Freezing to death on the sidewalk in Toronto
It’s getting cold again, and Toronto paramedics are responding to calls about frozen bodies on the street. It’s a sad winter tradition here in Toronto, and it owes largely to the unacceptable state of our city’s shelter system.
In late November, Ontario’s Conservative government announced their social assistance “reform.” It includes more barriers to qualifying for disability support, and cuts the planned increase in social assistance to below the rate of inflation. In Toronto, where housing is at a premium and shelters are bursting at the seams, these changes threaten to worsen an already disastrous situation. On the day of their announcement, Toronto set a new cold weather record with the coldest temperatures ever recorded on that date, sending hundreds of individuals to over-capacity shelters.
Seeing patients die from cold exposure doesn’t surprise us anymore. As a doctor and trainee in Toronto’s downtown core, we frequently witness the deadly impact of precarious housing. We know that homelessness is bad for health and the winter months can be particularly dangerous, yet we continue to see its devastating effects. Between January 1 and March 31, 2018, Toronto Public Health reported on average 1.8 deaths per week among people experiencing homelessness. The average age among the deceased was only 50 years. As medical professionals, we frequently have no choice but to discharge patients from our emergency departments back to the street, largely because of the lack of shelter beds.
In January 2018, Health Providers Against Poverty (HPAP) released an investigative report exposing the appalling conditions within Toronto shelter spaces. The group visited 10 centres, which were run either by non-profit organizations or by the City of Toronto itself. Not a single one met Toronto’s official shelter standards, which include modest necessities such as access to a shower, secure storage for belongings, a blanket, and sufficient space to prevent the spread of disease. This is a poor reflection on our city’s ability to meet the needs of its people.
The report called for 1,500 new shelter beds to meet the ongoing need, a 20 percent increase from the current number. On November 9 of this year, the City of Toronto issued a news release announcing plans to improve winter shelter services, including the addition of three new 24-hour respite centres in large tent-like structures and the addition of 102 permanent shelter beds. Yet this only represents a 1.5 percent increase and falls well short of the recommended target.
Stop-gap measures may be touted as a success, but without a parallel increase in permanent shelter spaces, the new 24-hour respite centres will become inappropriate substitutions for housing. Homeless citizens will be forced to sleep on the floor or in chairs of the respite centres, as they currently do in the waiting rooms of our city’s emergency rooms.
Other cities in Canada, though, seem to be getting things right. The federal Advisory Committee on Homelessness chaired by Toronto MP Adam Vaughan, reported that a number of cities in Quebec and Alberta have witnessed a drop in the demand on their shelter systems largely because they’ve made it a priority to expedite access to affordable housing. Quebec’s strategy to prevent homelessness has included access to a strong social safety net (affordable housing, income and access to services), and transition supports after discharge from institutions such as hospitals and jails.
Research suggests that the most effective and cost-efficient solution to homelessness is to provide subsidized and affordable housing for those who need it. Unfortunately, as housing prices continue to rise, Toronto is not even close to achieving its supposed goal of providing affordable options to its most vulnerable citizens.
The federal government’s $40-billion National Housing Strategy, released in 2016, is an optimistic step in the right direction. It includes an anti-homelessness program to be launched in April 2019, which boldly aims to cut chronic homelessness by 50 percent by 2026. The details of the program, though, are not yet known.
We seem to be at a critical moment with respect to homelessness, with the highest numbers of people in need in Toronto to date, but with the issue also having a prominent place in public consciousness and discussion. Interested citizens and organizations can contribute to an ongoing online consultation for the Housing Supply Action Plan, a provincial initiative that has been created to tackle the housing crisis. The survey closes January 25, 2019, so now is the time to demand a change in how we house our most vulnerable citizens.
Together, all three levels of government must collaborate on long-term housing solutions through strategies such as the development of new social rent-geared-to-income housing, rent control, subsidies for social housing and improved social assistance. We need to hold our governments accountable for providing safe and adequate shelters for the people of Toronto and work toward a future where freezing to death on the sidewalk is no longer commonplace.
Madeline McDonald is a medical student in Toronto (follow at @madlmcdonald on Twitter). Conor Lavelle is an emergency physician in downtown Toronto, he has written for Maclean’s, the National Post, Quartz, and Canadian Press (follow at @conway_twitty_ on Twitter).