Toronto transit hikes an unfair burden to low-income patients
John* is a kind and humble middle-aged man who I met as a patient a couple years ago. He worked part time for minimum wage and spent the rest of his time in the library, trying to improve his reading and computer skills. He had several health conditions that required specialist appointments, which most likely stemmed from the daily challenge of living in poverty.
He was often forced to make decisions on whether to spend his limited income on transit fares or food, since rent consumed most of his monthly earnings. On numerous occasions, he told me he would have to miss medical appointments because he could not afford to pay for transit. The cost to get to work and back was already too high.
Many of us thought of our patients like John a couple weeks ago when we heard that the Toronto Transit Commission (TTC) had approved another fare hike in 2017. The price of a token will jump from $2.90 to $3, representing the sixth year of rising costs.
While Toronto Mayor John Tory recently approved a 33 percent discount on TTC adult fares for low-income riders in the city, the first phase will not roll out until 2018, leaving many in the lurch for all of next year.
In addition, while this change is welcome, transit costs will remain out of reach to those with the lowest incomes. If we are going to make any real progress on improving health and social inclusion for this group, we need to listen to organizations across the city, which have called for a free Metropass program for those on social assistance.
Public transit that is affordable and accessible is an important element of a healthy, inclusive, and equitable city. This was highlighted in a 2013 Toronto Public Health report that flagged cost as a barrier to transportation use that impacts people’s ability to access food, employment, education and health services. Since people with low incomes are less likely to own a car and more likely to rely on public transit, fare increases deepen health and social inequities for this group.
Rising transit costs also affect children’s health. Twenty-seven percent of children live in low-income families, the highest percentage of any large urban area in Canada. While children age 12 and under ride for free on the TTC, their parents must pay. Research by Toronto Public Health shows that the cost of public transportation affects low-income parents’ ability to take their child to the doctor, access community based-programs, and visit food banks.
It is clear that the TTC faces a funding shortfall, but it is unfair and shortsighted for the City to continuously raise revenues in ways that disproportionately impact the lowest income Torontonians. This regressive tactic leaves those with lower income spending a higher proportion of their income on public services.
There are alternatives to raising transit fares, which were explored in a Wellesley Institute report earlier this year. It proposed that a non-residential parking tax or vehicle registration tax could generate revenue to improve public transit affordability. There are also important health and environmental arguments for this type of endeavour. Toronto Public Health estimates that air pollution due to vehicle emissions causes 280 premature deaths and 1,090 extra hospitalizations in Toronto each year.
It is my hope as a healthcare provider that Tory and Toronto city councillors will stand for a more fair, inclusive and equitable city by stopping funding cuts to social services, rejecting fare hikes to public transit and working towards immediate solutions such as a free Metropass for those on social assistance. The municipal, provincial and federal governments must work together to find a solution to ensure that public transportation is affordable.
*This name and some identifying factors have been changed for confidentiality.
Katie Dorman is a family physician at St. Michael’s Hospital in Toronto and a member of Health Providers Against Poverty.