Deaths among Toronto's unhoused people still trending high with drug toxicity crisis to blame

The number of people experiencing homelessness dying in Toronto continues to be much higher than what was seen prior to the COVID-19 pandemic.

New Toronto Public Health (TPH) data released on Sept. 28 found that 79 unhoused individuals passed away in this city in the first six months of 2023 – an average of three people a week. The median age of those who died, which includes people staying within the shelter system and outside of it, was 52 for males and 48 for females.

In the first half of 2022, the city saw 92 deaths among unhoused people during the same timeframe. A total of 191 people experiencing homelessness died in Toronto that year, with the median age of death at 55 for males and 42 for females.

Looking back to 2019, the year prior to the pandemic, in total, 128 people experiencing homelessness died in the city.

The information is verified in collaboration with the Office of the Chief Coroner of Ontario.

CAUSE OF DEATH

Another ongoing trend is how Toronto’s unhoused people are dying, with drug toxicity continuing to be the top cause of death.

This data, which is updated twice a year to the City of Toronto’s interactive dashboard, indicated that 46 per cent of the reported deaths among people experiencing homelessness from January to June 2023 were drug-related.

Since the city started collecting this kind of data in 2017, 48 per cent of Toronto’s 961 homeless deaths have been found to be caused by drug toxicity.

“A large portion of drug toxicity deaths stem from the toxic, unregulated drug supply. The use of highly potent opioids combined with unexpected substances are significantly increasing the risk of overdose in Toronto,” the city said in a Sept. 28 news release.

“These deaths are an example of the negative health impacts of the ongoing drug toxicity crisis.”

Dr. Eileen de Villa, Toronto’s medical officer of health, pointed to “notable increases” in the number of unhoused people dying in the city during the pandemic.

“(In 2020, 2021, and 2022,) 145 deaths, 223 deaths, and 191 deaths were reported respectively,” she said.

“In the environment of an unregulated drug supply that is more toxic, more contaminated and less predictable, Toronto Public Health, our City, government and community partners are challenged to secure new and continued funding for harm reduction services and supports and more affordable housing options for people across the city. These are two key components of reducing the negative health impacts of homelessness.”

STEPS TO ADDRESS HOMELESSNESS, DRUG TOXICITY CRISIS

The City of Toronto said that it is working with community partners to “build on ongoing work to address the public health issue of homelessness, by improving access to harm reduction programs and services and affordable housing.”

Some of the steps being taken include implementing an overdose action plan, strengthening its response to the drug toxicity crisis in the shelter system, supporting efforts to expand safer supply options, and “developing a comprehensive, city-wide strategy to address the mental health and substance use issues within the city.”

A partnership has recently been established between TPH, Unity Health Toronto, and University Health Network to expand public health’s long-standing harm reduction program.

The city noted that it is also working with Inner City Health Associates and Loft Community Services to provide integrated physical and mental health services as well as collaborating with Ontario Health Toronto Region and other organization to establish a “consistent approach to health services in all shelters, as well as to map harm reduction, mental health and primary care resources to shelter locations to identify resource needs and gaps.”

Another important part of this ongoing effort is the HousingTO 2020-2030 Action Plan, which has an approval target of 47,500 new affordable rental homes by 2030.

“The City is committed to improving the health outcomes of individuals experiencing homelessness, but provincial and federal government support is needed. Additional long-term investments will help address the scale of need for deeply affordable housing, as well as access to mental health, harm reduction, and treatment resources,” it said in a release.

“Chronic homelessness continues to be a public health issue in Toronto, with thousands of people experiencing homelessness on any given night,” Toronto Centre Coun. Chris Moise, the chair of the Board of Health, said in a release.

“We know that better information helps us identify the scope of this issue and provides solid evidence to base efforts on improving the health and wellbeing of people experiencing homelessness. It also underscores the importance of housing as a social determinant of health that influences health outcomes across the lifespan.”