The past decade in Canada has seen a material escalation in visible homelessness. With a highly financialized housing market driving housing unaffordability and escalating inflation putting pressure on mortgages, rents and food, the crisis of homelessness has continued to worsen.

This has resulted in considerable social, emotional and health-related consequences for a growing population experiencing homelessness while also placing enormous economic and infrastructural pressures on the social institutions that provide care to this population.

This strain is felt acutely in Canada’s emergency departments (EDs).

People experiencing homelessness have a two to five times higher morbidity and mortality from all diseases compared to the general population and often have no choice but to use EDs for their health care. Emergency health-care workers must in turn contend with responding to the complex comorbidities that accompany a life of living rough and have little recourse to affect the underlying pathologies that engender a revolving-door relationship that many unhoused patients have with EDs across Canada.

Fundamentally, being unhoused is the primary medical concern facing this population, but chronically overcrowded EDs rooted in disease-oriented and episodic models of acute care are not well oriented to respond to this reality. The result is countless individuals cyclically discharged back into homelessness, with poorer access to care for all Canadians.

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Healthy Debate
October 3, 2023