expenditures 2009

24. $3,250
$3,000
$2,750
$2,500
$2,250
$2,000
$1,750
17
20
16
20
15
20
14
20
13
20
12
20
11
20
10
20
09
20
08
20
20
07
$1,500
Federal housing investments
(in millions)
Canada Mortgage and Housing Corporation 2012

25. When the feds cut a dollar in housing
investments… matching funds from
provinces, territories, municipalities,
community and business are lost

26. 626,300 homes in 2007
492,500 homes in 2017
Loss of 133,800 homes
22% of entire stock
650000
600000
550000
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
450000
2007
500000
Federally subsidized homes
Canada Mortgage and Housing Corporation 2012

27. Steve Pomeroy - Focus Consulting - 2012

28. Federal government reinvest
savings gained from end of social
housing agreements into programs
that will enable providers to
maintain their units as social
housing

29. www.wellesleyinstitute.com
Thank you!