Toronto Public Health releases mid-2023 data for deaths of people experiencing homelessness

Toronto Public Health (TPH) is releasing new data for the first half of 2023 related to the deaths of people experiencing homelessness. Consistent with data from recent years, drug toxicity continues to be the leading cause of death.

From January 2023 to June 2023, TPH received 79 reports of deaths among the unhoused population. While this number is lower than the 92 deaths reported for the same timeframe in 2022, it is still higher than pre-pandemic levels. Almost half – 46 per cent – of the reported deaths among people experiencing homelessness in the first half of 2023 were due to drug toxicity.

A large portion of drug toxicity deaths stem from the toxic, unregulated drug supply. The use of highly potent opioids combined with unexpected substances are significantly increasing the risk of overdose in Toronto. These deaths are an example of the negative health impacts of the ongoing drug toxicity crisis.

Other leading causes of death for people experiencing homelessness in 2023 include cancer (five per cent), accidents (three per cent) and deaths due to suicides (three per cent). The cause of death is unknown or pending in 38 per cent of cases reported between January and June 2023. When pending coroner reports are received, the number of deaths for each cause may rise.

People experiencing homelessness are at increased risk of dying prematurely. In 2021, the median age of death for the general population in Toronto was 78 for males and 85 for females. In comparison, for the first half of 2023, the median age of death of people experiencing homelessness was 52 for males and 48 for females.

Data collection and reporting

Data on deaths of people experiencing homelessness in the community are updated twice a year and are publicly available on an interactive dashboard on the Deaths of People Experiencing Homelessness webpage. 

Providing this data to key audiences can help to improve the health and wellbeing of people experiencing homelessness and support collective action.

The TPH dataset encompasses both deaths of residents within Toronto’s shelter system and deaths outside of shelters. The information is verified in collaboration with the Office of the Chief Coroner of Ontario. In contrast, the Toronto shelter system data specifically centres on outcomes related to shelters.

Addressing public health issues

The City of Toronto and community partners continue to build on ongoing work to address the public health issue of homelessness, by improving access to harm reduction programs and services and affordable housing. Actions include:

• Implementing the Toronto Overdose Action Plan, including providing harm reduction and treatment services, such as supervised consumption services, a drug checking service and an Injectable Opioid Agonist Treatment program available through The Works, TPH’s harm reduction program
• Strengthening the City’s response to the drug toxicity crisis in the shelter system through partnerships with community health and harm reduction partners and people with lived experience of homelessness and substance use to expand the delivery of harm reduction supports and services, including through iPHARE (Integrated Prevention and Harm Reduction Initiative)
• Supporting efforts to expand prescribed safer supply options for people who use drugs, to provide alternatives to the toxic, unregulated drug supply, reduce fatal overdoses and improve health outcomes for people who use drugs
• Developing a comprehensive, city-wide strategy to address the mental health and substance use issues within the city
• Creating a partnership between TPH, Unity Health Toronto and the University Health Network to expand TPH’s long-standing harm reduction program – The Works – to address the drug toxicity crisis
• Partnering with Inner City Health Associates and Loft Community Services to provide integrated physical and mental health services, including harm reduction supports, to people living outside and at most shelter sites
• Working with Ontario Health Toronto Region and other partners to review and update the Homelessness Health Services Framework, to provide a consistent approach to health services in all shelters, as well as to map harm reduction, mental health and primary care resources to shelter locations to identify resource needs and gaps
• The HousingTO 2020-2030 Action Plan targets the approval of 47,500 new affordable rental homes, including 18,000 supportive homes with approximately 6,500 rent-geared-to-income homes by 2030. Since the start of the HousingTO Plan, more than 150 City-led and/or City-supported affordable housing projects have been approved and added to the City’s development pipeline. Once completed, these projects will provide more than 14,400 affordable rental and supportive homes to provide a range of homes to address the needs of residents.

The City is committed to improving the health outcomes of individuals experiencing homelessness, but provincial and federal government support is needed. Additional long-term investments will help address the scale of need for deeply affordable housing, as well as access to mental health, harm reduction, and treatment resources.

Quotes

“Chronic homelessness continues to be a public health issue in Toronto, with thousands of people experiencing homelessness on any given night. Since Toronto Public Health first began collecting these reports in 2017, 961 people have lost their lives tragically amid this social crisis. We know that better information helps us identify the scope of this issue and provides solid evidence to base efforts on improving the health and wellbeing of people experiencing homelessness. It also underscores the importance of housing as a social determinant of health that influences health outcomes across the lifespan.”
– Councillor Chris Moise (Toronto Centre), Chair of the Board of Health

“We have seen that over the course of the COVID-19 pandemic more deaths were reported than pre-pandemic. There were notable increases in 2020, 2021 and 2022 during the height of the pandemic. During those years, 145 deaths, 223 deaths, and 191 deaths were reported respectively. In the environment of an unregulated drug supply that is more toxic, more contaminated and less predictable, Toronto Public Health, our City, government and community partners are challenged to secure new and continued funding for harm reduction services and supports and more affordable housing options for people across the city. These are two key components of reducing the negative health impacts of homelessness.”
– Dr. Eileen de Villa, Medical Officer of Health

 

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