Where Do You Live? Why Housing Is Health Care
Nearly 30% of people in Canada live in insecure, unsafe, or inadequate housing. Here's why where you live may matter more to your health than any doctor's visit.
For a fuller discussion of how we overspend on medicine compared to other government functions, see [Where Do Our Tax Dollars Go?]
When we think about health, we tend to picture hospitals, doctors, and medications. But one of the most powerful determinants of health is much closer to home — literally.
Housing is a health issue.
In Canada, nearly 30% of people live in housing that is insecure, unsafe, or inadequate. That’s a widespread condition shaping the health of millions. And the evidence is remarkably consistent: access to safe, stable, and suitable housing has a direct and lasting impact on physical and mental well-being.
So what makes housing “good” from a health perspective?
Four Elements of Healthy Housing
There are four key elements: condition, size, affordability, and neighbourhood. Each one plays a distinct role, and when even one is missing, health begins to suffer.
Condition. Start with the physical condition of a home. Substandard living environments — excess heat or cold, mold, leaks, pests, asbestos, radon, or exposure to volatile organic compounds — can directly cause disease. These risks translate into higher rates of respiratory illness, cardiovascular strain, and chronic conditions that often end up being treated downstream in the medical system.
Space. Overcrowded housing isn’t just uncomfortable — it’s a public health concern. Close quarters facilitate the spread of infectious diseases and can place enormous strain on mental health, particularly for families without access to private or quiet space. Think COVID, and the high rates of the disease found amongst those who lived in denser quarters, such as multigenerational households.
Affordability. When too much income goes toward housing, people are forced to make trade-offs — cutting back on food, recreation, transportation, medications, or other essentials. The stress of financial insecurity compounds the problem, contributing to anxiety, depression, and other long-term health consequences.
Neighbourhood. Where you live shapes how you live. Access to public transit, grocery stores, community centres, and green space all influence daily habits and overall well-being. On the flip side, living near high-speed roadways or in areas with high pollution exposes residents to harmful particulate matter, persistent noise, and environmental stress. These factors have powerful effects — conditions like asthma and other respiratory illnesses are both triggered and worsened by proximity to heavy traffic.
Housing Shapes Futures, Not Just Present Health
The impact of housing goes beyond immediate health outcomes. It also shapes life trajectories.
In one landmark study, children who moved out of poor housing in poor neighbourhoods into better housing environments were significantly more likely to attend college and went on to earn higher incomes over their lifetimes, compared to those who remained in low-income housing. The implications are profound: improving housing conditions doesn’t just change present circumstances — it alters futures.
This is what upstream health looks like.
If we are serious about improving health outcomes and reducing pressure on the medical system, we cannot ignore housing. Investments in safe, affordable, and well-located housing are not just good social policy — they are good health policy. They are prevention in its most practical form.
Because where you live should not determine how healthy you are.
But right now, for far too many people, it does.
What Can and Is Being Done
“Housing First” is a policy which begins all interventions to assist vulnerable people by finding housing first, then supporting people from that stable base into getting a job, planning meals and buying groceries, getting a doctor, dentist, and optometrist, and so on. In this model, housing is the first step! And it has worked in decreasing the numbers of unhoused people in communities. It has also brought along all kinds of other benefits to health and well-being.
New York City has introduced a plan for preventing homelessness: a risk assessment tool used to predict who might be on the verge of homelessness, and then to put supports in place to avoid that outcome — for example, paying for utilities, linking people to job training programmes, and finding volunteer lawyers to dispute unfair evictions.1
What Can You Do
Get better informed. Find out the cost of an average rental accommodation in your community. How much do people living on government subsidies such as employment insurance, disability insurance, or pension plans receive? Is housing affordable with this level of support? Speak up and vote on the basis of information such as this.
