Housing considered a social determinant of health
While the need for decent affordable housing is something we can all understand, the connection between housing and health might be less obvious.
Housing is considered an important social determinant of health, a factor that influences our opportunity to be healthy and live a long life. People who are not able to afford safe and secure housing are at more risk for health problems. Unsafe or inadequate housing can cause an increase in illness and premature death from infection, heart disease, asthma, and mental illness, as well as fatal injuries. The high cost of housing can also limit the amount of money people have left over for food, childcare and transportation.
Housing is considered affordable if it costs less than 30 per cent of before-tax household income.
However, in both Simcoe County and the District of Muskoka almost half of renters spend more of their total household income than that on rent.
There are a number of other social determinants that also influence our health. Income, which is directly related to housing, is an important determinant because living in poverty can create chronic stress, and because income influences other living conditions, including access to safe and affordable housing, education, nutritious and affordable food, and health services like dental care. In Simcoe Muskoka, 12 per cent of the population live with low income, including almost 16,000 children and more than 9,000 seniors. People with less money have higher rates of chronic disease, use the health care system more often and are more likely to die earlier than those with more money.
The good news is that the province, local municipalities and organizations are making great strides in improving access to affordable housing in Simcoe County and the District of Muskoka. For example, Simcoe County’s 10-Year Affordable Housing and Homelessness Prevention Strategy has already created 544 new units towards reaching their goal of 2,685 units by 2024. Similarly, the District of Muskoka also has a 10-Year Housing and Homelessness Plan, and has created the Muskoka Homelessness Sharing Table to look at conducting a count of those who are homeless and ensuring they receive the services they need.
Locally, there has been a great deal of interest in a living wage – the hourly wage rate at which a household can meet its basic needs, once government transfers and deductions have been subtracted. In Simcoe County the living wage has been calculated at $17.74; in the District of Muskoka it’s $15.84.
Poverty reduction organizations are strongly advocating for a living wage, a number of local employers have made a deliberate decision to pay their employees a living wage, and campaigns such as the health unit’s Centsless promotion are raising awareness about the need for income solutions to food insecurity.
Another encouraging action is the province’s recently launched Basic Income pilot project. This pilot will test how a basic income might help people living on low incomes better meet their basic needs, while improving outcomes in a number of areas, include housing stability and health and health care usage. The pilot will ensure that those participating receive up to $16,989 per year for a single person and $24,027 per year for a couple, less 50 per cent of any earned income.
When we think about what makes us healthy, we often think about access to health care, lifestyle choices and our genetics, but our health is determined by so much more. It starts with the social determinants of health.
Dr. Lisa Simon is an Associate Medical Officer of Health with the Simcoe Muskoka District Health Unit.