Heat wave deaths linked to housing
Renters among most vulnerable in hot weather
The recent heat wave in Quebec is reported to have caused 70 deaths, with Montreal alone recording 34 of them.
While many in Canada are alarmed by the numbers, the fact remains that the heat wave-related deaths in Quebec pale in comparison with the August 2003 death toll in France, where a spike in temperatures that lasted for weeks caused 15,000 excess deaths.
The subsequent analysis of at-risk populations in France revealed that the elderly, women and those living alone faced much higher odds of dying in a heat wave. Furthermore, those without air-conditioned dwellings also faced higher risks of mortality.
The lessons learned from the 2003 heat wave in France suggest that living arrangements and dwelling conditions are two important determinants of vulnerability to heat waves. Seniors living alone in inadequate housing are more likely to experience the adverse impact of a sudden heat wave than others.
Any plans to safeguard against future heat waves must, therefore, include improving dwelling conditions and real-time health monitoring of seniors living alone.
The link between dwelling conditions of seniors and vulnerability to heat waves has already been suggested in Quebec. Dr. David Kaiser of Montreal’s Regional Public Health Department revealed that many heat wave victims in Montreal were more than 50 years old, male, and lived alone in non-air-conditioned dwellings.
A review of Census data can help us identify the likely size of vulnerable populations in Canada. The Census recorded almost 5.4 million seniors, aged 65 years and over, who had a household income greater than zero and lived in non-farm, nonreserve private dwellings. More than one in four seniors lived alone.
Statistics Canada and the CMHC have jointly developed three indicators of housing appropriateness. Adequacy refers to housing being structurally sound for a living. Suitability refers to having enough space (i.e., bedrooms) for those living in the dwelling. Lastly, affordability refers to households spending 30 per cent or more of their total income on shelter costs. A senior household who does not meet any one or more of the three criteria is considered living in inappropriate housing.
Based on the above standards, one in four seniors lives in inappropriate housing in Canada. Affordability is the single largest component that defines why a senior’s dwelling might be inappropriate.
Dwelling inappropriateness worsens with age. Whereas one in four seniors (65 years or older) fit the criteria, that number rose to almost one in three for seniors over the age of 84.
Living arrangements, however, are even more relevant to dwelling appropriateness. Almost 43 per cent of seniors who live alone — the cohort most vulnerable to heat waves — reside in housing deemed inappropriate.
By contrast, senior couples whose children no longer live with them are most likely to live in dwelling conditions deemed appropriate.
Household income remains a key underlying variable in explaining the appropriateness of a dwelling. Senior households with larger incomes should be able to live in structurally sound housing, without crowding and with sufficient funds on hand after paying for shelter.
Seniors living in subsidized housing are, therefore, more vulnerable with 56 per cent of them reside in inappropriate dwellings. Oneperson senior households in subsidized housing are only marginally worse off at 59 per cent indicating that housing vulnerability is high for seniors in subsidized housing, irrespective of their living arrangements.
Seniors who rent are particularly vulnerable. No fewer than 62 per cent of Canadian seniors living alone in rental units meet the inappropriate housing criteria. In comparison, only 29 per cent of one-person senior households who own live in inappropriate dwellings.
A greater proportion of seniors living alone in urban areas reside in inappropriate dwellings. In Toronto, almost three-out-of-four seniors living alone in rental units reside in inappropriate housing.
It is important to boost the health system’s resilience to cope with catastrophic outcomes caused by extreme weather conditions.
A preferred approach will be to improve the structural condition of dwellings and increase the supply of affordable housing for the most vulnerable seniors who often live alone.