September 27, 2023

Housing ‘prescription’ to combat health impacts of Toronto homelessness

The mortality rate in Toronto of people who deal with chronic homelessness is dramatically higher than those who have a place to live, and soon a new modular housing unit will open — something the University Health Network (UHN) is “prescribing” as a means to tackle homelessness and health care pressures at the same time.

What was once a UHN parking lot near King Street West and Jameson Avenue is now a bustling construction site filled with workers putting the final touches on the Toronto’s latest modular housing project. The city, having opened several of the pre-fabricated sites in recent years, has used the approach because once land is identified, they can go from shovels in the ground to offering a home for a low-income resident within a year.

This location is no different, but when its doors open this winter, the residents will be determined not only by where they sit on the housing waitlist, but by how often they end up in emergency departments throughout the city.

UHN’s director of Population Health and Social Medicine, Dr. Andrew Boozary, said the hospital network has about 230 patients making up over 15,000 emergency department visits in Toronto — not because people are going there inappropriately, he said, but because there’s been a failure on housing as a human right.

“People who are unhoused generally live half as long as the general public, they’re more likely to have chronic disease conditions by two-to-three-fold, more likely to have mental health condition,” said Dr. Boozary.

The factors that bring them to hospitals, he said, are as much health-related as they are based on a constant quest for social supports which inevitably end up in a loop of desperation.

A partnership between UHN, the City of Toronto and the United Way of Greater Toronto may be the solution. Fifty-one rental units will soon open by the end of the year, offering rent-geared-to-income housing for those who need it the most.

Like other modular housing units the city has constructed, the residents will have wraparound supports to ensure they’re able to thrive.

“If people are able to have safety and security, they would not have to tend to the emergency department or be in the general medicine ward when there’s no other real options,” said Dr. Boozary. However, he stressed the program is not simply a “hospital discharge exercise.” Everyone has access to medical professionals and social workers, he said, and access to primary care. They can even bring their pets and use the community garden.

Dr. Kevin Smith, UHN’s president and CEO, said a similar program has been tested in New Jersey and elsewhere in the United States. But Toronto’s will not have a time limit for how long a person can stay. Success, he said, will be measured by their residents not ending up in an emergency room again when the better alternative is having primary care at home.

Dr. Smith said the program will be evaluated once tenants move in later this year, but UHN is already looking at other potential sites to expand more prescriptive housing.

He added he has spoken to counterparts in York Region who have expressed an interest in building a site of their own.

Global News