Michael Shapcott The Wellesley Institute CFMS, February 2014

Health and

your home

Res

earc

h an

d po

licy

inst

itute

???

Toronto 1911: Founding of

Wellesley Hospital

“The health of Toronto must necessarily mean the health of its citizens. It must mean, too, the continued progress and development of Toronto along desirable lines. ...but I fear, in all candour one must confess that this city, in common with every large city, has acquired inevitable ‘slum districts’... You will probably say: “But Toronto has few such areas and they are not of great extent!” I say, and I think you will agree with me, that Toronto wants none of them, and that the Toronto of the future which we like to contemplate will have none of them.” ! Dr. H.A. Bruce Lieutenant-Governor of Ontario 1934

Toronto

slum

s

trans

formed

into

good

homes

Equity, access, income and social determinants of health

Inequality

“After 20 years of continuous decline, both inequality and poverty rates have increased rapidly in the past 10 years,

now reaching levels above the OECD average.”OECD (2008), Growing Unequal? : Income Distribution and

Poverty in OECD Countries

Selected policy recommendations for OECD countries from Divided We Stand •Reforming tax and benefit policies is

the most direct instrument for increasing redistributive effects. Large and persistent losses in low-income groups following recessions underline the importance of government transfers and well-conceived income-support policies. •The growing share of income going to

top earners means that this group now has a greater capacity to pay taxes. In this context governments may re-examine the redistributive role of taxation to ensure that wealthier individuals contribute their fair share of the tax burden.

Toronto 1911: Founding of

Wellesley Hospital

OECD social expenditures

Canada 32nd out of 34

From poor to rich: Key household spending categories

Survey of Household Spending 2011

Systems thinking: How interconnections in complex, dynamic

world impact our lives and our health

Wellesley Urban Health Model

Practical proposals: The Mexico City Charter

Four observations: !!

1.Housing insecurity deep / persistent 2.Costly to people, communities,

economy, government 3.Federal housing / homelessness

investments eroding 4.No comprehensive national plan

Most housing

needs invisible

!

For renters, average market rents are outpacing renter household incomes

Canada Mortgage and Housing Corporation 2010

Bad housing makes you sick!Homelessness:

Increased morbidity Increased premature mortality

Mental health: Alarming rates... especially

Clinical depression and anxiety Control / meaning Collective efficacy

Homelessness: Homelessness:

Biological / physical: Chemicals, gases, pollutants Design (accidents) / crowdingSocio-economic:

Affordability / energy Transportation / income / jobs

Contextual: Individual / neighbourhood deprivation

networks / friends / crime

Good housing good for health!Physical and mental health:

Better health outcomes / decreased health care utilization

Community safety: Reduced recidivism among people leaving incarceration

Affordability interventions: Income-based housing subsidies

Environment / physical infrastructure: New housing, repairs, heating, noise,

indoor + outdoor environmental issues, allergens, water + sanitation

0.50%

0.60%

0.70%

0.80%

0.90%

1.00%

1.10%

1.20%

1989

19

90

1991

19

92

1993

19

94

1995

19

96

1997

19

98

1999

20

00

2001

20

02

2003

20

04

2005

20

06

2007

20

08

2009

Federal housing investments as a percentage of GDP)

Government Revenues and Expenditures 2009

SupplySupply

Federal housing investments (in millions)

Canada Mortgage and Housing Corporation 2012

$1,500

$1,750

$2,000

$2,250

$2,500

$2,750

$3,000

$3,250

2007

20

08

2009

20

10

2011

20

12

2013

20

14

2015

20

16

2017

SupplySupply

When the feds cut a dollar in housing investments… matching funds from

provinces, territories, municipalities, community and business are lost

450000

500000

550000

600000

650000

2007

2008

2009

2010

2011

2012

2013

2014

2015

2016

2017

626,300 homes in 2007 492,500 homes in 2017 Loss of 133,800 homes

22% of entire stock

SupplySupply

Federally subsidized homes

Canada Mortgage and Housing Corporation 2012

Steve Pomeroy - Focus Consulting - 2012

Federal government reinvest savings gained from end of social

housing agreements into programs that will enable providers to maintain their units as social

housing

Thank you!

www.wellesleyinstitute.com