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Most homeless men and women died alone, in streets, parks and driveways from preventable causes and 30 years earlier than those who had a home, according to a study.
Researchers from the University of Waikato studied the coronary findings of 171 homeless people at the time of their death from 2009 to 2018.
The mean age of death for the study participants was 45 years. The average life expectancy of New Zealand is 82 years.
Lead author Sabrine Charvin-Fabre said the study was limited to a smaller group of homeless people without an address at the time of death, as this provided the most complete data set.
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The broader definition of homeless included people who lived in temporary or overcrowded accommodations and would have a registered address at the time of death, even if it was a night shelter, Charvin-Fabre said.
Chris Skelton / Stuff
Dave is homeless and sleeps on the street outside Christchurch’s Ballantynes department store. Dave gave his permission for this photograph to be taken.
But all the homeless experienced difficulties accessing health care, he said.
Slightly more than three-quarters (118) of the study participants died “from conditions amenable to timely and effective health interventions, mostly from natural causes and suicide.”
“Most … were alone at the time of death and were found deceased by witnesses, sometimes several months after death occurred,” the study found.
People over 75 years of age in whom the cause of death or criminal cause could not be established were excluded.
The study highlighted the need for health care services to be provided in a way that meets the health care and social needs of the homeless, Charvin-Fabre said.
Supplied / Stuff
Sandrine Charvin-Fabre, lead author of a University of Waikato study on homeless deaths.
“I think that within society and within the health sector there is obviously a certain marginalization and stigmatization with respect to homeless people, so homeless people feel guilty about their situation.”
Census estimates from 2018 found that about 41,600 Kiwis were homeless by the accepted definition, as “unable to access a house to rent or own with all the basic amenities.”
The figure is likely an underestimate, as homeless people are unlikely to participate in the country’s first digital census, said University of Otago public health researcher Kate Amore.
Maori were nearly four times more likely to be homeless than Europeans, while those from the Pacific were six times more likely.
The most prevalent natural causes of death were cardiovascular disease, including heart disease and heart failure.
Other preventable conditions that led to death included pneumonia, alcohol-related illnesses, diabetes, “transportation-related injuries,” and hypothermia.
A large majority had experienced “significant and multiple traumatic and stressful life events.”
Andy Jackson / Stuff
The majority of homeless people in a University of Waikato study had their last contact with a healthcare professional a year or more before their death. One in five had no contact with a health professional.
Suicide accounted for nearly a third (28.6 percent) of all deaths, and in people 44 and younger, it was the cause of two-thirds of deaths (67.3 percent).
Of those who committed suicide, the majority were found in public spaces, or private vehicles, temporary accommodations, and private garages.
The report noted that suicide was prevalent among homeless youth and young adults.
Just under three-quarters of those who committed suicide were diagnosed with a mental health condition, primarily from alcohol or drug abuse and depressive disorders.
Fewer than half of the homeless were treated for a psychiatric disorder and there was evidence of recent contact with a healthcare professional in only about a quarter of the cases, the study found.
Most homeless people had their last contact with a healthcare professional a year or more before their death. One in five had no contact with a health professional.
“The magnitude of social isolation and disconnection from the healthcare system, combined with chronic psychological distress and unstable living conditions, negatively affects the health-seeking behaviors of the homeless,” the study said.
The homeless were often unable to enroll in a GP without a permanent address and were unable to pay an appointment fee.
Carvin-Fabre, who is a qualified GP in his home country of France, said he noticed how difficult it was for homeless people to get medical care in his volunteer work with the non-profit organization Tauranga Street Kai.
I wanted to see more homelessness awareness and training for healthcare providers.
It was also an issue that transcended the healthcare sector, Carvin-Fabre said.
“As citizens we can give a hand, give a smile, something simple, it’s free … just to say that you are not invisible, I see you.”
