Vicki Mylonas
Homeless people in Australia are dying on average 30 years earlier than the general population, according to several recent studies. The reports, which suggest that even a brief period of rough sleeping can have an enormous impact on health and life expectancy, are of particular concern amid a rise in homelessness, including of people with paid jobs.
The true extent of this crisis remains concealed to the general public, as no Australian government compiles specific data on deaths among the homeless population.
The Guardian’s “Out in the Cold” series is based on a 12-month investigation into the cause of 627 homeless deaths it was able to identify between January 2010 and December 2020. This involved combing through 10 years’ worth of non-public death reports to state coroners and an analysis of inquest findings.
As not all deaths are reported to the coroner, and the fact that a person was homeless is frequently not noted in the coronial records, the Guardian considers this to be a “vast undercount.”
Of the 627 deaths that could be identified, the average age at death for homeless men was 45.2 years and for women, 40.1 years. The median age at death among the general population is 79 years for men and 85 years for women.
The overwhelming majority of the deceased—87.1 percent—were men. Indigenous Australians were also significantly overrepresented, making up 21.5 percent of the 627 deaths despite comprising 3.2 percent of the total population.
Natural causes were responsible for 158 of the deaths, while 130 were from intentional self-harm. At least 24 were caused by assault. Drug toxicity was the most common external factor, as the primary contributor to 203 deaths, while 74 were from asphyxiation by hanging.
Deborah Di Natale, chief executive of the Council to Homeless Persons, described the premature deaths as the “stark reality” of homelessness. “It is really dangerous to be experiencing homelessness,” she said, adding that living on the streets poses an increased risk of death due to untreated illnesses and lack of adequate access to health care.
The overrepresentation of “deaths of despair”—suicide and drug overdose—points to both the demoralising and debilitating effect of homelessness and poverty, as well as the broader crisis of public mental health care.
Another study, of 324 deaths in Sydney, by Macquarie University researchers found that the mortality rate of homeless people was 80 percent higher than that of the general population, across age groups.
A 15-year longitudinal study by Melbourne researchers determined that people who experienced even a single episode of homelessness were almost four times more susceptible to premature death than the average.
In Perth, a study led by the University of Notre Dame Australia’s Professor Lisa Wood, based on hospital records, found that the median age of death for homeless was 50 years. Their research revealed that in 2021, at least 70 homeless people died in Perth, a city of around 2.2 million people.
Wood said, in response to the refusal of governments to track homeless deaths, “I can’t help but think it’s such an uncomfortable truth that in some ways, it’s less confronting for governments and others if it remains hidden.”
In 2021, David Pearson, chief executive of the Australian Alliance to End Homelessness, wrote to Greg Hunt, then health minister in the federal Liberal-National government under Scott Morrison, warning that the failure to collect even the most basic data about homelessness deaths was a national emergency.
Pearson called on the government to develop a reporting framework that would allow hospitals and other services to report on these deaths. He said that Hunt did not respond to this appeal and that the Morrison government referred him to the (predominantly Labor) state governments. Most of the states, he added, did not even respond.
The Australian Medical Association has called the premature deaths of homeless Australians a national tragedy and has advocated for the government to both invest in a monitoring regime and improve housing and health services.
The Guardian investigation has prompted a degree of hand-wringing in parliament.
Federal Housing Minister Julie Collins described the premature deaths as “completely unacceptable,” but refused to commit to the establishment of a federal reporting scheme. Instead, she reiterated the Labor government’s paltry pledge to deliver 30,000 new social and affordable homes over the next five years, not even 5 percent of the expected shortfall.
Reforms to the reporting of homeless deaths are now being considered in New South Wales, South Australia and Victoria. But while tracking these figures is critical, it would not in and of itself address the roots of the crisis—an acute lack of affordable housing and the slashing of real wages and social spending, spearheaded by Labor governments at state and federal level.
Confronted with unprecedented and growing demand, homelessness services are facing a $73 million funding cliff by the end of 2024, which would put at risk 700 critical support jobs.
The tragedy of premature homeless deaths is not an isolated phenomenon but the sharpest expression of the broader impact of social inequality on health outcomes. A study by Victoria University in 2021 revealed that wealthy Australians live up to 6.4 years longer than those on the lower end socio-economic scale. The report added that even middle-income Australians are 23 percent more likely to die early of a preventable illness compared to the top income earners.
This underscores the fact that the capitalist system is fundamentally incapable of satisfying even the most basic needs of human life. This has been starkly revealed during the ongoing COVID-19 pandemic. The profit-driven “let it rip” policies embraced by governments worldwide have caused some 30 million preventable deaths. In Australia, overall life expectancy declined for the first time since World War II as a result.
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