The ER Is Not a Home: Why Dunn House Proves Housing Is the Only Real Medicine
AI-generated image · Bay Street Wire
A Toronto hospital network's expansion of its permanent housing project reveals a staggering truth: the most effective way to reduce emergency room congestion is to give people a place to live.
OPINION: For too long, we have treated the crisis of homelessness as a series of medical emergencies to be managed in triage. We treat the symptom—the infection, the overdose, the mental health crisis—and then we discharge the patient back into the very environment that precipitated the collapse. It is a revolving door of inefficiency and cruelty.
But as first reported by CBC Toronto, a shift is happening at the University Hospital Network (UHN). The network is preparing to significantly expand Dunn House, Canada's first social medicine housing project. The premise is simple, yet revolutionary in its practicality: provide permanent housing to homeless individuals who frequently utilize hospital emergency departments, and the medical crises will begin to subside.
According to Dr. Andrew Boozary, a primary care doctor and the executive director of UHN's Gattuso Centre for Social Medicine, this model represents a more humane method of supporting vulnerable populations. More importantly, the data suggests that housing is not just a social good, but a clinical necessity.
CBC Toronto reports that preliminary data from 48 residents of Dunn House showed a 52 per cent reduction in emergency room visits per year after they moved into the program. Furthermore, when those residents were admitted to the hospital, the length of their stays dropped by 79 per cent.
When we stop treating the street as a waiting room, the system actually begins to function. The financial implications are just as stark as the human ones. CBC Toronto notes that the 48 patients in question incurred $2.1 million in hospital costs during the 12 months prior to moving into Dunn House. In the year following their transition to permanent housing, the hospital saved $1.66 million.
This is the efficiency of dignity. By addressing the root cause—the lack of stable shelter—the UHN is reducing the burden on our overstretched healthcare infrastructure. Dr. Boozary notes that this approach is cost-effective, proving that the most expensive way to house a person is to leave them on the street and rely on emergency medicine to keep them alive.
While the initial success was seen among 51 residents, the program is set to expand its reach to help 300 people. This expansion is made possible through a partnership involving the city, the hospital, and both the provincial and federal governments.
If we are honest with ourselves, we know that a hospital bed is no substitute for a front door. The success of Dunn House demonstrates that the cure for the 'frequent flyer' phenomenon in our ERs isn't more triage or more security—it is a key and a lease. It is time we stopped asking how many beds we need in the emergency ward and started asking how many apartments we can build.