Investing in public housing as a health strategy
A new, first of its kind analysis of public housing across the GTHA shows an unavoidable conclusion: the condition and stability of housing is a strong determinant of health in the region. The Public Housing Dividend used advanced modelling with real Canadian population and housing data, in tandem with real world and agency data, to examine how investment decisions could shape economic and social outcomes through 2050.
As the report states,
“In the reduced funding scenario, over 67% of residents are likely to have poor or very poor health… In contrast, only 12% would be in that category in the combined renewal and construction case.”
That single comparison captures the scale of impact. But the detailed findings are even more consequential.
1. When building conditions decline, resident health declines with them.
In the scenario with reduced funding, buildings deteriorate rapidly, units close, conditions worsen, and this takes a physical toll on residents. By 2050, The Public Housing Dividend projects:
Two thirds of residents would fall into poor or very poor health.
Mental health scores would drop sharply across nearly every age group.
The model shows a clear chain reaction: declining conditions drive up stress, worsening chronic illnesses. Those illnesses lead to more acute health issues and well-being drops.
2. Renewal and new construction reverse the health trajectory.
The combined scenario with investment in renewal and new construction delivers the strongest health outcomes because it fixes what exists and adds what’s missing. By 2050, The Public Housing Dividend projects:
Only 12% of residents would be in poor or very poor health.
Mental health scores would rise across all demographic groups.
No residents would live in buildings in a state of critical condition.
Families would experience greater stability.
The study notes that these improvements directly contribute to improved well-being of the residents, reflecting empirically derived relationships between housing, health, and life satisfaction.
3. Better health reduces pressure on hospitals, emergency rooms, and justice systems.
One of the most striking findings in the new analysis is how sharply health outcomes shape the workload of public systems: when residents are healthier, the entire region benefits.
In the combined renewal and new construction scenario, the GTHA sees a dramatic drop in demand for public services. By 2050, The Public Housing Dividend projects that the region avoids:
524,000+ inpatient hospital days.
156,000+ emergency department visits.
44,200+ justice system events.
$1.8 billion in cumulative health and justice costs.
These are real reductions in demand on hospitals, paramedics, shelters, and courts—evidence that housing investment is also a form of system relief that benefits others in society even if they don’t live in public housing.
4. Reduced funding drives a surge in illness and system strain.
In a reduced funding scenario, building conditions worsen, and so does the health of residents. As a consequence, hospital and emergency room usage rises sharply.
By 2050, reduced funding could push the region into a preventable surge of illness- and crisis-driven service use. The Public Housing Dividend projects:
285,800+ additional inpatient days.
107,000+ additional Emergency Room visits.
22,500+ additional justice events.
Almost $1.2 billion in added system costs.
Reduced funding doesn’t just weaken the housing system; it drives more illness, more crises, and more pressure on hospitals, paramedics, and courts across the GTHA.
The health case is the human case.
The Public Housing Dividend delivers strong economic and social value arguments for investment in public housing. But the health findings are the most human—and hard to ignore. It shows that public housing investment is not just about units or capital plans. It is about whether tens of thousands of people across the GTHA live longer, healthier, happier and more stable lives.
The Public Housing Dividend was published by the GTHA Community Housing Collaborative. It was produced by the Canadian Centre for Economic Analysis (CANCEA), supported by Scotiabank.