Dr. Carolyn Snider, chief of the emergency department at St. Michael's Hospital in downtown Toronto, says there's been a significant increase in the number of homeless people taking refuge in emergency departments over the last few winters.

When Dr. Carolyn Snider arrives for her early morning emergency room shifts, she regularly sees between five and 10 people in the waiting area who don’t need medical attention— just a safe place to stay warm.

“[They’re] truly there to just stay out of the elements,” said Snider, chief of the emergency department at St. Michael’s Hospital in downtown Toronto.

“This has already been occurring this fall. I can’t even imagine what will be occurring over the upcoming [winter] months,” she said.

There’s been a significant increase in the number of homeless people taking refuge in downtown Toronto emergency departments over the last few winters, Snider said. She and colleagues did some research to see if they could quantify what they were seeing.

The resulting study, published on a pre-print website Tuesday, examined data that had been collected from hospitals across Ontario, documenting ER visits from the winter of 2018-19 through to last winter, ending March 31, 2023.

It found that non-urgent emergency department visits among people who are homeless increased by 24 per cent across the province over those five winters.

Visits skyrocketed nearly 70% in Toronto hospitals

In Toronto hospitals specifically, those cold-weather ER visits by homeless people skyrocketed by 68 per cent.

The researchers submitted the study for publication in a peer-reviewed journal, but chose to release the results earlier out of a sense of urgency as the days and nights get colder.

“We wanted to get this information out right away because we think that it can help inform the policy decisions that are being made right now about shelter spaces,” said Dr. Stephen Hwang, the study’s senior author and a physician-researcher at the MAP Centre for Urban Health Solutions based at St. Michael’s Hospital.

“When we have high levels of homelessness and not enough shelter beds for people … the emergency department is the shelter of last resort. It’s the warming centre of last resort,” Hwang said.

The health administrative data used for the study came from the Canadian Institute for Health Information, the Institute for Clinical Evaluative Sciences and an Ontario Health Insurance Plan database.