Homelessness adds to health care costs. A strong welfare state is a healthier one

Inadequate access to safe and affordable housing is an expensive health care bill, and all Canadians are paying the cost. Additionally, access to safe and affordable housing is imperative for good health. Nevertheless, many debates surrounding the issues of inadequate housing and homelessness for Canadians have not resolved the issue.

Federal government policies have been developed, housing strategies and incentives announced and yet, according to homelessness statistics in 2024, the estimated number of homeless people in Canada ranges from 30,000 to 35,000 on any given night. It is estimated that more than 235,000 Canadians are experiencing homelessness at any given time, and some say this number is grossly underreported due to hidden homelessness.

The Canadian Institute for Health Information reports that the number of reported unscheduled emergency department visits was almost 15.5 million in 2023–2024, up from 15.1 million in 2022–2023. Visits to hospital emergency departments by persons experiencing homelessness has increased from an estimated 141 visits per 100 persons per year during 2010–2011 to 310 during 2020–2021.

“Homeless people visit emergency departments because of illness, trauma and injury, but also because they may have difficulty accessing mainstream health care. In addition, they may also visit emergency departments due to food, shelter, and safety needs,” according to the Homeless Hub. Canada’s homelessness problem is adding costs to and straining our health care system.

Why is homelessness such an issue in Canada? What are the costs of homelessness and what is being done about it?

Statistics Canada estimates that the annual cost of homelessness is over $10 billion. In 2024, the Canadian government committed to spending $5 billion to combat homelessness over a nine yea period. The math doesn’t add up.

Homelessness knows no bounds and touches every demographic. Homelessness statistics in Canada from 2024 reported that 23% of people experiencing homelessness are 13-24 years old and 66.7 per cent are males. About one third, 33.1 per cent of the homeless in Canada come from Indigenous communities. People aged 25 to 49 were most likely to use shelters in Canada at about 60.3 per cent. Seniors account for less than 5 per cent. Women account for 31.1 per cent. A Point-in-Time count of homeless from 2010 found that 71 per cent of women were experiencing homelessness because of domestic violence or abuse.

While most people seeking accommodation in homeless shelters are adults, the number of children living in shelters is growing. In 2020, approximately 4,000 children were staying in shelters across the country. Twenty-six per cent of young homeless people identify as LGBTQ+. The Indigenous community have a disproportionate risk of becoming homeless. In Canada, while 5 per cent of the population are Indigenous people, over 39.1 per cent of people who do not have a permanent home identify as Indigenous. Veterans make up 1.4 per cent of the shelter population in Canada.

Homelessness is clearly an issue in our country. We know that access to affordable and safe housing is a social determinant of health. The lack of housing continues to pose ongoing health risks for physical and mental health and is a barrier to primary health care and chronic disease management.

“Research reveals a complex set of links between homelessness and health – people who are homeless are poorly nourished, they are unable to get proper rest, [and] when they get sick they are unable engage in proper healthcare practices (such as following a drug or treatment regime).” How can Canada do better?

Canada’s gross domestic product for revenue for housing hovers around 40 per cent. Housing has become a significant profit driver within the Canadian economy. There seems to be little political will or motivation to cap the markets or lower housing prices as it is a money maker. Investor trusts hold 20 per cent of the housing market stock and the federal government halted public housing development in the 1990s.

The cumulative effects of inflation, the increased ratio of income spent on mortgage and/or rent, and low rental vacancy rates in conjunction with inadequate public housing stock has created the perfect storm for Canada’s most vulnerable citizens. The federal government has not developed an effective de-commodification strategy for the housing crisis and the results have increased social stratification.

As a federal election is nearing, these issues are of increased relevance. Voters ought to pay close attention to political and policy platforms. There needs to be an independent review to assess the short comings of the current Canadian Strategy on Housing.

Homelessness affects all Canadians. The costs are not limited to providing a physical space, but are carried over to institutional health, psychiatric services and the criminal justice system.

Stronger social policy must be developed and implemented to address the multidimensional and complexity of homelessness. A strong welfare state is a healthier one.

Amanda Coombs is a first year Masters of Social Work student at Dalhousie University.