The housing crisis costs Quebec’s health-care system at least $2 billion annually, according to calculations by the Quebec Observatory on Inequality. That’s the main conclusion of the second part of a comprehensive economic study by the observatory entitled “The Health Costs of Inadequate Housing.” Last September, the first part of the study, which focused on the overall economic cost, revealed that the housing crisis was costing the Quebec economy $4.2 billion, which is the amount that households would have spent to keep the economy going if they did not have to devote more than 30 per cent of their income to housing. Poor housing conditions The authors of this second part focused on the multiple consequences of the housing crisis on general health and mental health. Several housing-related factors affect health, foremost among them the quality—or in this case, the poor quality—of housing. Examples include air infiltration, dampness and mould, the presence of pests, and the overall cleanliness of the living space. “Across all the findings in the literature, living in inadequate housing is associated with cardiovascular and respiratory diseases, anxiety and psychological distress,” explains the study’s lead author, economist Ferdaous Roussafi, in an interview with The Canadian Press. The observatory’s study shows that people living in poor-quality housing are twice as likely to report poor overall health. They are also 64 per cent more likely to report poor mental health. Too small or too expensive Other health problems are associated with housing that is too small, particularly because a household is unable to find adequate housing that it can afford for the family. “Households living in undersized housing have more respiratory symptoms and an increased risk of communicable infections. Overcrowding promotes the spread of infectious diseases and increases exposure to pathogens, particularly among young children,” according to the nearly 60-page document. In terms of data, inadequate housing increases the likelihood of reporting poor overall health by 12 per cent. And of course, there is the issue of unaffordability, which forces households to spend too much money on housing, explains Dr. Philippe Robert, acting director of public health for the Quebec City region. “When you have to spend too much on housing, your budget is limited. So what do you cut back on? We cut back on food, sometimes medication, transport, leisure activities, visiting loved ones. So it affects other areas of life. It also has an impact on stress.” The study proves him right, concluding that spending more than 30 per cent of income on housing is associated with a 37 per cent increased risk of reporting poor general health. The observatory’s researchers used proven models to make their calculations. Based on these models, the study concluded that these housing conditions – poor quality, insufficient size, unaffordability – represented, at a minimum, $27.4 million in primary care consultations in 2023. However, these consultations are only the starting point, explains Ferdaous Roussafi. “We know from data from the Canadian Institute for Health Information that consultations account for only 1.5 per cent of total health expenditures, and it is from this 1.5 per cent that we were able to extrapolate. To simplify, we have to multiply this cost of $27.4 million by 68 to get the total cost.” It is based on these calculations, with some additions, that the Observatory arrives at the figure of $2 billion. The cost of inaction “It has long been known that there is a very strong link between housing and health, and this study confirms in a more quantitative way what we already knew from numerous studies,” said Robert. “I think we wanted to quantify the extent of this because obviously the costs of taking action are also considerable. On the other hand, the costs of not taking action are also considerable. Health is complex; there are many dimensions to health. That’s why there are also many results in the study. We can’t just look at the effect of housing on one health indicator. But what the study does is look at several health indicators, perceived health, food insecurity, which is a form of stress or precariousness for people.” In terms of food insecurity, the study shows that each of the different negative housing variables – poor quality, insufficient size and unaffordability – increases the risk of food insecurity. Although the researchers do not quantify the direct costs of food insecurity on health, their work highlights that “unaffordability of housing accounts for approximately 12.9 per cent of food insecurity observed in Quebec, at a cost of approximately $87.7 million in 2023.” Impact on mental health “The repercussions of food insecurity are even more pronounced on mental health,” the study states. Analyses of Canadian and North American cohorts reveal a progressive and systematic relationship: as the severity of food insecurity increases, the prevalence of mental disorders and the use of health care intensify. A large portion of the health costs of inadequate housing are mental health care costs. Each of the negative variables of housing brings its share of distress, stress and anxiety, for example. The portion of the cost of mental health consultations that can be attributed to inadequate housing in Quebec is $10 million, according to the researchers. “Obviously, we can’t add up all these costs,” said Roussafi, pointing out the limitations of extrapolation models. “Even for food insecurity, we can’t just add everything up because the mechanisms overlap.” Investing in social housing “The key message to remember,” Robert said, “is that these are extremely significant costs that justify significant public investment. There is also data from Europe that shows that one of the best ways for society to improve quality of life and reduce disparities in quality of life, to offer a better quality of life for everyone, is by investing in social housing. “For us, as public health professionals, (a study like this) allows us to initiate and maintain discussions with our municipal partners and local elected officials about the importance of housing for health and that it is not only a cost-of-living issue, but also a quality-of-life and health issue.” This report by The Canadian Press was first published in French on Dec. 10, 2025.
