Health and health care utilization of social housing residents across Ontario

Gina Agarwal and the Vulnerable Individuals in Primary Care (VIP) Research Lab have published a series of trailblazing papers using administrative health data to create a cohort of over 300,000 social housing residents based on the Social Housing of Ontario (SHO) Registry.

As expected, the relative prevalence of chronic disease was 31% to 100% higher in social housing residents aged 40 years and older, compared to the general population: diabetes (30% vs 18%), hypertension (51% vs 39%), COPD (22% vs 12%), asthma (19% vs 13%), and CHF (6% vs 3%).

In 2018/2019 (pre-COVID), social housing residents had relative cancer screening rates 12-17% lower than the general population (mammography: 46% vs 57%; pap screening: 34% vs 41%; colorectal cancer screening: 67% vs 76%), indicating barriers to accessing preventative care. A study examining how this changed in the first two years of the COVID-19 pandemic has just been accepted for publication, so keep an eye out!

Looking at vaccination rates, the team found a delayed uptake in COVID-19 vaccination and a sustained disparity among social housing residents (18 years and older), especially with the third dose (“booster”). Given the higher rates of chronic disease in this population, this vaccination gap may have led to worse health outcomes but this study is currently underway.

The results described above can be found here:

• Agarwal G, Keshavarz H, Angeles R, Pirrie M, Marzanek F, Nguyen F, Brar J, Paterson JM. Chronic disease prevalence and preventive care among Ontario social housing residents compared with the general population: a population-based cohort study. J Epidemiol Community Health. 2025 Jan 28:jech-2024-222762
• Agarwal G, Keshavarz H, Angeles R, Pirrie M, Marzanek F, Nguyen F, Brar J, Paterson JM. SARS-CoV-2 testing, test positivity and vaccination in social housing residents compared with the general population: a retrospective population-based cohort study. J Epidemiol Community Health. 2025;79(4):233-238.
• Agarwal G, Keshavarz H, Angeles R, Pirrie M, Marzanek F, Nguyen F, Brar J, Paterson JM. Temporal trends in COVID-19 vaccine uptake among social housing residents compared to the general population in Ontario, Canada: A population-based panel study. Ann Epidemiol. 2025;110:154-159.

PI: Gina Agarwal
Contact: Melissa Pirrie (pirrie@mcmaster.ca)