Housing crisis costs $2 billion annually in Quebec healthcare costs, study finds

The housing crisis costs Quebec’s health system at least $2 billion annually, according to calculations by the Quebec Observatory of Inequalities.

This is the main conclusion of the second part of a major economic study by the Observatory entitled “The Health Costs of a Lack of Adequate Housing.” Last September, the first part, focusing on the overall economic cost, revealed that the housing crisis was depriving the Quebec economy of $4.2 billion—the money that households would have spent to keep the economy going if they did not have to dedicate more than 30 per cent of their income to housing.

Poor condition of the accommodation

The authors of this second installment focused this time on the multiple consequences of the housing crisis on general and mental health. Several housing-related factors affect health, first and foremost the quality—or in this case, the poor quality—of housing. One need only consider, for example, air leaks, dampness and mold, the presence of pests, or the overall cleanliness of the living space.

“Throughout all the results found in the literature, living in inadequate housing is associated with cardiovascular and respiratory diseases, anxiety problems, and psychological distress,” explains the study’s lead author, economist Ferdaous Roussafi, in an interview with The Canadian Press.

The Observatory’s study shows that people living in poor-quality housing are twice as likely to report poor general health. They also have a 64 per cent higher risk of reporting poor mental health.

Too small or too expensive

Other health problems are associated with overcrowding, particularly when a household cannot find adequate housing for the family it can afford. “Households living in undersized dwellings experience more respiratory symptoms and an increased risk of communicable infections. Overcrowding promotes the spread of infectious diseases and increases exposure to pathogens, especially among young children,” reads the nearly 60-page document. Data shows that undersized housing increases the likelihood of reporting poor general health by 12 per cent.

And of course, there’s the issue of unaffordability, which pushes households to spend too much on housing, explains Dr. Philippe Robert, the interim director of public health for the National Capital Region. “When you have to spend too much on housing, your budget is limited. So, what do you cut back on? You cut back on food, sometimes medication, transportation, leisure activities, visiting loved ones. So, it affects other aspects of life. It also has an impact on stress.” The study supports his point, concluding that spending more than 30 per cent of income on housing is associated with a 37 per cent increased risk of reporting poor general health.

Researchers at the Observatory used proven models to perform their calculations. Following these models, the study concluded that these housing conditions – poor quality, insufficient size, unaffordability – accounted for at least $27.4 million in primary care consultations in 2023.

However, these consultations are just the starting point, explains Ferdaous Roussafi. “We know, from data from the Canadian Institute for Health Information, that consultations represent only 1.5 per cent of total health spending, and it is from this 1.5 per cent that we were able to extrapolate. To simplify, we must multiply this cost of $27.4 million by 68 to get the total of all costs.” It is from these calculations, with some additions, that the Observatory arrives at the figure of $2 billion.

The cost of inaction

“It has long been known that there is a very strong link between housing and health, and this study confirms in a more quantitative way what we knew from numerous studies,” emphasizes Dr. Robert.

“I think we wanted to quantify the extent of this, because obviously, the costs of taking action are also considerable. However, the costs of not taking action are also considerable. Health is complex; there are several dimensions to health. That’s why there are several results in the study as well. We can’t just look at the effect of housing on a health indicator. But what the study does is look at several health indicators, such as perceived health and food insecurity, which is a form of stress or precariousness for people.”

Regarding food insecurity, the study shows that each of the various negative housing variables—poor quality, insufficient size, and unaffordability—increases the risk of food insecurity. Although the researchers do not quantify the direct health costs of food insecurity, their work highlights that “unaffordable housing accounts for approximately 12.9 per cent of the food insecurity observed in Quebec, representing a cost of approximately $87.7 million in 2023.”

Impact on mental health

“The repercussions of food insecurity are even more pronounced on mental health,” the study states. “Analyses of Canadian and North American cohorts reveal a progressive and systematic relationship: as the severity of food insecurity increases, the prevalence of mental disorders and the use of care intensify.”

A significant portion of the healthcare costs associated with inadequate housing are mental health care costs. Each negative aspect of housing contributes to distress, stress, and anxiety, for example. Researchers estimate that $10 million of the cost of mental health consultations in Quebec can be attributed to inadequate housing.

“Obviously, we can’t just add up all these costs,” explains Roussafi, highlighting the limitations of extrapolation models. “Even for food insecurity, we can’t just add everything up because the mechanisms overlap.”

Investing in social housing

“The key message to remember,” emphasizes Dr. Robert, “is that these are extremely significant costs that justify substantial public investment. There is also data from Europe showing that one of the major ways, as a society, to improve quality of life and reduce quality of life disparities, to offer a better quality of life to everyone, is by investing in social housing.”

“For us, as a public health organization, (a study like this) allows us to initiate and maintain discussions with our municipal partners and elected officials at the local level about the importance of housing for health, and that it is not only a cost-of-living issue, but also a quality-of-life and health issue.”

–This report by La Presse Canadienne was translated by CityNews