We can build a future in which everyone in the Greater Toronto Area [GTA] has the opportunities and resources they need to have a healthy home.
Healthy housing must be affordable, as people spending more than 30% of their income on housing means significant stress on their resources. Healthy housing must also be safe, of good quality, stable, and include supports for those who need it.
Currently, the disparities amongst GTA residents on this social determinant of health are significant and devastating. Those who cannot access and afford the housing they need are more likely to be from traditionally disadvantaged groups.
The COVID-19 pandemic demonstrated, and continues to demonstrate, how important housing is for health. At the beginning of the pandemic, many people with low incomes and smaller, shared spaces could not physically distance. If it were possible at all, they did not have space to work from home. Their children had no place to quietly homeschool. Infections ran through households, and residents suffered an echo-epidemic of stress related problems linked to families with insufficient space. The long-term impacts of our failure to provide healthy housing throughout the pandemic upon child development and mental health is not yet known.
We call for a new normal in which every individual or family pays no more than 30% of their income for a home that meets their needs. The homes must be healthy, which includes safe air quality, water supply, and being in good repair. The homes must include enough living space for each person in the household, space to support older adults or other family members in need, and space to work, study, and play where needed.
We can, and must, guarantee everyone in the GTA has the housing they need to be in good health.
TARGETS
Achieving this vision requires swift, significant action on multiple fronts. Governments and political parties must commit to measurable goals they will meet each year until the above vision is achieved.
The federal, provincial, and municipal government of Toronto have all previously committed to ending or greatly reducing chronic homelessness, with ten years as a common timeline – although we are not on track to meet it. Although the targets and methods fall short of our vision, meeting the targets below within ten years would significantly help to ensure housing that is unaffordable, unsafe, or does not have enough space for those living in it no longer negatively impacts health.
All three levels of government must take a role in achieving a vision for healthy housing and are jointly and individually responsible. They cannot wait for other levels to act and must, at minimum, demonstrate they are achieving their share of the progress we need.
Those of us who are low income, socially marginalized, and who need extra support are not able to have a healthy home. Because of this, any strategy must:
- Increase the number of affordable units available by building more and ensuring that current affordable units are not lost through poor repair or rent hikes.
- Increase the number of units that include needed supports.
- Decrease the number of people who lose their homes.
To do this, yearly targets must be set for each level of government:
- New affordable and adequate units must be constructed to ensure everybody who needs one, gets one. [i]
- These new homes must include enough supportive housing units[ii], and adequate supports must be funded for everyone needing them. The Toronto Supportive Housing Growth Plan (TSHGP) estimated that 18,000 new supportive housing units would be needed in Toronto alone by 2030.
- Enough current affordable units must be repaired and updated to ensure the entire stock has been addressed (i.e., 10% of all units needing repair each year).
- Evictions must be reduced each year until there are no evictions due to unaffordability or unfair, preventable causes.
- Rental affordability must be improved by 10% each year until each single-family unit or renter can afford an apartment at 30% or less of income.
It is also essential that these targets include sub-goals on equitable needs, so that those who are disproportionately impacted by homelessness and under-housing are protected. This includes, but is not limited to, racialized communities, low-income households, the 2SLGBTQIA+ community, and people with disabilities. A growing body of evidence also demonstrates that racialized households are subject to higher rates of eviction, which must be stopped. Meeting these targets equitably will also mean more rapid improvements in health.
Therefore, each level of government should also:
- Ensure that for each of the above targets a needs-based share of improvements reach the groups outlined above each year.
Achieving the above targets would be a meaningful step towards ensuring everyone has a healthy home and would allow policy makers to turn their focus towards other needs, including adequate space and good repair for all. If progress falls short due to the failings of other levels of government, their obligation is to meet all of the need themselves, and explain to voters where the other levels have fallen short.
METHODS
Toronto, Ontario, and Canada have an unfortunate history of describing housing as “affordable” if it meets affordability criteria for a select few, failing to provide affordable housing for all. For a very low-income household, 30% is $400 a month. For a median income GTA household, it is $2,000. Government targets and results reporting should therefore be categorized as: very low income, low income, moderate income, middle income, upper income.
To guarantee the construction of new units, government must primarily fund the construction and take steps to make this process timely. This includes increasing funding for not-for-profit housing providers to help maintain and increase existing supply and deliver repairs and improvements. Mandating inclusionary zoning in municipalities can meet some of this need.
All levels of government must come together to deliver adequate supportive housing. The federal government is best positioned to provide funding for construction; the provincial government must fund the necessary supports for each unit (and individual); the city is closest to the agencies providing the supports and has a crucial role in approving new developments and regulation. Each level must clarify how it is ensuring its share of units and supports are built each year, such that 10% of net projected need is met. The federal government should also hold all three levels accountable through funding controls.
Rental affordability and eviction elimination can be achieved through various policy changes. Poverty reduction measures and improved income security programming would go a long way in preventing evictions related to arrears along with helping overall housing affordability. At least for the medium term, rent subsidies should and could be provided by any level of government. The provincial government must put in place rent control policies that will hold rents down enough for incomes to catch up, at least until supply meets the need. They should also make changes to the Residential Tenancies Act designed to address unnecessary evictions. All levels of government can, and must, make investments in building out non-market housing that are significant and adequate to the need.
When it comes to market housing, the federal government and all major Ontario political parties are aligned on a target of 1.5 million new homes over the next ten years. This will have to factor in “middle-income affordability” needs, federal immigration targets, and increased lifespans. Finding ways to incentivize and enable new market-based building is laudable, and measures to achieve it, if carefully designed with equity in mind, may assist with the necessary targets above. This might include reducing demand for converted units and increasing the number of units delivered through inclusionary zoning requirements. However, there is no evidence that market housing construction alone will end homelessness, improve equity, or achieve affordability for lower income people. There is much more to do.
All possible methods to meet these needs should be swiftly studied through publicly available Health Equity Impact Assessments to propose tax, funding, legal, and policy changes.
NEED
Everyone should have access to housing that is stable, suitable for their wellbeing, and affordable. A wealth of research shows that lack of housing, poor housing quality, and unaffordability is directly and indirectly associated with mental and physical illnesses. In particular, those experiencing homelessness suffer from numerous compounding adverse health effects that often lead to premature death. Severe underinvestment in affordable housing and lack of policy action on other determinants–including poverty reduction–is exacerbating this issue. There are significant moral, economic, and health-related costs for not taking immediate action to deliver adequate and affordable housing and reduce – and eventually eliminate – homelessness.
Governments have also long fallen short on addressing the needs of those who are disproportionately impacted by homelessness and under-housing, including racialized communities, low-income households, the LGBTQIA2S+ community, people with disabilities, and other equity-seeking groups. These groups should consistently inform the above-mentioned targets and methods through recurrent community engagement and needs assessments.
CONCLUSION
Creation, implementation, and evaluation of a housing strategy to deliver affordable and adequate housing for all will require participation and collaboration across various institutions and sectors–including all levels of government, the public and private sector, housing experts, the health sector, and other partners.
The emerging consensus amongst political leaders around market-based solutions to middle and upper-income housing affordability must now be expanded to include those in most need. To do this, all actors should emphasize the economic and health impacts of unaffordable and inadequate housing.
The damage done to the health of GTA residents due to historic failures in providing adequate and affordable housing can, and must, be reversed. The solutions are available. It is time to act.
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[i] Census data from 2016 showed that in the GTA, 386,000 households lived in moderately unaffordable housing and 205,940 households lived in severely unaffordable housing. Both categories primarily consisted of low-to-moderate income households that had median incomes of below $90,000. Targets for affordable units must also address eliminating this discrepancy in rates of housing affordability between low-to-moderate and high-income groups.
[ii] Supportive housing, as defined in the Toronto Supportive Housing Growth Plan: Needs Assessment, refers to a range of approaches that vary by housing sector, housing type, support model, and support services. Central features of most supportive housing units include the provision of financial supports – such as rent supplements – to subsidize the cost of housing, and integrated support services for people experiencing mental health and substance abuse issues, chronic homelessness, and other challenges.