The Toronto Shelter Standards require that shelter operators provide written reports of the deaths of clients or recent clients to the City within 30 days. Shelter, Support and Housing Administration (SSHA), has collected this information since 2007, and does an annual review of the data.

Key points

  • Since 2007, there have been 250 reported deaths, with an average of 25 deaths per year
  • 136 of the 177 deaths (77%) that occurred outside of shelter have taken place in some type of health care facility (e.g. hospital, palliative/hospice care)
  • The highest number of deaths occurred in 2015 – there were 45 deaths with the average age of decedent of 58.3 years. 2014 had the second-highest number of reported deaths with 30. Approximately 16,500 unique individuals accessed the shelter system in 2015
  • Of the deaths that occurred within shelters the most deaths have occurred in Seaton House programs (i.e., Annex/Infirmary and Long-Term), year over year
  • The Death of a Shelter Resident Reporting Form, Guidebook (i.e., instructions for shelter providers about when and how deaths of shelter residents are reported), and the relevant guideline were updated in January 2016 in order to simplify the reporting requirements, thereby improving the timeliness and reliability of reported information

Background

  • SSHA, in conjunction with Toronto Public Health (TPH), developed a database to track DoSR data. This data, along with similar data from the provincial Coroner’s Office and the Toronto Disaster Relief Committee, was collected annually by TPH and reported bi-annually to the Toronto Board of Health.
  • The Office of the Chief Coroner discontinued its practice of monitoring homeless deaths (under the TIDE project). Additionally, the Toronto Disaster Relief Committee lacked sufficient resources to continue to formally track homeless deaths.
  • In June 2010, TPH announced that it would discontinue the biannual reporting of aggregate findings and trends in deaths in the homeless population, in response to this loss of data sources. SSHA was no longer obliged to report to TPH.
  • SSHA elected to continue to monitor this data and present annual findings to the SSHA General Manager, Director of Hostel Services, Manager of Operations and Support Services and the Manager of Policy and Planning.
  • In 2013, Hostel Services committed to publishing DoSR statistics on the SSHA website, updated on a monthly basis.
  • In 2017, Toronto Public Health (TPH) recommitted to capturing and reporting the deaths of homeless persons who may not have necessarily been residents of the shelter system. SSHA – through the newly created Homelessness Initiative and Prevention Services [HIPS] unit – will maintain its current responsibilities regarding data collection, storage, analysis and publication via the SSHA website and will additionally submit anonymized DoSR information to the TPH online reporting tool on a quarterly basis.

Data Summary

Of the 250 reported deaths of shelter residents since 2007:

  • The average number of deaths per year is 25
  • The majority of decedents were male (206 or 82.4%), with no transgender/other gender decedents reported
  • The average age at death was 54.7 years (all genders combined), with no age difference between genders (i.e., both male and female average to 54.7 years)
  • Age breakdown:
    • 1 (0.4%) were children (0-15 years)
    • 6 (2.4%) were youth (16-24 years)
    • 166 (66.4%) were adults (25-60 years)
    • 77 (30.8%) were seniors (61+ years)
  • 73 deaths occurred within shelter and 177 deaths occurred outside of shelter
  • 136 of 177 deaths (77%) outside of shelter occurred in some type of health care facility (e.g. hospital, palliative/hospice care)
  • Seaton House’s Annex and Long-Term Programs have reported the most deaths (100, combined), which represents 40% of total deaths, and
  • The median length of stay in shelter prior to death was 86 days, with a range between 0 and 5475 days.

Of the 33 reported deaths of shelter residents in 2016:

  • The majority of decedents were male (27 or 81.8%), with no transgender/other gender decedents reported
  • The average age at death was 55.6 years, with male decedents at 57.5 years and females at 47.0 years
  • Age breakdown:
    • 0 were children (0-15 years)
    • 2 (6%) were youth (16-24 years)
    • 20 (60.6%) were adults (25-60 years)
    • 11 (33.3%) were seniors (61+ years)
  • 13 deaths occurred within shelter and 20 deaths occurred outside of shelter
  • 18 of 20 deaths (90%) outside of shelter occurred in some type of health care facility, with St. Michael’s Hospital being the most common location, and
  • The median length of stay in shelter prior to death was 98.5 days, with a range between 1 and 5475 days.

Of the 45 reported deaths of shelter residents in 2015:

  • There were approximately 10 times as many male decedents than female (41 male and 4 female) and there were no deaths of self-identified transgender residents reported
  • The majority of decedents (all genders combined) fell within the age range of 50 – 70 years (23 of 45 deaths or 51.1%), with the average age at death of 58.3 years
  • 9 deaths occurred within shelter and 36 deaths occurred outside of shelter
  • 34 of 36 deaths (94%) that occurred outside of shelter took place in some type of health care facility with St. Michael’s Hospital being the most common location
  • The general pattern of reported deaths identified in 2015 is consistent with prior reporting years in that it involves a majority of male residents between 50 to 70 years of age, and that the highest number of deaths were reported by Seaton House programs (current admissions + discharged directly from program to a medical facility), the residents of which are known to suffer from a disproportionately high incidence of mental and physical health conditions.