What Toronto’s housing crisis means for public health
Dr. Andrew Boozary at UHN leads with compassionate care and a drive for change
If you’ve been unlucky enough to head to the emergency room in Toronto recently, or have just been keeping up to date on the news about at-capacity-critical-care units or delayed cancer screenings, then you know that the Covid-19 pandemic has wreaked havoc on our health-care system. The pandemic also did a great job of exposing who was most likely to suffer because of this strain on the system, and just how interconnected the web of health, social programs and housing really is.
“Whether it was about access to health care or testing and vaccines, Covid-19 showed how the structural drivers of illness really determined who made it through this pandemic,” says Dr. Andrew Boozary, executive director of the Gattuso Centre for Social Medicine at Toronto’s University Health Network (UHN). “What we are dealing with [thanks to Covid-19], from surgical backlogs to delayed cancer screenings to unprecedented income inequality, is playing out with very real consequences.” Those consequences include an increased number of people relying on the health-care system and even more people without shelter and housing thanks to widening income inequality. Dr. Boozary hopes to address these consequences at UHN with a greater emphasis on social medicine and equitable health-care delivery.
What is social medicine?
Social medicine is an understanding that you cannot divorce health from the social and economic conditions that affect it, and the practice of social medicine seeks to address those inequalities through compassionate care. “We know that we need a broader notion of health and that improving health outcomes is not just about conventional health care alone,” says Dr. Boozary. “We must change the way we deliver health care.” This is especially true given that the inequalities continue to grow and that the health system feels more and more fragmented.
How does this relate to the Toronto housing crisis?
“You cannot disconnect the housing crisis from the hospital bed crisis,” says Dr. Boozary. “There are hundreds of people languishing in hospital beds because there is no supportive housing.” As the cost of both buying and renting in the city rises, people are often faced with choosing between their health (including the cost of medications) and paying for housing. A growing number of people living on the streets or in encampments is evidence of this divide, and the result is more people in need of medical care with less access to that care. While homelessness is a Toronto issue that needs attention, UHN is hoping to meet people where they are in the meantime. “The ‘health’ in University Health Network is about partnerships with community-based organizations to ensure we are providing care outside of our hospital walls,” says Dr. Boozary. “We are seeing mobile health care get out to where people are living, and that can mean everything from social housing to people living on the streets or in encampments.”
What’s next for UHN in this area?
“What we are trying to do is prioritize human dignity in the way we deliver health care,” says Dr. Boozary. “This means listening to people with lived experience and community experts in the way we deliver programs. It also means advocating for a Health in All Policies approach, knowing that failing on housing as a human right is cruel and expensive on the life expectancy of our patients and communities.”
To learn more about the future of public health and social medicine from Dr. Boozary, register for the Maclean’s Ideas Summit. You can buy a pass for the whole event, which takes place Jan. 24 to 30 at various locations throughout the city, or simply purchase a ticket for the closing-night panel with Dr. Boozary, which will be held Jan. 30 at 6:30 p.m. at OCAD University. A portion of the proceeds from the tickets supports UHN Foundation through the UHN Impact Collective’s Serving Knowledge Supper Club series. Click here to reserve your spot.