Thank you very much, Mr. Chair, and thank you to the committee for this opportunity to be able to present today. I want to commend the committee for centring the voices of lived experience in the expertise of designing some of the solutions in responding to the housing crisis.
I approach this testimony as a physician who has predominantly worked with unhoused patients over the past 10 years. I'm the executive director of the Gattuso Centre for Social Medicine and a researcher at the Dalla Lana School of Public Health at the University of Toronto.
My thesis, and the thesis that I believe we have all shared and heard today, is that we need to have a more expansive view of the housing crisis as an economic, social and health crisis.
In making the argument for housing as a health crisis, I would like to point to some of the data that I believe is incredibly damning for us as a country, one of the leading OECD countries. We know that people who are chronically unhoused live half as long as the general public. That is 20, 30 or 40 birthdays and birth years that are lost. If any drug could restore 10 to 20 life years, you would think that all funders would be tripping over themselves to ensure that these solutions and treatments could reach more people.
We know that people who are unhoused are likely to be in hospital twice as long, for 15 to 16 days on average. We also know that health care costs for people who are chronically unhoused are sevenfold to eightfold higher, according to CIHI data that was just released last year.
The moral failure, though, which was just recently published by Toronto Public Health, is that the average life expectancy of women who are chronically unhoused in the city of Toronto is 36 years. This is why I and colleagues, as health workers and frontline workers, have been calling homelessness the most powerful social determinant of health, or really a thief of life years, productivity, health and well-being in this country.
I do not believe there is more powerful testimony than what we heard from Mr. Miles, but I think it underscores the view that this is not about individual failures: These have been policy decisions. As we've seen more recently, there has been a real reduction over the last 20 to 30 years in the availability of social housing, now at less than 4%. I urge the committee to read the Scotiabank report entitled “The Public Housing Dividend”, which calls for a doubling of the social housing supply in Canada.
We've heard that the wait-list to access social housing in Toronto, where I work, is eight to 10 years, so it is not sensationalist when colleagues and I call homelessness a terminal condition. Many of the patients we serve will pass away before their number is called to get into social housing.
This was the impetus for us to launch a social medicine housing model at the University Health Network, which was able to leverage a parking lot—in partnership with the federal, provincial and municipal governments and with Fred Victor as a supportive housing agency—to establish Dunn House. We really appreciate that Parliamentary Secretary Desrochers was able to visit earlier this year and was able to visit with Mr. Miles and many of the staff who have been working to provide a more comprehensive model that has health care right on site.
I am privileged to work there as a primary care physician. We have mental health and addictions treatment, psychiatry, indigenous health programming, peer workers and community health workers all wrapped around the patient and tenant in their journey.
Many of these patients have been high utilizers of the health care system. We know from some of the local data that in downtown Toronto, 234 patients can make up over 15,000 emergency department visits in one year. The preliminary results we've been able to see for 51 individuals who've been living at Dunn House over the last 12 months show a 79% reduction in hospital bed days and a 62% reduction in emergency department visits.
We're grateful that this has led to an expansion, with 54 more housing units supported by the federal government, the Province of Ontario and the city government, to ensure that more people can receive these life-saving interventions and to interrupt doom loops and what I would argue have been deaths of indifference, which have been occurring across the country.
When we look at some of the other jurisdictions across the country, we see extremely notable examples of supportive housing working, reaching people and helping people re-establish their own trajectories. Sometimes we can look at countries like Finland, which has been the poster child for a progressive way of addressing homelessness. Their rates of homelessness in the 1980s were higher than what we have seen in Canada, but over the last 10 to 20 years, they have been trying to eradicate homelessness.
Sometimes when I reference Finland, people dismiss the example by saying that it's too progressive or too socialist of a country to have as an example for us in Canada. Then I turn to another city, Houston, Texas. In the last five to 10 years, it has housed 25,000 individuals. We've seen in Toronto a complete reversal in this tale of two cities, where homelessness has doubled over the last four years.
I believe that the urgency for us to act has never been more dire. We know what the solutions are. I'd like to commend the Crown agency Build Canada Homes, which has tried to be a vehicle to see more supportive housing reach people. I believe it's an effective avenue, and we need to see more investment there to see many of the housing options reach people, as Mr. Miles spoke to, and we obviously need to see a cross-partisan, every-level-of-government approach to trying to end homelessness as a health care crisis.
When we look at Houston and some of the examples that were laid out earlier today, a large part of their success was about having the focus and political will across political parties to end homelessness and about the removal of some of the silos and barriers to try to bring the private sector, the public sector and various community health organizations all together in one room to be focused.
Thank you so much for your time.