Coronavirus death rate among homeless New Yorkers is 61% higher than general population: Report
As of June 1, the overall New York City mortality rate due to Covid-19 was 200 deaths per 100,000 people. For sheltered homeless New Yorkers, it was 321 deaths per 100,000 people
Homelessness poses multiple challenges that can worsen and intensify the spread of Covid-19, and a new report now shows the disproportionate impact of the pandemic on homeless New Yorkers.
Researchers found that compared with a citywide average of 200 deaths per 100,000 people as of June 1, the mortality rate for sheltered homeless people in New York City (NYC) was 321 deaths per 100,000 people. This is 61% higher than that of city residents in general, say researchers from the advocacy group Coalition for the Homeless. “This means that many more homeless people have died from Covid-19 than would have been expected if they were dying at the same rate as all NYC residents. The reported New York State mortality rate as of May 29 was 152 deaths per 100,000 people,” says the report which calculated the age-adjusted mortality rates among sheltered homeless New Yorkers.
The analysis says that as of May 31, the Department of Homeless Services (DHS) reported 926 confirmed positive Covid-19 cases in approximately 179 shelter locations. As of that date, DHS had reported 86 deaths of homeless people due to Covid-19. “In April alone, 58 homeless people died of Covid-19, the vast majority (54) among homeless people living in shelters. In comparison, during 2019, an average of 34 homeless people died each month, including 21 in shelters. Thus, the number of Covid-19-related deaths among homeless New Yorkers in shelters in April 2020 was 157% higher than the number of deaths from all causes during an average month in 2019,” say researchers. They, however, emphasize that this is a “preliminary impression” of the impact of the virus for those living in shelters based on confirmed cases alone. “Government responses at every level have been far too slow to contain the spread of the new coronavirus, leading to chaos for those sleeping in shelters, on the streets, and the subways,” says the research team.
According to experts, homeless shelters are often crowded, making social distancing difficult. The issue is also highlighted in the report. It says that the type of shelter setting and prevalence of risk factors among homeless people affect their exposure and vulnerability to Covid-19, with outcomes even worse for people staying in dormitory-like congregate shelters.
The analysis shows that the age-adjusted mortality rate for those staying in shelters varies by sub-population and is highest among those living in congregate shelters (most single adults) and those with higher rates of disability and risk factors (adult families and single adults). The team explains that for homeless New Yorkers in congregate shelters, the ability to adequately socially distance is impossible: 19,000 single adults are currently sheltered in approximately 150 locations across the city. The vast majority of these locations provide shared dormitories, bathrooms and dining areas, they added. But regardless of household composition or shelter setting, the report finds that the age-adjusted mortality rate for all homeless New Yorkers exceeds that of the New York City population in general, say researchers. The rate for families with children is 11% higher, for adult families without minor children it is 47% higher, and for single adults, the rate is 53% higher based on the calculations using the Department of Homeless Services data for May 17.
Many persons experiencing homelessness are older or have underlying medical conditions, which places them at higher risk for severe Covid-19-associated illness. “In a survey conducted by the Department of Homeless Services in 2017, the agency estimated that 67% of all single adults sleeping in the shelter system have some type of disability that may require a reasonable accommodation to ensure they have meaningful access to shelters and shelter-related services. Significantly, 27% reported a condition requiring air conditioning and 34% reported a condition requiring specific appliances or medical equipment. These underlying health conditions and disabilities likely place homeless New Yorkers at particular risk for complications should they contract Covid-19,” says the report.
The study also says that black and Hispanic/Latinx New Yorkers are disproportionately affected by homelessness, and these communities are also disproportionately affected by Covid-19. Approximately 57% of heads of household sleeping in shelters are black, 32% are Hispanic/Latinx, 7% are White, less than 1% are Asian-American or Native American, and 3% are of unknown race/ethnicity. “The age-adjusted Covid-19 mortality rate per 100,000 population calculated by the NYC Department of Health and Mental Hygiene as of June 1 for total deaths (confirmed and probable Covid-19 deaths) was 218.11 among Black New Yorkers, 230.02 for Hispanics/ Latinx, 108.79 for Whites, and 102.51 for Asians. All of these rates are exceeded by the June 1 age-adjusted mortality rate for homeless people sleeping in NYC shelters,” says the report.
The research team warns that coronavirus infections, hospitalizations and deaths among unsheltered homeless New Yorkers may take several months to measure due to delays and incomplete reporting, as well as the hesitance of many unsheltered New Yorkers to visit drop-in centers, shelters, and emergency rooms amid the Covid-19 pandemic.
“The mortality rate for those living in shelters may well be even higher because it was calculated without the inclusion of probable deaths due to the lack of complete public reporting, although there is ample anecdotal and documentary evidence of probable excess mortality among those staying in shelters and those who are unsheltered, just as there is for the general population,” says the team. They add, “However, the excess mortality rate for unsheltered homeless individuals will likely be found to be high as well because they suffer high rates of serious underlying health conditions, are less likely to have been tested for Covid-19, and may face a similar, if not greater, Covid-19 mortality risk compared with sheltered adults.”
The group has called on the city and state to provide single-occupancy hotel rooms for all homeless individuals living in congregate shelters and those living on the streets or sleeping in the subway system to facilitate appropriate social distancing, besides ensuring that homeless people have access to free coronavirus testing and basic hygiene supplies.