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In the quiet Toronto neighborhood of Parkdale, a four-story modular building stands across from a row of unassuming townhouses. The building pairs an unlikely combination, social medicine and housing, to address a critical issue: the unending cycle of hospital visits found in the homeless population.
Individuals without stable housing often find themselves discharged from hospitals only to return to the streets, leading to repeated visits due to their precarious living conditions. The innovative approach not only eases pressure on overflowing hospitals by offering on-site health care for the most vulnerable but also tackles rising homelessness in Toronto.
Completed in 2024, Dunn House is Toronto’s first social medicine housing project and the first of its kind in Canada. After nearly two years of successful testing, Toronto’s Mayor Olivia Chow, Canada’s Housing Minister Gregor Robertson, and provincial Housing Minister Rob Flack announced funding for phase two of Dunn House with support from federal, provincial, and municipal governments.
This concept was pioneered by Dr. Andrew Boozary, a primary care physician, policy expert, and researcher. Born to a doctor father who immigrated to Canada as an Iranian refugee and a human rights lawyer mother, Dr. Boozary has established himself as a fierce advocate for marginalized populations in the medical sphere and is the founding executive director of the Gattuso Centre for Social Medicine. At its core, this center works on the idea that health isn’t just medical — it’s also social.
The Gattuso Centre for Social Medicine is not a standalone hospital or university department; rather, it is a healthcare innovation program under the University Health Network (UHN) in Toronto, the largest publicly funded research hospital in Canada and the owner of the land where Dunn House is located. The house was opened in partnership with United Way Greater Toronto (UWGT), a non-profit organization dedicated to alleviating homelessness, and the charitable housing organization Fred Victor, which operates the house.
Dr. Boozary developed the program based on the belief that traditional healthcare often treats symptoms but ignores root causes. He asserts that homelessness and healthcare are intertwined, and that tackling one issue means dealing with the other. In 2024, the University Health Network (UHN) reported that “the top 100 patients without fixed addresses accounted for over 4,309 Emergency Department visits in a one-year period”. Canada operates under a public healthcare system, and under the Canada Health Act enacted in 1984, all Canadian citizens, permanent residents, and eligible temporary residents are covered by provincial health insurance.
Dunn House offers 51 rent-geared-to-income housing units, a subsidized housing model in Canada where tenants pay rent based on their income, typically capped at 30% of their gross monthly household income. The building includes amenities such as shared laundry facilities, a communal kitchen, dining areas, and spaces for socialization. Residents also have access to healthcare support, such as an on-site nurse, psychiatrist, and a 24/7 virtual emergency room linked to UHN. Dr. Boozary is frequently present at Dunn House as a primary care physician.
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Residents at Dunn House are selected from unhoused UHN patients who have a history of frequent visits to the Emergency Department (ED). The house serves as transitional housing for individuals between hospital visits and recovery, providing access to around-the-clock medical care. Additionally, the shared spaces and services offered by the charitable organization Fred Victor help residents maintain stable households through routines, chores, and social engagement.
The facility also has a 24/7 harm reduction program that provides residents with access to harm reduction kits for those struggling with addiction and substance abuse issues, while UHN offers mental health services.
Early reports on the Dunn House indicate a 52% reduction in ED visits at the University Health Network hospital and a 79% drop in hospital bed days, achieved simply by providing individuals with a stable home and medical care. This reduction in hospital visits is expected to save hospitals $2.1 million annually.
“The data is clear — homelessness is a terminal condition,” said Dr. Andrew Boozary in a press release last year. “On average, patients who are unhoused live nearly 20 years less. The health care costs are seven times higher.”
“People can’t improve their health, maintain employment, care for themselves, or those they love without a home. This project is a shining example of what we need to be doing more of in our city and beyond,” he added.
City Councilor Gord Perks, representing Parkdale-High Park where the Dunn House is located, noted that offering on-site medical services alongside housing is not only much less expensive than repeated ED visits, but also leads to far better health outcomes. “The treatment and care people receive at home are better tailored to their needs, but also, you get the much more important benefit of providing them with stable housing”, he says.
However, some critics argue that this model excludes unhoused individuals who do not frequently visit hospitals, as eligibility for residency heavily weighs past hospital visits, despite many unhoused people in the city having stopped seeking hospital care. Like many major cities across North America, Toronto is grappling with rising homelessness rates and an overburdened healthcare system. As of Fall 2024, the number of unhoused individuals in Toronto reached 15,400 people, more than double the number in 2021.
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“There are many homeless people who gave up on trying to go to the hospital and who are just waiting in despair to die on the streets,” explained Bee Lee Soh, an anti-poverty advocate and a member of the Housing Rights Advisory Committee at the press conference. Dr. Boozary expressed his commitment to expanding eligibility requirements and mentioned that the Dunn House would work with neighborhood watch groups and other partners to identify those who have fallen through the system.
This situation highlights the need for further government support and funding, as the limited capacity of Dunn House accounts for only a small percentage of Toronto’s homeless population. This year, the Federal, Provincial, and Municipal governments announced funding for a second Dunn House featuring 54 units focused on at-risk seniors in the same neighborhood as the first house.
Despite the announcement of the second Dunn House, Councilor Perks emphasized that more support from the Provincial Government is necessary to tackle homelessness in Toronto. “The Province of Ontario does not provide the kind of health and housing support needed to expand our supportive housing system. This is a case of being penny-wise and pound-foolish. While they may contribute to Dunn House Phase 2, they are not broadly supporting the expansion of the supportive housing system, leading to higher costs and worse health outcomes,” he stated.
When asked how the municipal government is contributing to support and expansion, Perks replied, “The City of Toronto, more than any administration in the past 50 years, is making historic contributions to providing supportive housing. This area within our budget has grown the most in recent years. However, we are limited in the revenues we can collect; we cannot collect income or sales taxes. Furthermore, healthcare services are a provincial responsibility. This situation illustrates the province passing responsibility onto municipalities, which lack the financial capacity to solve the issue.”
Dunn House demonstrates that social medicine is a promising approach to breaking the cycle of homelessness and repeated hospital visits in Toronto by providing structure and stability to the city’s most vulnerable individuals. However, it requires further financial backing and support from higher levels of government to enable expansion and implementation efforts that can genuinely make a difference in our communities.
