Background
- Since 2007, Shelter, Support and Housing Administration (SSHA) has collected and reported on deaths of individuals staying in municipally administered shelters. When residents or recent residents of Toronto shelters die, shelter providers must notify the City within 24 hours and submit a written report within 30 days.
- Note that shelter operators are not generally advised of cause of death information or presented with a Medical Certificate of Death because this information is not readily shared with anyone other than next of kin.
- In 2017, City Council directed Toronto Public Health (TPH) to expand the scope of data capture and reporting of the deaths of homeless persons that occur beyond the SSHA reporting criteria. SSHA continues to supplement TPH data collection efforts with quarterly reporting from its DoSR database. For more detailed statistics, see Toronto Public Health’s Deaths of People Experiencing Homelessness Dashboard.
Key Points
- Since 2007, there have been 675 deaths reported to SSHA, an average of 42 deaths per year.
- 110 deaths occurred in 2022, which is down 16 per cent from 2021. Expressed as a proportion of the total size of the shelter population (as measured in bed nights), deaths decreased by 34 per cent per capita. This is because the shelter system served an average of 8,012 people a night in 2022, as compared to 6,382 people a night in 2021, when the shelter system reported 132 deaths.
- Shelter operators do not have access to official cause of death information for their clients, but they do report where possible a suspected cause of death. Based on these reports, opioid overdose remains the leading suspected cause of death of shelter residents.
- Sadly there was a substantial rise in non-fatal and fatal overdoses in the shelter system, as well as in the broader community during the COVID-19 pandemic. In response, in December 2020, the Integrated Prevention and Harm Reduction Initiative, or iPHARE, was established – a multi-pronged effort by the City and community agencies to address opioid-related deaths in Toronto’s shelter system.
- A decrease in overdose deaths has been observed since 2021. This may be in part due to harm reduction measures implemented in the City’s shelter system, as well as other factors including the unpredictable nature of the unregulated drug supply and lack of access to safe supply. This is consistent with data from the Ontario Office of the Chief Coroner that has also indicated a reduction in opioid overdose deaths in homelessness service settings.
- The average age of decedents in 2022 was 50.7 years. This is an increase from 2021’s average of 47.3, and represents a reversal of a downward trend that began in 2018. In 2018, the average age at death was 56.5 years, and the average had been dropping every single year through 2021. This trend toward a younger average age of decedents coincided with an increase in deaths where an overdose was reported as the suspected cause of death. Over the past four years, the average age for decedents where an overdose is the suspected cause of death was 43.0 years.
Summary of Data
Of the 675 deaths of shelter residents reported to SSHA since 2007:
- The majority of decedents were male: 521 or 77.2 per cent
- The average age at death across all genders has been 52.3 years
- 302 deaths (or 44.7per cent) occurred within a shelter/respite facility or outdoors on shelter property whereas 373 deaths (or 55.3 per cent) occurred off-site (e.g., at a healthcare facility or in the community).
Of the 110 deaths of shelter residents reported to SSHA in 2022:
- 81 (72.9 per cent) were male and 29 (25.7 per cent) were female
- The average age at death was 51.0 years; this continues a downward trend since 2018 in the average age at death. From 2019 to 2022, the average age of death was lower for homicide and overdose (38 and 42, respectively) than infection, COVID-19, organ failure/stroke, cancer, injury/accident and unknown (61, 61, 60, 57, 53 and 53, respectively) related deaths.
- 71 of 110 deaths (or 64 per cent) occurred on site within shelter. The remaining 39 deaths occurred in other locations (e.g. hospital) and were reported to SSHA as recent residents of a shelter.
