Brick by Brick: Medical Students Building a Foundation for Housing Justice

The Housing Crisis 

Recovery from acute illness or the long-term management of a chronic condition requires tremendous energy and can be a significant source of stress for any individual. Without stable housing, these challenges are often compounded by harms posed by limited access to clean water, fears over safety, uncertainty about where one will sleep, reduced access to nutritious food, and increased mental stress that comes with living in unpredictable environments. 

These challenges are a reality that an increasing number of Calgarians face. Over the past year, Alberta experienced the greatest population growth within Canada and the availability of affordable housing has been unable to keep pace (1). Between 2023 and 2024, there was a 26% increase in people accessing emergency shelter at the Calgary Drop-In Centre (2). Further, one in five Calgarian households are currently unable to afford where they currently live, spending over 30% of their income on housing increasing their risk of becoming unhoused (3).

The link between housing and health is complex and reciprocal whereby poor health can lead to unemployment and poverty putting an individual at higher risk of being unhoused which then increases exposure to various threats to health including communicable disease, extreme weather, and violence. A lack of stable housing can also make managing chronic disease more difficult by creating barriers to accessing medication or medical equipment storage, nutritious food, and comfortable spaces to rest. 

In addition to physical health, housing instability can cause and perpetuate poor mental health related to the stressors of not having a safe and secure place to live. Recently, much attention has been placed on the relationship between housing and addiction. While many initiatives focus on short-term housing during recovery from addiction, long-term discharge to street can prompt relapse as people are reintroduced to conditions that provoked substance use initially. 

Housing insecurity also places a direct burden on our healthcare system. Individuals without housing have average hospital stays twice the duration of the national average (4).  Extended hospitalization stems from unaddressed complex health conditions exacerbated by housing instability and difficulty managing outpatient care without a stable home environment. Notably, the majority of hospitalizations from individuals without a fixed address present through the emergency department with severe acute presentations associated with the chronic lack of access to primary care (4).

Current initiatives such as Calgary’s Housing Strategy (3) offer promising steps towards addressing homelessness; however, long-term support and sustainable funding for these solutions are needed to make a meaningful impact. Further, as specific subpopulations are overrepresented among those who are unhoused, it is evident that solutions to the housing crisis need to be multi-focal and tailored to their unique needs. Populations that would benefit from special consideration in tailored programs include older adults, those who are unable to work, individuals escaping violence, youth, and Indigenous Peoples. 

Medical Student Advocacy: 

In response to the Housing Crisis, Medical Students at the University of Calgary launched their inaugural Municipal Month of Action where the following recommendations were made: 

1. Accelerate affordable housing development: expedite affordable housing projects with a target of 15,000 new units to meet demand. 

2. Enhance supportive housing for vulnerable populations: direct funding toward housing with integrated supports for seniors, Indigenous populations, and individuals facing a chronic lack of shelter. 

3. Expand rent subsidy and implement rent control: promote stable and affordable housing options for low-income and at-risk populations by preventing sudden rent increases. 

Our Municipal Day of Action was inspired by National and Provincial Days of Action that run annually in collaboration with other schools. During these days, students participate in advocacy training and topic briefing workshops. Afterward, students participate in meetings with various politicians where they can practice their advocacy skills while working towards a meaningful solution to promote health in their community.  By scaling this event to a municipal level, we aimed to increase accessibility for student participation and encourage students to tackle a health systems challenge that is especially relevant within their community. This event also enabled us to adopt a multifocal approach to a challenge that requires intergovernmental solutions as we engaged politicians in our community belonging to municipal and provincial governments. 

In the current context of our health system, we believe it is paramount to address health inequities from their root causes. To discharge patients to the same conditions that made them sick ultimately leads to a revolving door in healthcare that perpetuates the existing burden on our system. Addressing housing insecurity in our community and the impact it has on health requires collaboration across all community sectors. As future healthcare practitioners, we believe events such as our Days of Action can help students entering any speciality gain the critical advocacy skills that are needed to promote a healthier patient population in the future.

References: 

1. Current provincial population estimates [Internet]. [cited 2024 Nov 30]. Available from: https://www.alberta.ca/population-statistics 

2. Ramirez S. Calgary is in a housing crisis. affordable, non-market housing is part of the solution. [Internet]. 2023 [cited 2024 Nov 30]. Available from: https://calgarydropin.ca/blog-housing-crisis-oct-2023/

3. The City of Calgary’s housing strategy [Internet]. The City of Calgary Council ; 2023 [cited 2024 Nov 30]. Available from: https://www.calgary.ca/communities/housing-in-calgary/housing-strategy.html

4. Canadian Institute for Health Information. Homelessness and hospital use [Internet]. [cited 2024 Nov 30]. Available from: https://www.cihi.ca/en/homelessness-and-hospital-use