Home remedy: Understanding housing as a medical intervention could transform the homelessness crisis

Where I want us to start is I, I wanna go back and kind of find something that lit the spark for you, but a moment that made you realize that thinking about housing was important when it comes to delivering healthcare.

Well, thank you, and good, good morning.

This is a real privilege to be at MaRS.

Uh, you know, I think, again, talking about the innovation and new ideas, and I think you described it as a radical idea.

Uh, but I think the reality is I know there's folks, uh, who've long advocated for housing as a solution, and I think we as a hospital system and a healthcare system have been slow to catch up, but also having to fill gaps that we probably wouldn't have anticipated.

You see people come through the emergency department, and the best you can offer is, at best, a Band-Aid solution.

And this happens on repeat throughout the country and especially what's happening in Toronto.

Uh, and we're trying to treat the symptom and not get at the root cause, which is there is really what I've described as the pathologies of poverty.

And so the idea is that if people are without housing, without basic human rights, it's impossible to treat amenable conditions.

I would say, sadly, there are countless stories, and I think the hardest ones are where you see people pass away prematurely, not because of a lack of the quality of care, which argue again at UHN and across the system is really world-class in the Canadian healthcare system, but because of the pathologies of poverty.

And I think that stays and sits with every health worker in various domains and at various times.

I would imagine that it feels like you're applying a Band-Aid only to see this person back again in about a week.

Yeah, it's, it's back again, but it's also, I think, the realities of outcomes that would be totally preventable.

I mean, we also have to be clear about some of the data that in Ontario we have some of the highest limb amputation rates.

And so for folks who might be familiar with diabetes, some of the sequelae is that you can see the, the need for amputations but should be more extreme or where there's not, uh, treatments in a primary care setting.

We have some of the highest rates because people are not getting access to housing.

We have real systemic factors facing Indigenous, Black, and refugee newcomer populations.

And I think, you know, many times seeing people have to lose limbs that could have been totally preventable, and I've talked about patients who I've seen pass in tragic circumstances I think really shape and drive the work.

And I think this is something that's not exclusive to us at UHN.

It happens so much in community, and I should also acknowledge that we're at a time where we've also have a toxic drug overdose crisis that's intersecting with the homelessness crisis, with, you know, mental health crisis and people having challenges to access care.

And that comes with real human costs.

I think the weight that many people working in the front line, whether it's in harm reduction or medicine or in social work, are feeling and facing.

And so that's why I think these conversations are hopefully helpful to try to galvanize some of this energy for the solutions like Dunhouse or we'll talk to some of the social medicine housing.

But I think really more broadly, and this has been a conversation that people have been fighting and pushing and willing, uh, for twenty, thirty, forty years, and I just don't think we've seen it this bad