Homelessness is a health crisis: Why hospitals are resorting to building housing

Abstract

Editorial

In this issue of CMAJ, Alston and colleagues describe the urgent and complex problem of homelessness among older adults, a growing population nationwide. The latest report from the Canadian Institute for Health Information (CIHI) revealed that, in 2023, 30 000 people experiencing homelessness were admitted to hospitals in Canada, and these admissions lasted twice as long and were more than double the cost than admissions for people who were not unhoused. Both the CMAJ analysis and the CIHI report illuminate distressing compounding health effects of being unhoused, whereby people are sicker at hospital admission because they are unhoused and, when discharged, are not able to receive the primary care and home care services they require. Faced with the rising numbers of people experiencing homelessness, who often require extended hospital-based care, and in the absence of alternative solutions, some hospitals are building housing. Is this the most appropriate response, given the current demand for outstripped hospital resources?

Under ideal conditions, hospitals and other health care institutions would not need to build supportive housing; realistically, the health sector will not be able to create enough affordable housing to extinguish the housing crisis. But the health care system and hospitals can help in concrete ways. The neglect of homelessness as a public health crisis is not sustainable, and Canadian society’s inaction has proven far too costly.

See related article Tackling late-life homelessness in Canada.