Saving lives while saving money
Toronto’s Dunn House is addressing the health costs of homelessness
Canada’s first social medicine housing initiative is about saving lives while also saving money - because the homelessness crisis is a health crisis that highlights the need for stable housing and integrated health care services, say its proponents. They hope to see the initiative scaled across Canada.
In reshaping how housing and health care intersect, Canada’s largest hospital network says it is building a more stable, health‑focused system that keeps people housed, supported and better able to recover while reducing avoidable emergency visits. And that saves lives. "On average, patients who are unhoused live nearly 20 years less,” says Dr. Andrew Boozary, executive director of the Gattuso Centre for Social Medicine. “The health care costs are seven times higher.”
Toronto’s Dunn House, which since 2024 has housed 51 formerly homeless people who had chronically wound up in hospital, is saving up to $2.1 million in health-care system costs while reducing their visits to University Health Network emergency departments by 52% and their hospital bed days by 79%.
The story of one 44-year-old man whose life was turned around by Dunn House, reported at length in the Toronto Star at the end of January, provides a specific example. “(A) Star analysis shows his battle with homelessness and addiction before moving into Dunn House cost public systems at least a quarter of a million dollars.” That is before costs for policing, public defenders and prosecutors, court resources, ambulances and visits to other hospitals.
As well as letting individuals live healthier lives, advocates say a preventive approach can use precious public funds more effectively for everyone. A hospital bed costs at least $30,000 for a month, when a supportive housing unit, after upfront costs, is between $2,000 and $5,000 a month. Dunn House costs an estimated $4,000 per person per month.
The social medicine model, developed by the Gattuso Centre in partnership with the City of Toronto, and United Way of Greater Toronto, approaches patient care through the lens of the social determinants of health, focusing on stable housing, food security and access to care.
Dunn House provides accessible, safe and affordable housing with on-site health and social support for 51 socially and medically complex patients. After one year of operation, a “dramatic” reduction in their ER visits was evident.
“Dunn House has generated strong early evidence demonstrating the essential role of secure housing in improving health outcomes for individuals for whom emergency departments too often serve as the front door to care,” says Dr. Kevin Smith, President and CEO of University Health Network.
The four-storey modular Dunn House was built on a parking lot in Toronto’s Parkdale neighbourhood on land owned by UHN and leased to the City of Toronto. Each studio apartment is 275-square-foot and pet-friendly with a kitchenette, a living room area, a bedroom and a bathroom. There are 15 barrier-free units for people who use mobility devices. Fred Victor, a social service charitable organization, manages the 51 units as well as the communal areas, community garden and on-site commercial kitchen, and its staff provide support for the residents.
A 2019 Memorandum of Understanding for UNH’s Social Medicine Program between the City of Toronto, United Way and UHN is the first of its kind in Canada, aiming to better align health and social services for Toronto’s most high-needs patients.
Toronto Mayor Olivia Chow calls it “a great example of how partnerships across governments, the non-profits and the health care sector can work together to support people and address homelessness.” Dunn House “will bring meaningful change to the lives of the people moving into these homes and help guide our ongoing response to Toronto’s housing and homelessness crises.”
Co-designed with UHN’s Social Medicine Lived Experience Advisory Council, Dunn House was shaped by consultation with international experts, community organizations, and people with lived experience of homelessness, substance use and mental health challenges. “We hope to set a new and scalable standard for how health care systems can address the social determinants of health and create lasting, impactful change in people’s lives,” says Dr. Boozary.
Dunn House has been so successful that a second phase has been launched that will feature 54 new rent-geared-to-income studio units for at-risk seniors. The Government of Canada is investing $21.4 million towards construction, the Province of Ontario will contribute $2.6 million in annual operational funding, and the City of Toronto will lead project delivery.
UHN is also expanding the Dunn House model with a novel approach – by offering social medicine support in existing homes across the city, like public housing units and available rental homes. The expansion will extend health and social services to up to 100 previously unhoused individuals in the coming year.
Also in January 2026, the Gattuso Centre began rolling out Ontario’s first hospital-based homelessness and eviction prevention program. Launched with a $1 million donor-led investment, the Eviction Prevention Fund uses donations to provide short-term, targeted support for patients at immediate risk of eviction.
Patients are identified by Peer Support Workers and Community Health Workers embedded within clinical teams who work with individuals facing complex social and health challenges.
“This is preventative medicine,” says Dr. Boozary. “This is social medicine at its core.”
The City of Toronto highlighted UHN’s program when announcing an unprecedented increase to Toronto’s Rent Bank, which provides grants to help families pay rent, cover arrears or secure a new home. The city’s 2026 budget allocates $10.8 million to the program, supporting 2,800 families, and funds eviction prevention for 1,100 households through case management and rent subsidies via the Canada Ontario Housing Benefit.
“By expanding access to rent relief, the City of Toronto is taking an evidence-informed step that will keep people housed, reduce strain on our health system and improve health outcomes across the city,” says Dr. Boozary.
Together, these approaches help ensure that patients whose health and housing needs intersect are not left without options at a critical point in their care, says UHN.