Persistently High Unhoused Deaths in Toronto Since Pandemic, Attributed to Ongoing Drug Toxicity Crisis

 

Persistently High Unhoused Deaths in Toronto Since Pandemic, Attributed to Ongoing Drug Toxicity Crisis

The homeless crisis in Toronto has persisted with alarming death rates even beyond the COVID-19 pandemic. Recent data released by Toronto Public Health (TPH) on September 28, 2023, reveals that 79 unhoused individuals lost their lives in the city during the first half of 2023, averaging three deaths each week. These unfortunate individuals, both sheltered and unsheltered, had a median age of 52 for males and 48 for females.

Comparatively, in the corresponding period of 2022, the city recorded 92 deaths among the homeless population. Over the entirety of 2022, 191 individuals experiencing homelessness succumbed in Toronto, with median ages of 55 for males and 42 for females. To provide further context, in 2019, the year before the pandemic struck, the city reported a total of 128 homeless deaths. The accuracy of this data is confirmed in collaboration with the Office of the Chief Coroner of Ontario.

One concerning trend that persists is the cause of death among Toronto's unhoused population. Drug toxicity remains the primary cause of death among them. Data updated biannually on the City of Toronto's interactive dashboard reveals that 46 percent of the reported homeless deaths from January to June 2023 were linked to drug-related issues. Since the commencement of data collection in 2017, 48 percent of the city's 961 homeless deaths have been attributed to drug toxicity.

The city attributes a significant portion of these drug toxicity deaths to the perilous, unregulated drug supply. The use of highly potent opioids mixed with unexpected substances significantly heightens the risk of overdoses in Toronto. This crisis underscores the negative health ramifications of this ongoing drug toxicity issue.

Dr. Eileen de Villa, Toronto's Medical Officer of Health, has noted significant increases in homeless fatalities within the city during the pandemic. She stated, "In 2020, 2021, and 2022, we recorded 145 deaths, 223 deaths, and 191 deaths, respectively." In the face of an unregulated and increasingly toxic drug supply, Toronto Public Health, in partnership with the city, government, and community organizations, faces the challenge of securing funding for harm reduction services, affordable housing initiatives, and tackling the adverse health consequences of homelessness.

Efforts to address the homelessness and drug toxicity crisis are underway. The City of Toronto is collaborating with community partners to enhance access to harm reduction programs, affordable housing, and other essential services. These efforts include implementing an overdose action plan, fortifying the response to drug toxicity within the shelter system, supporting safer supply initiatives, and devising a comprehensive city-wide strategy to address mental health and substance use issues.

In addition to these initiatives, a partnership has formed between TPH, Unity Health Toronto, and University Health Network to expand public health's harm reduction program. The city is also working with Inner City Health Associates and Loft Community Services to integrate physical and mental health services. Collaboration with Ontario Health Toronto Region and other organizations aims to establish consistent health services across all shelters while mapping harm reduction, mental health, and primary care resources to identify needs and gaps.

Another integral aspect of these ongoing efforts is the HousingTO 2020-2030 Action Plan, which seeks to create 47,500 new affordable rental homes by 2030. While the city is committed to improving the health outcomes of homeless individuals, it emphasizes the need for provincial and federal government support to address the scale of deeply affordable housing requirements and access to mental health and harm reduction resources.

Chronic homelessness remains a pressing public health concern in Toronto, with thousands experiencing homelessness on any given night. Better data helps identify the issue's magnitude and supports evidence-based efforts to enhance the well-being of those without homes, emphasizing the pivotal role of housing as a determinant of health that influences outcomes throughout one's life.