Background
- Since 2007, Toronto Shelter and Support Services (TSSS) 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 TSSS’ reporting criteria. TSSS continues to supplement TPH data collection efforts with quarterly reporting from its Death of Shelter Resident database. For more detailed statistics, see Toronto Public Health’s Deaths of People Experiencing Homelessness.
Key Points
1) Total deaths of shelter residents have steadily declined over the last three years but remained unchanged from the previous year.
- Since 2007, there have been 884 total shelter resident deaths reported to TSSS, an average of 49 deaths per year.
- 59 deaths occurred in 2025, which remains unchanged from 2024.
2) When allowing for the increasing size of the shelter system, proportional rates of death have significantly decreased over the last three years, with a slight increase in the last year.
- The shelter system provided nearly 44% more bed nights in 2025 as in 2021, so while deaths in 2025 were 55% lower than 2021 totals, when allowing for the larger service population, they were 68% lower.
3) Opioid overdose remains the most reported suspected cause of death, but more than half of deaths could not be attributed a cause by shelter staff.
- Shelter operators do not have access to actual cause of death information for their clients but do report where possible a suspected cause of death. Opioid overdose as the suspected cause of death has decreased significantly since 2020 (by 72%) with a consistent downward trend since 2022. This is consistent with data from the Ontario Office of the Chief Coroner.
- Enhanced harm reduction supports were implemented, beginning in December 2020, in response to opioid-related deaths in the shelter system. These supports are aligned with priority actions under the “Our Health Our City: Mental Health, Substance Use, Harm Reduction and Treatment Strategy for Toronto.”
4) From 2024 to 2025, rates of death decreased in shelters, shelter hotels, and respites.
- The rates of deaths among shelter residents have shown varying patterns across three major service setting types. Both shelters and hotel shelters have experienced decreasing rates since 2021. Allied services (including 24-hour respite sites) saw an increase from 2022 to 2023 following a decline from 2021 to 2022, however rates have been on a steady decline since 2023.
5) Males make up 60% of the shelter population, but 75% of decedents for 2021-2025.
Summary of Data
Of the 884 deaths of shelter residents reported to TSSS since 2007:
- The average number of deaths per year has been 49
- The majority of decedents have identified as cis gendered male: 684 or 77%
- The average (mean) age at death across all genders has been 52 years
- 442 deaths (or 50%) occurred within a shelter/respite facility whereas 442 deaths (or 50%) occurred off-site (e.g., at a healthcare facility or in the community).
Of the 59 deaths of shelter residents reported to TSSS in 2025:
- 42 (71%) were male, 16 (27%) were female and 1 (2%) were Two-Spirit/Transgender/Non-binary
- The average (mean) age at death across all genders was 53.0 years;
- 34 of 59 deaths (or 61%) occurred within shelter. The remainder occurred in other locations (i.e. hospital) and were reported to TSSS as recent shelter residents.
