(The Pavement, 11 February 2012) The outdated and overused statistic that “the life expectancy of someone who sleeps rough is 42 years” has finally been updated. The original figure came from Crisis’ 1996 report Still Dying For A Home (which we reported on in May 2010). The new report from Sheffield University, also commissioned by Crisis, ups this figure to 47.
But this doesn’t mean 46-year-old Pavement readers should start worrying. What the 1996 and 2011 Crisis reports calculate is not how long homeless people can expect to live, but their average age of death.
The briefing to the new report, Homelessness: A Silent Killer, makes this clear (unlike the 1996 study) by avoiding the term “life expectancy.”
In comparison to the average age of death in the so-called general population (77) it’s a shocking, headline-grabbing figure – even though the reason the figure is so low is that more homeless people die at a young age, dragging down the overall average.
Cause and effect
In the briefing to the report (which is still to be released in full), Crisis chief executive Leslie Morphy summarises: “This report paints a bleak picture of the consequences homelessness has on people’s health and wellbeing. Ultimately, it shows that homelessness is killing people.”
However, while being homeless can exacerbate existing health problems or even cause them, not having a home was not found to be the main cause of death among those counted. Instead, the study found homeless people are over nine times more likely to commit suicide than the general population, three times as likely to die as a result of a traffic accident, twice as likely to die of an infection and three times more likely to suffer from a fatal fall.
Most significantly, however, it calculated that drug and alcohol abuse account for just over a third of all deaths – a huge proportion. But drug and alcohol abuse of course also affects (and kills) members of the general population too. And as Jeremy Swain, CEO of Thames Link, commented on Twitter soon after the release of the report briefing on 21 December: “we know from robust academic research that alcohol and drug misuse nearly always precedes homelessness”.
The researchers also faced major obstacles in methodology. As Dr Bethan Thomas admits in the report: “Almost by definition, it is difficult to count homeless people and it is not possible to reliably estimate mortality for the previously homeless who have now found secure accommodation and so to discover what the long term effects of a period of homelessness might be. It is also difficult to count deaths of homeless persons. Death certificates do not record the deceased’s housing status.”
Despite these obstacles, Dr Thomas went ahead with the report – finding potential homeless deaths by matching postcodes from mortality data provided by the Office for National Statistics with postcodes of homeless day centres and hostel accommodation as provided by Homeless Link. In total 1,731 deaths (where the person was definitely homeless or there is a high probability they were) were counted.
Crisis has used the new report’s findings to outline a set of recommendations to improve homeless people’s health, in short: prioritise the needs of homeless people in the restructure of the NHS, reform health service delivery for homeless people and ensure provision meets needs and is integrated and holistic.
The next phase of the project, to be published in summer 2012, will investigate cause of death by age and analyse more detailed causes of death – plus, it is hoped, mortality by different accommodation type and area.