Houston and Toronto address homelessness with different results

Dr. Andrew Boozary, a physician in Toronto, Canada, contrasted the city’s rising homelessness rates with successes in Houston, Texas, where over 30,000 people have been housed since 2012.

Boozary noted that while Toronto saw a nearly 9-per-cent reduction in homelessness last year, its homeless population more than doubled between 2021 and the latest count, reaching over 15,000 people.

He observed that Houston, despite lacking universal healthcare, reduced homelessness by more than 60 per cent since 2011 by prioritizing housing as the first step in care. Boozary drew a comparison to Finland, which nearly eliminated homelessness by treating housing as healthcare, and argued that objections to this approach often stem from a desire to maintain the status quo.

He explained that his work with unhoused patients shows illness results from a lack of social housing, not a lack of willpower, and that homelessness is a pathology of poverty with a known solution. A report by the Canadian Centre for Economic Analysis found that investing in public housing in the Greater Toronto and Hamilton area would save over 524,000 hospital bed days and roughly 156,000 emergency department visits over 25 years.

Denver, Colorado, also achieved a drop in homelessness after housing approximately 7,700 people since 2023. Boozary identified three key lessons from these successes: prioritizing housing, coordinating services across sectors like housing, health, and justice, and recognizing homelessness as a major health crisis. He argued that failing to invest in housing leads to higher costs in emergency services, hospitals, and the justice system, and cited a Canadian report from decades ago that highlighted the importance of social conditions for health.