Many factors contribute to keeping Canadians healthy. Just as crucial as access to healthcare, social supports and good working conditions, is housing. Currently, we are facing a housing crisis due to lack of affordability, disrepair, crowding, short supply, and the list goes on. If Canada is going to solve the housing problem, we need to put public health back into the equation and address it accordingly.
We need good quality housing, not just more housing. We need a robust, concrete and understandable definition of healthy housing and we need a way to measure it. It is not enough to have a roof over one’s head if that roof is unsafe or in disrepair. It is understood that quality housing must be affordable, suitable, comfortable, safe, and close to required supports, community resources, transportation, etc. But that is as far as our collective understanding goes. We have no way to know when these criteria have been met.
To move toward healthy housing in Canada, we need to direct attention specifically to existing housing in desperate need of repair. Public health reports have already warned of an increase in communicable diseases. We have learned from COVID-19 how important the ability to isolate is. Climate change and other environmental changes are likely to result in even more future health risks. Many of the purpose-built apartment buildings built sixty years ago could be at risk of catastrophic failure as their natural life span ends. This has already been seen in downtown Toronto with the St. Jamestown electrical fire in 2018. When crises like these occur on a wider scale, it will be a true disaster; thousands of people will be left homeless. We need to ensure that existing housing is built to accommodate our needs, but also be resilient to age and climate change.
Right now, the province and municipalities are responsible for building codes and enforcement, but these types of standards are not necessarily based on health evidence or best practices. According to the World Health Organization, if we are to narrow the health gap, key policies on housing standards for those in the poorest group have to be improved.
And how do we do this?
Canada is currently lagging behind other countries in the development and collection of housing data. Our current national housing standards are minimal. CMHC has a two-stage indicator of ‘core housing need.’ Homes only qualify for housing assistance if major repairs are required, there aren’t enough bedrooms, and the home is unaffordable. There is also the CMHC National Occupancy Standard, dating from the 1980’s, which states the number of persons per bedroom. Though this does not conform to international standards, and bedroom size alone is not enough to allow for adequate spacing. Common areas and square footage must be considered as well according to the UN.
The National Housing Strategy is a “10-year, $55 billion plan creating a new generation of housing in Canada giving more Canadians a place to call home.” It must be pointed out that the strategy is mostly a funding stream to build new housing, although the rental and repair stream of the strategy gives almost half a billion dollars in funding to modernize and renovate 300,000 homes. Unfortunately, this stream is not geared to private sector housing, where the vast majority of people live, and only provides standards on energy efficiency and renovations for accessibility. What is not included is what Canadians need to live in a healthy home: electrical system upgrades, well-functioning elevators, repair of broken appliances, repair of water damage, good air quality, adequate pest control, repairs for common areas, and unusable balconies made safe. And these are just some of the items that have been overlooked. The National Housing Strategy could go so much further in helping people understand and achieve healthy housing.
But there are some examples Canada can look to, one right here at home. Alberta has created a Minimum Housing and Health Standard to establish minimum conditions that are essential to good health. England has the Housing Health and Safety Rating System, embedded in national legislation to provide the standards of quality housing through an evaluative tool. Building owners that fail in their duty to provide adequate housing are identified on a publicly accessible database and can be banned from renting accommodation. Both of these programs use public health inspectors to enforce the requirements.
This is the approach needed to achieve healthy housing. Policies that recognize housing as a public health issue are required – in other words, policies based on accurate information about the state of housing and housing need, and specifically informed by the health impacts of housing on residents. Public health must be funded and mandated to resume its natural and historical role in determining and implementing healthy housing.
We also need a truly collaborative approach. The many players within this sector must come to the table to make the healthy housing vision crystallized and actionable. The federal government must step up, as they have in the past, and bring the rest of the country with them to repair and rebuild housing so it is safe, affordable and resilient, and supported by the required healthy housing standards and policies embedded in legislation.