Housing needs in Canada: Healthy lives start at home

Question 1

What are the tpes of housing need (as per Canada Mortgage and Housing Corporation)

Answer 1

• inadequate housing: in need of mjaor repairs
• unsuitable housing (crowded): fails to meet the National Occupancy Standard requirements for number of bedrooms for the size and make-up of the household
• Unaffordable housing: 30% or more of gross household income spent on shelter costs
• Unacceptable housing: doesn’t meet at least 1 of the standards of adequacy, suitability, and affordability
• Core housing need: Unacceptable housing and household would have to spend 30% or more of gross household income to access acceptable housing in their community

Question 2

What are additional factors leading to housing need that aren’t included in types of housing need (as per Canada Mortgage and Housing Corporation)

Answer 2

• infestations (cockroaches, bed bugs, mice, other pests)
• poor water and air quality
• unsafe neighbourhoods
• Unstable housing, leading to frequent moves (>3 in child’s lifetime) or use of temporary housing
• Inaccessibility for family members with a disability

Question 3

Health impacts from housing need?

Answer 3

• Inadequate, crowded, unaffordable housing
  
  • aggressive behaviours, property offences, diminished school performance
  • psychological distress & helplessness
  • diminished overall health status
    
    • asthma symptoms and increased risk
    • poor air quality
    • lead exposure
    • exposure to health hazards and injury risks
    • Spread of communicable disease: LRTI & gastro
  • food insecurity, inadequate childhood nutrition
• Unstable housing - move frequently, live in shelters, couch surf (stay with friends/family)
  
  • Moved >= 3 x at higher risk for emotional problems, repeating a grade, being suspended or expelled fomr school
• Inaccessible housing - impacts independence & mobility, unintentional injures (falls, unsupported lifting, transfers)
• Exposure to environmental hazards - Infestations, Safe water
• Unsafe neighborhoods - anxiety, limited physical activity

Question 4

Populations at higher risk for housing need?

Answer 4

Recent immigrants

visible minority

lone-parent households (esp women-led, Indigenous, racialized, immigrant)

families of individuals with physical, developmental, or mental health disability

Question 5

How do you screen for housing need?

Answer 5

• Introductory question:
  
  • On a scale of 1 to 10 (1 difficult living situation, 10 ideal living situation), how would you rate where you are living now?
  • What would you like to make better about where you are living?
• HOME
  
  • Harm: is your home in need of major repairs?
  • Occupancy: how many people live you in your home, in how many rooms?
  • Moves: how many times has your child/youth moved? Have you used a shelter or informal, temporary housing such as staing with friends or family?
  • Enough/income: do you have enough money for housing, food and utilities?
• Other screening questions
  
  • do you have any concerns about where you live?
  • Do you have difficulty making ends meet at the end of the month?

Question 6

Recommendations for housing need?

Answer 6

• Government needs to implement housing-supportive policies. Collaborative action should involve:
  
  • local, provincial/territorial, federal government, community groups
  • policies that recognize housing as a public health issue and strategies at each governmental level
  • Investing in enhanced housing research and data - continue mandatory long-form census and fulfil commitments made in National housing strategy
• Pediatricians and physicians
  
  • advocate for improved housing as a determinant of pediatric health
  • ask about housing status of families
  • make sure families are aware of potential health effects of housing need and help them make informed housing choices
  • be aware of local resources
  • consider writing letters to help gain access to safe, adequate, accessible, suitable and affordable housing
• Undergrad & postgrad medical training programs must ensure competencies in addressing housing need
• Research priorities include:
  
  • building knowledge around causes of housing need & impacts on pediatric health
  • Identify housing needs for specific geographical regions & populations, evaluate efficacy of targeted housing intervention strategies
  • Validate housing need screening & assessment tools
  • Develop list of local resources for HCP & families