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 declined for the third year in a row.
- Since 2007, there have been 825 total shelter resident deaths reported to TSSS, an average of 46 deaths per year.
- 59 deaths occurred in 2024, which is down 35% from 2023.
2) When allowing for the increasing size of the shelter system, proportional rates of death have decreased even more significantly in the last three years.
- The shelter system provided nearly twice as many bed nights in 2024 as in 2017, so while deaths in 2024 were 68% larger than 2017 totals, when allowing for the larger service population, they were 15% higher.
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 remains high as compared to pre-2019 levels but has decreased 80% since the peak year of 2021. This is consistent with data from the Ontario Office of the Chief Coroner.
- Enhanced harm reduction supports were implemented in December 2020 in response to opioid-related deaths in the shelter system.
4) From 2023 to 2024, rates of death decreased in shelters, shelter hotels, and 24-hour 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, but rates decreased again from 2023 to 2024.
5) Males make up 60% of the shelter population, but 76% of decedents for 2020-2024.
Summary of Data
Of the 825 deaths of shelter residents reported to TSSS since 2007:
- The average number of deaths per year has been 46
- The majority of decedents have identified as cis gendered male: 643 or 78%
- The average (mean) age at death across all genders has been 54 years
- 408 deaths (or 49%) occurred within a shelter/respite facility whereas 417 deaths (or 51%) occurred off-site (e.g., at a healthcare facility or in the community)
Of the 59 deaths of shelter residents reported to TSSS in 2024:
- 43 (73%) were male, 11 (19%) were female and 5 (8%) were Two-Spirit/Transgender/Non-binary
- The average (mean) age at death across all genders was 51.0 years
- 26 of 59 deaths (or 44%) occurred within shelter. The remainder occurred in other locations (i.e. hospital) and were reported to TSSS as recent shelter residents
