Friday, May 11, 2012

When Homeless People Die

In the homelessness industry it is pretty well known that homeless people do not live as long as non-homeless people, and studies have confirmed as much.   And, occasionally in my writing, and in talks I've given on homelessness, I have echoed that fact  

One day, though, someone challenged me this.  It was a simple yet compelling argument, but I let it go without further investigation.   I mean, why should I investigate facts?  I am the leading authority on all things homeless, right?

Anyway, I've been reading some articles on the subject, and I'm beginning to change my view on this.   Lets take a look at this article from last year that ran in the Guardian. http://www.guardian.co.uk/  (Although this article concerns homelessness in the UK, I suspect the differences between homelessness there and in the US are minimal.) At the very beginning of the article it states very clearly the life expectancy of homeless people, and what exactly contributes to that - being alcohol and drug abuse.   Pretty simple.   Taking too many drugs, or drinking excessively over an extended period will kill people.  The article quotes findings in a recent study which you can download at http://www.crisis.org.uk/data/files/publications/Homelessness%20-%20a%20silent%20killer.pdf 

But look at what happens in the article.   Though the first couple paragraphs discuss the effects of alcohol and drug abuse, and the complications that arise from them, as being the cause of death among homeless people, the commentary that follows moves the discussion away from alcohol and drugs and onto the difficulties and stresses of living homeless.

The question becomes clear:  Is the low average life expectancy of a homeless person (between 45 and 50 years of age) due to alcoholism and drug abuse, or is it due to the harsh environment of homelessness?

Compare that article to this one in the NY Times which states that alcoholism can reduce a person's life expectancy by 10 to 12 years.  No mention of homelessness is involved, although certain aspects of alcoholism is confirmed in both articles, such as a higher rate of accidents and suicides.   The Guardian article attributes accidents and suicides to the stresses of homelessness, where as the NY Times article says that it's the alcohol to blame.  

The Guardian article says that homeless people die 30 years younger than non-homeless people, and the NYTimes article says that alcoholics die 10-12 years younger than non-alcoholics.  The difference between the two could be attributed to  homeless alcoholics drink a great deal more than non-homeless alcoholics.   I don't have facts to back that idea, but it seems pretty obvious that homeless alcoholics have less constraints on their drinking.  Their primary focus is on drinking, where as alcoholics with homes still have to maintain a certain level of functionality so to maintain their standard of living.

I think the biggest difficulty in answering this question outright, is that people become homeless at all different ages, and become alcoholics and drug addicts at different ages as well.    I have known a great many people who have died while on the streets, and I know there are a great many elderly homeless people.   And I cannot think of one elderly homeless person who is also an alcoholic or drug addict.

There is no doubt that living homeless is very stressful, but as they say, those things that don't kill you only make you stronger.   Alcohol and drugs are known killers, but homelessness?  I'm starting to doubt it.

Certainly more studies need to be done to determine the real effects of homelessness on individuals, studies that differentiate between different types of homeless people.  Is it really homelessness that kills, or is it just the alcohol and drugs?


1 comment:

  1. I would guess that medical care would also have a huge impact on life expectancy. Being able to go to the doctor when you are sick and obtain medication are probably not a high priority compared to affording food and shelter.

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