HPAP Deputation at Toronto Mayor’s Executive Meeting

HPAP member Dr. Keith Johnstone was one of many deputants at Toronto City Hall on January 23rd for the Mayor’s Executive Meeting.

Advocates were raising awareness of the shelter crisis currently unfolding in Toronto and reiterating the need to declare the crisis a state of emergency. In addition deputants discussed the shortcomings of the city’s “Housing Now” initiative to serve those who are most vulnerably housed in the city.

See here for media coverage of the event:



Below is Keith Johnstone’s deputation at the event:

Hello, my name is Keith Johnstone. I am a family physician from Toronto and member of Health Providers Against Poverty (or HPAP). We are an organization of concerned healthcare providers who see the negative impacts of social conditions such as poverty and homelessness on the health of our patients and society as a whole. Our mission is to eliminate poverty through positive social and political change. We are also part of the broader Shelter and Housing Justice Network present here today. Thank you for allowing me to speak at this meeting today on behalf of our organization.

As healthcare providers, we know that housing is a key social determinant of health. Research has shown that life expectancy for people who are living in shelters is a great deal shorter than that of the general population – 13 years for men and 8 years for women. In Toronto alone, we know of 4 homeless individuals who have died since the beginning of this year. For each of these people, there are countless more struggling with homelessness who we see in our clinics, emergency rooms, and hospital wards. The toll on their health is undeniable, unjust, and expensive to address.

Lack of affordable housing has reached a critical point in Toronto. The city’s social housing waiting list is enormous and is steadily increasing. The number of people accessing emergency shelters has also increased significantly. This past Monday alone Toronto’s shelter system saw almost 8000 people.

We agree with Mayor Tory that improving supports for people with mental health and addictions issues should be part of an overall strategy to address the housing crisis. However, it needs to be recognized that homelessness and inadequate housing are direct contributors to these very issues. It’s difficult to imagine our patients addressing their mental health challenges without the stability and safety that reliable housing provides. Thus, provision of stable housing should be considered a first priority in the city’s initiatives to improve mental health.

We ask that the city take steps to address the lack of housing with a plan that supports deeply affordable housing options. In terms of the Housing Now Initiative being discussed today, our colleagues at the Shelter and Housing and Justice Network have identified areas of weakness that need to be resolved in the planning of the project.

Additionally, we ask that permanent shelter bed spaces be expanded so that the city is able to meet its own criterion of having 90% or less occupancy consistently. All facilities should be low barrier and operated with a harm reduction perspective in mind to best support people also impacted by the opioid crisis.  

Finally, we want to add our voice to those calling for a state of emergency on Toronto’s homelessness situation. Last year, our organization released a report showing that conditions at Winter Respite Centres and 24 hour drop-ins were not meeting the city’s own standards or those of the UN for emergency situations. Nearly everyone we spoke to felt that conditions in the centres negatively impacted their health. And this is not the worst of it. Many others are turned away due to over-capacity, putting them in even riskier conditions in sub-zero temperatures. The homelessness crisis in our city is undoubtedly causing serious harm and is a public health threat. From our perspective, this is nothing short of a state of emergency.

Thank you again for allowing me to speak on this issue.