Published on February 3, 2014
Health and your home Michael Shapcott The Wellesley Institute CFMS, February 2014
Research and policy institute???
Toronto 1911: Founding of Wellesley Hospital
“The health of Toronto must necessarily mean the health of its citizens. It must mean, too, the continued progress and development of Toronto along desirable lines. ...but I fear, in all candour one must confess that this city, in common with every large city, has acquired inevitable ‘slum districts’... You will probably say: “But Toronto has few such areas and they are not of great extent!” I say, and I think you will agree with me, that Toronto wants none of them, and that the Toronto of the future which we like to contemplate will have none of them.” ! Dr. H.A. Bruce Lieutenant-Governor of Ontario 1934
s um o g sl nt to d i o n e es or rm m T fo o ns h ra t od o
Equity, access, income and social determinants of health
ity al qu Ine
“After 20 years of continuous decline, both inequality and poverty rates have increased rapidly in the past 10 years, now reaching levels above the OECD average.” OECD (2008), Growing Unequal? : Income Distribution and Poverty in OECD Countries
Selected policy recommendations for OECD countries from Divided We Stand • Reforming tax and benefit policies is the most direct instrument for increasing redistributive effects. Large and persistent losses in low-income groups following recessions underline the importance of government transfers and well-conceived income-support policies. • The growing share of income going to top earners means that this group now has a greater capacity to pay taxes. In this context governments may reexamine the redistributive role of taxation to ensure that wealthier individuals contribute their fair share of the tax burden.
OECD social expenditures Canada 32nd out of 34 Toronto 1911: Founding of Wellesley Hospital
From poor to rich: Key household spending categories Survey of Household Spending 2011
Systems thinking: How interconnections in complex, dynamic world impact our lives and our health
Wellesley Urban Health Model
Practical proposals: The Mexico City Charter
Four observations: ! ! 1.Housing insecurity deep / persistent 2.Costly to people, communities, economy, government 3.Federal housing / homelessness investments eroding 4.No comprehensive national plan
Most housing needs invisible !
For renters, average market rents are outpacing renter household incomes Canada Mortgage and Housing Corporation 2010
Bad housing makes you sick! Homelessness: Increased morbidity Increased premature mortality Contextual: Individual / neighbourhood deprivation networks / friends / crime Socio-economic: Affordability / energy Transportation / income / jobs Mental health: Alarming rates... especially Clinical depression and anxiety Control / meaning Collective efficacy Biological / physical: Chemicals, gases, pollutants Design (accidents) / crowding
Good housing good for health! Physical and mental health: Better health outcomes / decreased health care utilization Environment / physical infrastructure: New housing, repairs, heating, noise, indoor + outdoor environmental issues, allergens, water + sanitation Community safety: Reduced recidivism among people leaving incarceration Affordability interventions: Income-based housing subsidies
Federal housing investments as a percentage of GDP) 1.20% 1.10% 1.00% 0.90% 0.80% 0.70% 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 0.50% 1989 0.60% Government Revenues and Expenditures 2009
$3,250 $3,000 $2,750 $2,500 $2,250 $2,000 $1,750 17 20 16 20 15 20 14 20 13 20 12 20 11 20 10 20 09 20 08 20 20 07 $1,500 Federal housing investments (in millions) Canada Mortgage and Housing Corporation 2012
When the feds cut a dollar in housing investments… matching funds from provinces, territories, municipalities, community and business are lost
626,300 homes in 2007 492,500 homes in 2017 Loss of 133,800 homes 22% of entire stock 650000 600000 550000 2017 2016 2015 2014 2013 2012 2011 2010 2009 2008 450000 2007 500000 Federally subsidized homes Canada Mortgage and Housing Corporation 2012
Steve Pomeroy - Focus Consulting - 2012
Federal government reinvest savings gained from end of social housing agreements into programs that will enable providers to maintain their units as social housing
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