For every person sleeping in a shelter bed, there are 23 households on the verge of homelessness, according to a dire report released Friday.

These “vulnerably housed” Canadians are spending more than 50 per cent of their monthly income on rent in crowded and unsafe housing. And many face the same myriad health problems as those with no home at all, states the report that calls for a national strategy to address the housing crisis.

Dr. Stephen Hwang, the Toronto doctor who authored the report, called the country’s lack of a national housing strategy “deplorable.”

“Housing is just as essential to the health of Canadians as nutritious food, clean air and fresh water and access to medical care,” said Hwang, a physician with the Centre for Research on Inner City Health at St. Michael’s Hospital.

“If we ensure that people have their basic housing needs met, we would actually be making an investment in the health of our population.”

Earlier this week, a parliamentary committee released a report on poverty that also recommended a long-term national strategy on homelessness and housing.

The report, tabled in the House of Commons by the Committee on Human Resources, Skills and Social Development, argued that federal policies can make a significant impact on poverty, citing the 1998 National Child Benefit as an example.

Hwang will present his report Friday in Ottawa at a research forum on homelessness.

It was based on data from a landmark study tracking the health of 1,200 homeless and marginally housed people living in Toronto, Ottawa and Vancouver over two years.

Initial findings show both groups have similar rates of chronic health conditions like Hepatitis C, and nearly 40 per cent had been assaulted in the last year. About half have been diagnosed with a mental health problem.

Another 40 per cent cannot get the health care they need and 55 per cent had visited an emergency room in the last year.

Hwang said researchers and policy-makers have made a “false distinction” between the homeless and the marginally housed.

“We’ve kind of thought of it as, if you’re not homeless, you’re housed, and that means things are okay,” he said. “But one of the points of this report is that there are people who are vulnerably housed who are at as much risk as those who are homeless.”

In Toronto, around 5,000 people are homeless or marginally housed, according to the 2009 Street Needs Assessment.

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Hwang’s report put the number of Toronto households experiencing “housing vulnerability” at 70,085.

Hwang also led a study in 2009 that suggested homeless and marginally housed people die seven to 10 years earlier than those with suitable housing. Men in that study had the same chance (32%) of living to 75 as an average man in 1921, before the advent of antibiotics.