ICHA's Response to the Ontario Government's Pledge to End Homelessness

Read our open letter to the Minister Responsible for the Poverty Reduction Strategy in Ontario:

October 15, 2014

The Honourable Deborah Matthews
Minister Responsible for the Poverty Reduction Strategy/Deputy Premier
Room 4320, 4th Floor, Whitney Block
99 Wellesley St. West
Toronto, ON M7A 1W3

Dear Minister Matthews:

We are writing this open letter in response to your government’s recent release of the new five-year Poverty Reduction Strategy with the laudable goal of ending homelessness in Ontario. We congratulate the government for making this a priority. As members of Inner City Health Associates, a group of more than 60 physicians working in over 40 shelters and drop-ins across Toronto, we witness on a daily basis the devastating health impact of homelessness and precarious housing. We hear the stories of people who have had no choice but to leave subsidized housing due to unlivable conditions and of those who are on endless waitlists for these very same units. We observe the disruption to people’s health, work, education, and relationships when they do not have a stable home. We treat mental and physical health problems that are created and exacerbated by the experience of homelessness.  And we have seen first-hand the health improvements that come with stable housing, from the woman whose anxiety disorder resolves once she moves into a stable home in her own community near family and friends, to the man whose diabetes comes under control once he has a place to cook healthy foods and develop an exercise routine.

We urge the Minister to move quickly to draw up a concrete plan with timelines to address this urgent problem and to avoid further delays in the name of further defining the problem and its magnitude.  As physicians and scientists, we reject the conclusion that further research into the magnitude of homelessness is needed before action plans and timelines can be defined. In fact, the scale of the problem has been well described by organizations such as the Canadian Homelessness Research Network. According to its report The State of Homelessness in Canada in 2013, at least 200,000 Canadians experience homelessness in a year and 30,000 people are homeless on a given night. Moreover, 13.2% of Toronto households are in severe housing need and are at risk of homelessness. Meanwhile, the Ontario Non-Profit Housing Association latest survey estimates that a record 165,000 households are on a waitlist for affordable housing in this province. Rather than wasting time further quantifying the problem, it is time to get to work putting into practice those initiatives proven to work.

There is strong evidence for a Housing First approach, in which people experiencing homelessness are quickly moved into permanent housing and then supports and services are put in place to help them move forward with their lives.  This strategy reduces chronic homelessness, improves health and community engagement, and decreases use of health services and legal involvement.  We note that this evidence is acknowledged in the Poverty Reduction Strategy document, but there is no strategy defined for putting this evidence into practice. Rather, the promise is to increase funding to the Community Homelessness Prevention Initiative, offering flexibility to municipalities to develop programs based on local needs. While this flexibility may allow for some success stories, it does not hold local governments accountable for using the funds appropriately.

There is a significant cost to maintaining the status quo.  In addition to the human cost of allowing people’s health and well-being to suffer while we have at our disposal the interventions that have been proven to help, our current approach to homelessness is expensive. We can greatly reduce the money we spend on emergency shelters, on policing homelessness, and on treating the health problems created by homelessness, if we invest in long term Housing First programs. We can’t afford to wait.


Leslie Shanks
Medical Director
Inner City Health Associates