Mortality data on Hamilton’s homeless population points to overdoses as top cause of death

Between June and November of 2021, 19 people died in Hamilton while experiencing homelessness. A data study reveals the average age at the time of death was 36 years old. Don Mitchell / Global News

A pair of doctors is calling on the City of Hamilton to do more data collection after discovering people living rough have a below-average life expectancy, primarily driven by drug overdoses.

Dr. Jill Wiwcharuk, an inner-city physician who was co-author of the report, “Deaths in the Hamilton Homeless Population” says the probe revealed at least 19 people without residences died in the city during a six month period in 2021.

“The most alarming statistic we found in the data … was that the average age at the time of death was 36,” Wiwcharuk told 900 CHML’s Good Morning Hamilton.

“That’s compared to the life expectancy of the average Hamiltonian, which is 81, according to Stats Canada.”

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Data collection between June and November of 2021 from local shelters, agencies providing services as well as from St. Joseph’s Healthcare Hamilton and Hamilton Health Sciences revealed drug abuse was the number one cause of death.

Dr. Inna Berditchevskaia, co-author and internal medicine resident physician at McMaster University, says eight of the deaths were attributed to substance abuse, particularly opioids, which differs from afflictions that lead to death with the general public.

“Stats Can data for what are the biggest killers in the general population has things like heart disease … cancer, diabetes, and lung disease,” Berditchevskaia said.

“So these people are dying significantly younger and … from overdose … that’s a poisoned drug supply.”

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Wiwcharuk believes if the city were keeping track of the population, targeted interventions could have minimized the impact of street drug supplies.

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“I think … the goal is with data collection is to find out what are the biggest killers,” said Wiwcharuk

“Where are people dying? How are they dying? Who is dying and then make some interventions to change those to change what’s happening.”

Currently, the city only has a single permanent safe consumption site at St. Paul’s Presbyterian Church on James Street South.

That site is in the midst of being replaced with a location on Cannon Street East by September 2023, according to a timeline from the city.

Wiwcharuk suggests a single site is not enough to suit the needs of the city considering the opiod-related death rate in Hamilton per 100,000 has been higher than the provincial average since 2005.

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Also supporting the notion are opioid-related 911 calls, which were the highest the city had ever seen since keeping track in 2017.

Comparing numbers between June and November of 2021 with the same dates in the previous year, calls were up 83 per cent, according to city data.

August and September were up more than 120 per cent each.

“Safe consumption sites or safe injection sites are a very evidence-based way of helping save lives. No question.” Wiwcharuk said.

“For a city our size, …we certainly have way too few.”

In October, city councillors approved the next step in the AIDS Network’s pitch to bring a second Hamilton centre site.

Hamilton’s board of health unanimously supported an application to the province for a consumption and treatment services (CTS) site in the lower city.

Following the ask, the city’s director of epidemiology, wellness and communicable disease revealed that Hamilton’s Drug Strategy Program had been “on pause,” due to complications from COVID-19.

Michelle Baird characterized the uptick in opioid calls as an “unintentional consequence” of the pandemic and clarified that 79 per cent of product consumed was “purchased on the streets.”

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“So these are substances we don’t necessarily know what the components are,” Baird told councilliors.

“They are bought, sold on the street, and so there’s risks involved … just because the component make up of those products isn’t known to the user.”

A complication this month is the onset of colder weather and the Omicron variant in the COVID-19 pandemic, which is overwhelming emergency wards and the city’s shelter system.

Hamilton’s emergency operations centre (EOC) director confirmed on Monday afternoon most city shelter spaces are at or nearing capacity and that housing services is working with partners to improve capacity amid outbreaks at six locations.

Wiwcharuk says an added pressure for some may have been the removal of encampments which could spur a change in routine and present a higher risk for someone living rough.

“People have certain routines and schedules that they kind of use in, and when they’re in an environment that is familiar to them, they are less likely to overdose,” said Wiwcharuk

Berditchevskaia says the study is ongoing and mortality data will continue to updated in the future.

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An addition to the research will be a survey among shelter and social services staff who work with people experiencing homelessness.

“We have kind of a rolling agreement with the hospitals where we’re going to pull the data again in the spring,” said Berditchevskaia.

“Also have an agreement with the provincial coroner’s office, where hopefully we’ll get some more data.”

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