Tag Archives: #dying

Tracking Homeless Deaths

As of January.1st, 2017, the City of Toronto has begun tracking homeless deaths. The process is still in its infancy and has taken the city a while to speak to the public about how the new system is working and what their findings have been.

A press conference was held on January.10th with public health officials, some city councillors discussing how this is a problem that needs addressing in order to fully understand the scope of how many people are dying while homeless. We need this information for raising awareness and improving health.

cathy crowe press conference

Street Nurse Cathy Crowe

Up until now, tracking deaths has involved some volunteers from the Toronto Homeless Memorial Network who have called around to a few agencies once a month to find out who has died. The only other information provided by the city are lists of deaths that have occurred in city-funded shelters and even so, this page is not always up to date.Therefore, this does not include any deaths in hospitals or any other locations in the city.

Needless to say, there are many deaths that are not being recorded and we need to do better. Hopefully this new system will show us the extent of the homeless crisis in our city, but we have yet to hear more.

Advertisements

Importance of Names

“The dead cannot cry out for justice; it is a duty of the living to do so for them” 

– Lois McMaster Bujold

Every second Tuesday of the month, some community members gather at the Church of the Holy Trinity in downtown Toronto in order to remember those homeless people who have passed away. One of the hardest parts of attending the Toronto Homeless Memorial, is hearing the list of names that are read during the ceremony. If that wasn’t difficult enough, many of the deceased could not be identified and therefore are read as “Jane Doe” or “John Doe.”

We pride ourselves on our “first world” status, on how “developed” we are compared to other countries. The truth is, we are far from developed. People…and I will repeat this again…people who have died homeless should not have been in that position in the first place. But even further, we cannot even keep track of our citizen’s names? Who were they? And at the very least, what were their names? Where is the dignity?

FullSizeRender

Kumar and colleagues suggest that we are born with an identity and we deserve to die with one, as it is a fundamental right of being born a human (2014:80). Michael Stoops informs us that “[w]hen a homeless person dies they do no often get the same sense of dying with dignity as a housed person” (2007:6). What most of us might take for granted here is that for many, burials and funerals are commonplace. Gravestones are often marked with the names of the dead. Unknown soldiers are also another group that do not get named in death, however, they are much more exalted in our society.

In a recent paper I wrote, I unpack some of the answers surrounding Judith Butler’s question of “what makes for a grievable life?” (2003:10). In neoliberal times, those people engaged in economic gains and productivity tend to be considered more valuable than those people who “do nothing.” We think to ourselves that money makers are more valuable than John Doe’s who die on the streets because they never contributed to society in a productive economic way. Thomas Laquer would agree, “[w]e have a history of commemorating the dead through monuments, which include war veterans, public workers and political figures. Some of these sites only include those who have “done something for humanity” (2015:423). However, if you learn about people who are homeless and hear their stories, then you will learn some of them were “productive” members of society (which is actually beside the point, but needed to be mentioned).

A human life is a human life, and because we have labelled and stigmatized homeless people, we just don’t care enough as a society to learn their names. Tipple and Speak suggest, that “[t]he negative and exclusionary language used to describe and discuss homeless people helps to construct homeless people as ‘other’ and institutionalize their stigmatisation keeping them dissociated and disconnected from society” (Tipple & Speak 2004:2). Society in general seems to be ok with this, to see homeless people as parasitic and therefore who cares about when they die or what their names were, right?

Despite this, some of us are working to change that.

baby feet

Laquer has also pointed out that “[n]aming marks the entry not into biological but into human life” (2015:367). In Ontario, when we are born, we are required to submit our children’s names to the province that in turn, provides a birth certificate. This is an important societal ritual, not only because it is an official government act, but on a personal level, we can understand its importance. Psychologists have done research on the importance of names. The field has also labelled a phenomenon called “The Cocktail Party Effect” which is being able to recognize our name being said in a noisy room and a good overview of the literature can be found here. Nisbett and Ross (1980) inform us that we pay more attention to identifiable victims than statistical ones.

It is clear. Names are important to us all. We should not live in a society where we cannot keep track of our dead. If this is something important to you as well, contact your local MP and MPP and support affordable housing and social supports as a priority in order to prevent this tragedy from happening in the first place.

References

Bujold, L. (2002). Diplomatic immunity. Riverdale, NY New York: Baen Books.

Butler, J., (2003). Violence, Mourning, Politics. Studies in Gender and Sexuality. 4(1): 9-37.

Colman, A. M., Hargreaves, D. J., & Sluckin, W. (1980). Psychological factors affecting preferences for first names. Names, 28(2), 113-129.

Kumar, A., Harish, D., Singh, A., & Kumar, G. A. (2014). Unknown Dead Bodies: Problems and Solutions. Journal of Indian Academy of Forensic Medicine, 36(1), 76-80.

Laqueur, T. (2015). The work of the dead : a cultural history of mortal remains. Princeton, New Jersey: Princeton University Press.

Nisbett, R., & Ross, L. (1980). Human inference: Strategies and shortcomings of human judgment. New Jersey: Prentice-Hall, Inc.

Stoops, M. (2007). Dying without dignity: homeless deaths in Los Angeles County, 2000-2007. Los Angeles Coalition to End Hunger & Homelessness.

Tipple, G., & Speak, S. (2004). Attitudes to and interventions in Homelessness: Insights from an International Study. In paper delivered to International Conference Adequate and Affordable Housing for All, June (pp. 24-27).

Signatures Needed – Please Sign

Cathy Crowe, street nurse and local homelessness advocate, has started a petition to bring attention to Mayor John Tory to address the homeless deaths in our city.

She is hoping that there will be more funding for shelters and warming centres in the 2016 budget. Let’s all pitch in and do what we can, and hope that council will approve the funding

Sign here!

Death Is Everywhere

Death was always there, as if it were another parent raising me as a child. By the age of 12, I had experienced three deaths in my family, including my father. Death was quite salient for me throughout the rest of my life as well, heading into adulthood there were more deaths of friends and loved ones.

Death is not the only way to be introduced to the idea of mortality, as other experiences can cause people to reflect on their mortality, such as illness, injury or disability. Over 30 years of psychological research has been conducted on how becoming aware of our inevitable deaths can affect our behaviours. Those of us who have had to deal with mortality reflecting hardships understand that time is limited and precious. People in different vocations have to live with the salience of death in their lives, such as doctors. However, when it comes to the homeless population, the story becomes even more complex.

Many homeless people that die are without the resources of loved ones, proper health care and a home (Song et al 2007a:435). Death is hard for us all, but just try to imagine what it would be like to lose people without having support systems in place. No one to call when you are grieving, no shoulder to cry on and add to that mental exhaustion and the inability to cope. For homeless people, “[n]umerous experiences with death and dying causes homeless people to believe that death is ubiquitous, and should be expected at any moment” (Song et al. 2007b:431). Homeless youth in particular “…are experiencing serious distress as indicated by the high prevalence of suicide attempts, thoughts of death and suicide, and psychiatric disorders” (Yoder et al., 2008:97).

time

Life Expectancy: The Evidence is Clear

According to the report on homeless deaths in Los Angeles county, the average death for homeless people was 48.1 years old, while the average American life expectancy was 77.2 (Stoops, 2007:4). Homeless people die younger than the general population (Hibbs et al., 1994:307; Cheung & Hwang 2004:1243; Barrow et al., 1999:529; O’Connell 2005:13).

James O’Connell reviewed the literature for premature mortality in homeless populations and suggests that mortality rates may be higher than we predict since most studies focus on those homeless people who have utilized shelters and does not include the so called “rough sleepers” who are vulnerable to extreme weather and violence” (2005:12). These studies also do not include those who have moved away and who may have died without the researcher’s knowledge.

Why is death so common on the streets?

If we examine why homeless people face death regularly, then we notice that there are some common themes that arise. We know from research that “[h]omeless persons face many barriers to health care, have few resources, and experience high death rates. They live lives of disenfranchisement and neglect” (Song et al. 2007b:427). We tend to take for granted the little things in life that allow us certain privileges. When you are homeless, it’s not that simple just to walk into your doctor’s office and get treated, especially without any identification or a permanent address. Jonathan R. Hibbs and colleagues explain that “[h]omeless people are likely to die from a variety of preventable causes” (Hibbs et al., 1994:304). Preventable? And yet, they still lose years off of their lives. As a society, we tend to ignore the health aspect to homelessness and dismiss any problems that they encounter by victim blaming. Our individualist culture suggests that when homeless people become sick and die, it’s their fault.

hands

Researchers suggest otherwise. “Homelessness itself, rather than identifiable medical conditions, appears to be the risk factor that most needs to be eliminated in order to reduce preventable mortality” (Hibbs et al., 1994:308). Barrow et al maintain that interventions must be broadly based outside of specific health risks by focusing on “the general phenomenon of homelessness itself and the societal problems of poverty and discrimination that have given rise to it” (1999:533). Much work needs to be done. But in the meantime, maybe by recognizing that homelessness and death are heavily related we can be a little more compassionate when it comes to understand the lives of the homeless.

 

References

Barrow, S. M., Herman, D. B., Cordova, P., & Struening, E. L. (1999). Mortality among homeless shelter residents in New York City. American Journal of Public Health, 89(4), 529-534.

Cheung, A. M., & Hwang, S. W. (2004). Risk of death among homeless women: a cohort study and review of the literature. Canadian Medical Association Journal, 170(8), 1243-1247.

Hibbs, J. R., Benner, L., Klugman, L., Spencer, R., Macchia, I., Mellinger, A. K., & Fife, D. (1994). Mortality in a cohort of homeless adults in Philadelphia. New England Journal of Medicine, 331(5), 304-309.

O’Connell, J. J. (2005). Premature mortality in homeless populations: A review of the literature. Nashville, TN: National Health Care for the Homeless Council, 1-16.

Pyszczynski, T., Solomon, S., & Greenberg, J. (2015). Thirty Years of Terror Management Theory: From Genesis to Revelation. Advances in Experimental Social Psychology.

Shapcott, M. (2005). Dying for a place to call home: Women and homelessness in Toronto and Canada. National Housing and Homelessness Network: Toronto Disaster Relief Committee, 1-10.

Song, J., Bartels, D. M., Ratner, E. R., Alderton, L., Hudson, B., & Ahluwalia, J. S. (2007a). Dying on the streets: Homeless persons’ concerns and desires about end of life care. Journal of general internal medicine, 22(4), 435-441.

Song, J., Ratner, E. R., Bartels, D. M., Alderton, L., Hudson, B., & Ahluwalia, J. S. (2007b). Experiences with and attitudes toward death and dying among homeless persons. Journal of general internal medicine, 22(4), 427-434.

Stoops, M. (2007). Dying without dignity: homeless deaths in Los Angeles County, 2000-2007. Los Angeles Coalition to End Hunger & Homelessness.