Counting homeless deaths: remembering those who died while homeless

Following a week of grieving and anger at the senseless death of yet another woman, a vigil of a different kind was held on Wednesday 20th June. On the eve of the longest night of the year, around 200 people gathered in St Kilda to remember the hundreds of people who died while experiencing homelessness.

While we can pay respect to people who have died while homeless, we know very little about the role that homelessness plays in causing premature death. Our knowledge about mortality rates among the homeless is especially sparse at the pointy end of homelessness; rough sleepers. 

We track our road toll, the number of women who are killed in family violence incidents, how many Australians die of skin cancer, but we do not know how many people die because they didn’t have a safe, permanent home.

We estimate that hundreds of rough sleepers die every year from the impacts of homelessness, though these are unlikely to be the focus of a death certificate or coroner’s report. 

Pneumonia contracted after months on the streets, untreated wounds that lead to death from septicaemia, a fatal head injury sustained from a violent attack; the root cause of such deaths are all related to homelessness.

Research shows that people who have experienced long-term rough sleeping have an average life expectancy of just 47 years, compared to 77 years among other Australians. Research also shows that rough sleepers are 11 times more likely to be the victims of violence than those who haven’t experienced rough sleeping.

Rough sleeping represents just five per cent of all homelessness. Although a minority among the homeless population, rough sleepers experience the most extreme disadvantage, and represent the greatest moral challenge for us to solve.

For a long time the homelessness sector has been advocating for Victoria to adopt a Housing First approach to solve rough sleeping. Housing First has been proven internationally to end long term homelessness. It involves buying and building enough social housing to allow a home for every rough sleeper, and providing support to address the issues that lead to their homelessness. 

Sadly, we still do not have the political will required to end homelessness in Australia. The long-term commitment required extends beyond a single election cycle, and has so far evaded all sides of politics. And yet the solutions are at our fingertips.

The question is not how can we solve homelessness, but rather why have we been unable to solve it when the solution is so clear? We simply need more low-cost housing for those on the lowest incomes and ongoing support for those with significant complexity in their lives, such as mental illness, histories of extreme trauma, addiction and family violence.

Yes, Housing First is expensive, but its target group is very small. Any economic assessment must recognise the significant costs associated with maintaining the current levels of homelessness.

There is a huge cost attached to homelessness, both the cost to human lives and a very real financial cost. When people are sleeping on the street, they get sick, they die, they’re victims of violence requiring police and ambulance, they get caught up in the justice system and their mental health issues get worse.

A 2016 Sacred Heart Mission report, estimated that for every rough sleeper who is housed and supported to get off the street, the cost savings to Government are $17,591 per year, per person. There were 1,123 Victorians counted as sleeping rough on Census night in 2016. 

All forms of homelessness have a detrimental effect on people’s mental and physical health, but long-term rough sleeping exposes people to the most extreme physical and mental suffering. A cohesive, integrated response to homelessness must address rough sleeping while also investing in prevention efforts further up the chain.

We must solve homelessness because it is the right thing to do, because it saves lives and because having a safe home is a human right. It is also an economically sensible thing to do.

Providing a secure, affordable home to rough sleepers will save lives, and will most certainly save money being spent on band-aid responses.