Social Determinants of Health – Housing Insecurity
The following information is compiled and presented by Quality of Care NL, an applied health and social systems research and evaluation program aimed at improving social and health outcomes in Newfoundland and Labrador. This page is best viewed in full screen on a computer. Click here to download a PDF version of the information presented below.
Housing insecurity refers to the inability to secure safe, adequate and affordable housing. It can take a number of forms: housing cost burden; residential instability; evictions and other forced moves; living with family or friends to share housing costs; overcrowding; living in substandard, poor quality housing; and homelessness.
Housing adequacy, housing suitability, housing affordability, acceptable housing and core housing need are key household indicators and topics of interest for governments and housing organizations.
- An indicator of housing adequacy is the condition of the dwelling.
- An indicator of housing suitability (commonly used to measure “crowding”) is whether the dwelling has enough bedrooms for the size and composition of the household. Another indicator of crowding is the number of persons per room in a dwelling.
- An indicator of housing affordability is the proportion of household total income that is spent on shelter costs.
- Acceptable housing refers to housing that is adequate in condition, suitable in size and affordable.
- Core housing need is an indicator of a household’s relative ability to afford the median market rent of a dwelling in its region that meets its needs.
Housing Need: Housing Adequacy
Inadequate housing conditions have been associated with numerous physical and mental health conditions. Structural features of the home (e.g., mold, water leaks, pest infestation, peeling paint, drafts and energy inefficiencies, physical crowding) directly impact health and increase the risk of injury and illness due to safety issues.
Dwelling condition (an indicator of housing adequacy) is classified into three groups: needing regular maintenance only, needing minor repairs, and needing major repairs. Major repairs refer to problems that compromise the dwelling’s structure or major systems (i.e., heating, plumbing and electrical).
- The percentage of private dwellings needing major repairs decreased for all provinces from 2016 to 2021.
- In 2021, NL (and AB) had the lowest rate requiring major repairs with a 15% reduction from 2016.
Housing Need: Housing Suitability
Housing suitability (commonly used to measure “crowding”) classifies dwellings as not suitable if they do not have enough bedrooms for the size and composition of the household, as calculated by the National Occupancy Standard (NOS) developed by Canada Mortgage and Housing Corporation (CMHC).
- The percentage of private dwellings considered not suitable increased for all provinces, except for NL and QC, from 2016 to 2021.
- In both 2016 and 2021, NL ranked first regarding housing suitability (1=best and 10=worst).
Housing Need: Acceptable Housing
Acceptable housing refers to whether a household meets each of the three indicator thresholds established by the CMHC for housing adequacy, suitability and affordability.
- Adequate housing is reported by their residents as not requiring any major repairs.
- Affordable housing has shelter costs equal to less than 30% of total before-tax household income.
- Suitable housing has enough bedrooms for the size and composition of resident households according to the National Occupancy Standard (NOS), conceived by the CMHC and provincial and territorial representatives.
- From 2018 to 2021, acceptable housing rates have remained fairly stable across Canada, including in NL.
- Just under 20% of persons in NL live in unacceptable housing.
- In both 2018 and 2021, NL ranked first for acceptable housing rates among the Canadian provinces (1=best and 10=worst).
Housing Need: Core Housing Need
Households in core housing need live in an unsuitable, inadequate or unaffordable dwelling and cannot afford alternative housing in their community.
Core housing need refers to whether a household’s housing falls below at least one of the above three indicator thresholds and would have to spend 30% or more of its total before-tax income to pay the median rent of alternative local housing that is acceptable (attains all three housing indicator thresholds).
- The rate of core housing need has decreased from 2016 to 2021 across Canada, including in NL.
- In NL the rate dropped from 10.5% in 2016 to 8% in 2021. Approximately 1 in 12 households were in core housing need in 2021.
- In both 2016 and 2021, NL ranked fourth among the Canadian provinces (1=best and 10=worst).
Newfoundland & Labrador Housing Corporation (NLHC) Programs
The NLHC offers a number of programs to support individuals and families who are experiencing housing insecurity.
- Clients accessing the Transition House Program increased by 13% from 2019-20 to 2021-22.
- Clients housed by the Supportive Living Program increased by 38% from 2019-20 to 2021-22.
- Individuals at risk of or experiencing homelessness that were assisted by the Supportive Living Program increased by more than 145% from 2019-20 to 2021-22.
Homelessness
End Homelessness St. John’s (EHSJ) exists to prevent and end homelessness in St. John’s. EHSJ, along with its partners and volunteers, conducted four homeless point-in-time (PiT) counts between 2016 and 2024.
PiT counts provide a critical one-day snapshot of homelessness in a community. The PiT Count is broken up into two distinct parts: an enumeration night (which estimates the minimum number of people experiencing homelessness in unsheltered and sheltered locations) and an extended survey period (previously this was conducted over 48 hours but in 2024 it was conducted for up to one month after the enumeration night).
- The annual estimate of people experiencing homelessness in St. John’s has increased by 75% from 2016 to 2024.
- Approximately three out of four people experiencing homelessness self-report having a mental health disability and more than half report addiction issues.
- More than 25% of people experiencing homelessness report being admitted to hospital in the past 12 months and more than 55% report visiting an emergency room during that same time frame.
Homelessness
Since 2022, EHSJ has used By Name Data (BND) to report on people experiencing homelessness in St. John’s. The BND, is a real-time, centralized list of individuals who are known to the housing and homelessness system (Coordinated Access to Homes (CAH)) and who have given their consent to be included on the list. EHSJ created a monthly dashboard using a snapshot of the BND list as it stands on the last day of each month.
In Fall 2023, , EHSJ launched HIFIS 4.0 for St. John’s – a community-wide database of people experiencing homelessness shared by frontline homelessness service providers. HIFIS provides a fuller, more accurate picture of homelessness in St. John’s and includes people known to CAH through BND as well as people experiencing homelessness who aren’t yet connected to CAH. As of April 2025, EHSJ has used these two sources to update their dashboard.
- From March 2022 to September 2025, the number of individuals experiencing homelessness has increased by nearly 190%, and the number of individuals experiencing chronic homelessness¹ has increased even more (208% increase)².
- Each month, anywhere from 45%-75% of individuals experiencing homelessness are experiencing chronic homelessness.
¹ When someone has been homeless for six months or more of the last year, or 18 months or more of the last 3 years, they are considered chronically homeless.
² Some of the jump in numbers after March 2025 may be due to the methodology change in April 2025.
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