Politics as a determinant of health

Abstract

In 1986, the Ottawa Charter for Health Promotion (WHO, 1986) recognized shelter as a basic prerequisite for health. It is only recently however, that researchers and policy-makers have focused on housing as an important determinant of health. Housing insecurity can be determined by various indicators, including the number of people who sleep in the streets, use temporary shelters, live in substandard dwellings, and who spend more than 30% of their income on housing. Canada Mortgage and Housing Corporation (CMHC) uses the term core need to track the number of households unable to access adequate rental accommodation in their community. The term measures affordability, suitability of accommodation and adequacy. Increasing evidence shows that households with core housing needs face one or more of the following issues: Affordability. They spend more than 30% of their gross income on housing. Suitability. They live in overcrowded conditions, i.e., household size and composition exceeds their actual home space requirements. Adequacy. Their homes lack full bathroom facilities, or require significant repairs (Layton, 2000). Approximately 60% of Canadian households own their homes, while the other 40% rent, primarily in the private rental sector. Most rental households are concentrated in large urban centres, especially in Toronto, Montreal and Vancouver (Hulchanski (2001).