toronto's homeless need full-time warming centres, advocates say

but a group of healthcare providers say that’s not good enough, because preventable injuries from cold weather exposure don’t just happen in extreme weather. in fact, data from toronto’s map centre for urban health solutions demonstrates that most cold-weather injuries don’t happen when it’s very cold: 72 per cent of cases of hypothermia, for instance, happen when daily temperatures are above minus 15.

“opening the warming centres at a threshold of negative 20 does not necessarily mean negating the hypothermia that we’re seeing in emerg[ency rooms] — frostbite injuries, infections and deaths from the cold weather,” says dr. adria na di stefano.

‘being homeless is a risk factor’

in 2021, 221 people died while homeless, according to the city. that number is steadily climbing from 2020, when 144 people died, and 2019, when 128 did. (the most recent data is from mid-2022 — by late june, there were 22 deaths among homeless people.) 

these numbers can be hard to track: in b.c., deaths are only counted when the deceased isn’t under a doctor’s care. so if an unhoused person dies in a b.c. hospital, their death isn’t included in the official count.

and toronto, as a city, and the province of b.c. are among the very few canadian regions that make this data publicly available, and the tracking is fairly recent. a similar grassroots project has popped up in hamilton, after dr. inna berditchevskaia — who had attended medical school in toronto — was shocked to discover it didn’t already exist. there are some tracking efforts in b.c., but very few elsewhere in the country. there are no national statistics.

“this is a population that there are a lot of services directed toward,” berditchevskaia told the globe and mail in november. “if we don’t have data, how do we know where to direct the services to prevent morbidity and mortality?”

homeless deaths are on the rise

what’s most frustrating to hpap, di stefano says, is that so many of these deaths are preventable. “they can be prevented by having spaces for people inside,” she says. a common refrain is that warming centres aren’t necessary given the existence of shelters. but shelters are at capacity: the number of people turned away from homeless shelters in toronto because they were full was about ten times as high in june 2022 as the previous june, the star reported.

hpap maintains that permanent housing for people is the ultimate goal. housing-first strategies, where previously homeless people are given the stability of a permanent address, have worked in cities including houston and helsinki, finland. a small trial in five canadian cities — vancouver, winnipeg, toronto, montreal and moncton — was successful between 2008 and 2014. but the policy hasn’t been widely adopted.