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First major look at B.C. homeless deaths disappoints

November 8, 2014

dying-on-streets-cover

The Vancouver street magazine Megaphone issued a report on Thursday, November 6, showing that homelessness nearly cuts a British Columbian’s life expectancy in half.

The Megaphone report, called “Dying on the Streets: Homeless Deaths in British Columbia” uses B.C. Coroner statistics to contrast the short lives of homeless people with the longer lives that the rest of the B.C. population can expect.

The report’s authors, Sean Condon and Jenn McDemid, get right to their point:

“As the data in ‘Dying in the Streets’ shows, the median age of death for a homeless person in the province is between 40 and 49. This is almost half the life expectancy for the average British Columbian, which is 82.65 years.”

So they say.

I know that living on the street can be a challenge and it can be dangerous but after a decade of being homeless, I say that there’s nothing intrinsically dangerous about living outside.

What’s dangerous about homelessness and potentially life-shortening isn’t homelessness itself but rather the “culture” of drugs and addiction that surrounds street life.

And the skimpy data that Condon and McDermid draw on proves my point as much as it proves theirs.

Homelessness by the numbers

On the one hand, it’s important to credit the authors with attempting a popular analysis of homeless deaths in B.C. in order to come to useful conclusions.

On the other hand, “Dying on the Streets” reads like an attempt to find convincing statistics to backup the authors’ foregone conclusion that homelessness kills.

The executive summary begins by telling readers that at least 281 homeless people died in British Columbia between 2006 and 2013.

The authors then actually question the accuracy of the statistics they cite, saying that the true number of homeless deaths is likely much higher.

It’s an important secondary theme running through the report — the lack of hard data and the need to keep better records on the deaths of homeless people; not just in British Columbia but across Canada.

In fact, this report, thin as it is on facts, could probably only be done in British Columbia, thanks to the diligence of the B.C. Coroners Service, which even made additional 2012-2013 data available to the report’s authors.

All the hard numbers in the report are based on the findings of two B.C. Coroners Service reports: Deaths among Homeless Individuals. 2006-2007 and Deaths among Homeless Individuals. 2007-2013.

The B.C. Coroners Service prefaces the 2006-2007 report  by explaining that it uses the same definition of “homeless” used by the Greater Vancouver (now Metro Vancouver) Homeless Count. The B.C. Coroners Service considers someone homeless…

“…if they were known to be living ‘rough’ or on the street (street homelessness), or were in an emergency shelter or being provided temporary shelter by friends or family (less than 30 days; sheltered homeless).”

The authors of “Dying on the Streets” say the definition is too narrow to give an accurate picture.

“Counting someone as homeless only if they are without housing at the exact moment of their death does not properly reflect the realities of homelessness in British Columbia.”

Perhaps not, but the hard numbers provided by the B.C. Coroners Service are at least based on reality.

I really have to quibble with Condon and McDermid’s willingness to cling to the slim reed of “average life expectancy” in order to make their only point sensational and newsworthy.

Average life expectancy is not, as I understand it, synonymous with actual age of death. The later is a record of what has really happened while the former is merely a prediction, or educated guess about what might happen.

The Megaphone report takes its average life expectancy figure from a B.C. Stats document called Life Expectancy at Age 0. The “82.65” is the average for “2013” between men (80.71) and naturally longer-lived women (84.55).

The authors appear to take the “2013” to mean that the average life span of British Columbians in 2013 is 82.63.

Please someone correct me if I’m wrong but I read the “2013” as a person’s birth date — that a person born in 2013 can expect to live 82.63 years.

I’m under the impression that the concept of life expectancy is conditional on a person’s birth date. Or as the Australian Institute of Health and Welfare explains life expectancy:

“In Australia, a boy born in 2010–2012 can expect to live to the age of 79.9 years and a girl would be expected to live to 84.3 years compared to 55.2 and 58.8 years in 1901–1910 respectively.”

Sounds trivial but it means that if our median homeless person died last year at, say, age 48, their life expectancy was considerably less than 82.63 years.

Their death age properly contrasts with the life expectancy of a British Columbian born when they were — 50 years ago. And the life expectancy for a British Columbian born in 1965 was 72.17 years — more than 10 years less than the average cited by the Megaphone report and close to 68 percent of the predicted 1965 average.

No media outlet, so far as I have noticed, has questioned the report’s use (or misuse) of statistics. The report’s contention too-perfectly fits the preconceived notion of homeless people living short, brutish lives.

Again, I have to strongly disagree that homelessness is intrinsically harmful. What’s actually harmful about being homeless isn’t living outside. That’s actually a pretty healthy environment.

What’s unhealthy and life-shortening about homelessness is the poisonous haze of drugs and addiction that surrounds living on the street.

The authors of “Dying on the Streets” can completely ignore the fact but they can’t hide the glaring evidence in the statistics they cite.

Homelessness is a walk in a park (full of drug dealers)

cause-chart

Data from B.C. Coroners Service’s Deaths among Homeless Individuals. 2007-2013.

The B.C. Coroner’s report on homeless deaths between 2007 and 2013 separates the 250 deaths into 19 categories. The top two categories: Poisoning: Alcohol/Drugs (71) and Natural Causes (59) account for 130 deaths, over half of the total.

It’s true that far too many of the 250 deaths look preventable. But when I look at the breakdown by cause, I do not see homelessness killing people. I see drugs, disease and suicide as the real killers — and cars, of course.  And the neglect of society.

Society could provide homeless people with easy round-the-clock access to positive and inclusive services that would help them be healthy, productive, contributing citizens but it chooses not to.

Instead, society shuns and stigmatizes homelessness and all but condones the 24-hour access to cheap street drugs that promise many homeless people a release from their despair and boredom.

The Housing First crowd would have us believe that health and well-being for homeless people begins and ends with giving a street person a social housing bedsit but I disagree. I believe that change needs to happen first at the street level and to the drug culture associated with homelessness or else the homeless drug addicts put in new social housing will simply bring the dangers of the street home with them.

If British Columbia was actually trying to accessorize its nascent U.S.-style drugs and homelessness situation with honest-to-goodness U.S.-style slums then I don’t think it could do better than it is — putting drug addicts on lifetime government disability, packing them into towers, giving them the key but otherwise throwing them away.

And now this brief word from my work ethic

I admit that it hasn’t worked for me so far, but I still believe that in a market economy the only sustainable path off the street is through a job.

If the B.C. government really is going to give drug addicts housing and pay for it for the rest of their lives, then I guess that could work but I don’t believe that the addicts themselves will ever work again and I have to ask how that is good for anyone?

As I’ve said before, I believe society has an interest in providing bridging services so homeless people can have the same 24-hour access to showers and laundry and storage that they would have if they weren’t homeless. This would give homeless people the freedom to take jobs and work whatever hours an employer wanted them to without them having to sacrifice their hygiene.

Last time I tried full-time employment, the hardest part of my job was trying to fit my hygiene needs into my employer’s work schedule.

I strongly approve of homeless prevention programs like the City of Vancouver’s Rent Bank — long overdue, But if someone cannot be prevented from becoming homeless, I believe it’s in society’s interests to be available immediately to help clear any obstacles to a homeless person continuing with their existing job or rejoining the workforce.

The way things are now, as long as I’m homeless, it’s easier and less stressful for me to not have a job and earn the money I do collecting returnable containers. That way I can control my hours.

You see, I’m the most understanding employer I know. I’ll happily give myself time off to go do laundry when the laundromats are open or go get shower during the window of opportunity when city facilities with accessible showers are open.

Homelessness without drugs — like Wi without Fi?

With every reduction in the supply and addiction to street drugs, I believe you would see a direct reduction in the dangers associated with homelessness.

If you could eliminate just three street drugs — heroin, cocaine and amphetamines (and their siblings: crack and crystal meth) from the equation, just imagine how that would transform being homeless.

Without addictions…

  • You’re not nearly so forgetful so you don’t lose nearly so much stuff.
  • You don’t stay up for days and then sleep like you’re in a coma so you’re not such easy prey for thieves.
  • And there wouldn’t be nearly so many thieves to worry about.
  • Also less paranoia and aggression to fuel violent outbursts.
  • Not to mention less induced and aggravated mental illnesses like schizophrenia and bipolarity.
  • Plus much less cumulative and irreversible neurological brain damage.

Street drugs are certainly not the only stumbling block to people living on the street but I see addiction as the biggest barrier that both faces homeless people and keeps society from seeing homelessness for what it really is; extreme poverty.

How can it stand to not have all its legs?

The 12 metre-high Broken Chair in Geneva, one of the home of the Four Pillar drug strategy.

The Broken Chair in Geneva, Switzerland, a home of the Four Pillar drug strategy.

Remember harm reduction, prevention, treatment and enforcement? Whatever the hell happened to Vancouver’s four pillars strategy for dealing with drug addiction?

The harm reduction component is certainly visible and quite successful. The handing out of clean needles and crack pipes really does check the spread of transmittable diseases from sharing used drug paraphernalia and Vancouverites should be proud that no one using the  Insite safe injection site in the Downtown Eastside has ever died from a drug overdose.

But where are the other three legs of the chair? Are they quietly working in the background; ridding our streets of drugs and drug dealers and encouraging and welcoming drug addicts into widely and easily available drug treatment programs?

I hope!

These days no one seems to talk about any part of the four pillars except harm reduction.

The authors of “Dying on the Streets” certainly don’t seem interested in prevention, treatment or enforcement and that’s a shame because I’m sure they know as well as anyone the enormous toll drug addiction takes on street people.

And that’s my problem with the report; it declares homelessness dangerous without ever quite saying why.

I see homelessness as dangerous like a toxic work environment that can be made safer by changing the culture. The Megaphone report instead implies that homelessness itself is dangerous like a live volcano or wire-walking across Niagara Falls (many have tried and died!).

I’ll take reports and people and governments seriously when they begin to get serious about facing up to the central role that street drugs and addiction play in the misery of homelessness.

In the meantime Megaphone magazine should be applauded for publishing the Dying on the Streets report.

It really is worth reading. It raises many good issues; calls for several sensible changes in the way statistics about homeless people are collected and eloquently puts forward the authors’ belief that homelessness is the worst thing that can happen to a human being. It also has big colour photos and some heart-tugging stories that help put a necessary human face on homelessness.

And then, when you see a street corner vendors selling Megaphone magazine (the vendors are  either on low incomes or homeless), consider buying a copy and making their life that little bit less awful.

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