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Questioning 42

May 05 2010
A single statistic, often repeated by homeless organisations, deserves explanation

The average life expectancy of a rough sleeper is 42 years of age. But if you've just turned 41, don't panic.

Local authorities and homeless charities often use this figure; but this month, The Pavement wanted to see just how accurate it is. Like the official head counts or crime figures, reported statistics are not always what they seem and may be subject to a complex list of caveats or exceptions.

For anyone who is street homeless in their late 30s, or even 40s, reading a number like this could cause a wave of panic. But what neither the number nor the authorities reporting it, shows are the contributing factors. How long does an individual have to be a street sleeper before his life expectancy is reduced? Would an individual have to suffer from underlying health problems in order to see their life cut short? Which types of health problems are associated with premature death in street sleepers? Is this number based on individuals with long-term alcohol or drug addiction problems?

The number 42 comes from a Crisis report, Still Dying for a Home, which was published in 1996 and is still considered to contain the most robust data. The data was derived from Coroners Court reports, which took into account the age of those who had died and their cause of death. The age 42 was a mean value and could, therefore, have been reduced by, say, someone dying from a drug overdose aged 21. All those counted for this mean were street homeless at the time they died.

Despite this, and the fact that this number is 14 years out of date, this number keeps on popping up in local authority literature and guidelines, and is an emotive fact used in charity debates and fundraising.

In truth, there is no official government figure on how being homeless can affect life expectancy. The Office of National Statistics (ONS) provides life expectancy figures for the whole of the UK. This data is presented as a series of rolling averages, produced by aggregating the number of deaths and mid-year population estimates across each three-year period, the most recent of which is 2008. The figures do not delve into lifestyle, but are simply broken down by geographical region rather than socio-economic circumstances. The ONS data permits a reader to make casual assumptions about what can affect longevity on this planet - for example, that people tend to live longer in the South of England, where, typically, household income is higher. But to say that having more money makes you live longer is neither accurate nor true.

Similarly, the Department of Health (DoH) does not keep any data on life expectancy of those who find themselves sleeping rough; but Julia Harris, a spokeswoman for the DoH, was able to point us towards a paper from 22 March 2010 which aimed to better understand the health needs and relative healthcare costs of people who are homeless or living in certain types of short-term accommodation. This paper cited, and explained the limitations of, the 1996 Crisis figure amongst its research:

"There is abundant evidence that people who are sleeping, or have slept, rough and/or are living in hostels and night shelters, have significantly higher levels of premature mortality and mental and physical ill health than the general population. Several sources show that of deaths that occur in hostels or while registered with homelessness services, the average age at death is low, about 40-44 years." But the paper goes on the state that it is very important that these figures are not "misrepresented" as life expectancy figures. "The figures give the average age at death of a sample of homeless people who die whilst they are homeless and do not take into account those people who become settled in a home."

The DoH paper concluded a 40-year-old homeless person should not only expect to live another four years. Homeless Link, the umbrella organisation overseeing local authority and charity intervention and policy on rough sleeping also said they knew the figure was not accurate: "I understand that it is not really correct to say it is average life expectancy as there is no evidence related to those who move on from homelessness," Gill Perkins, their spokeswoman, said. However, Homeless Link and its partners recognise a fundamental need to monitor the health problems that come with sleeping rough.

As with health warnings about alcohol, salt and tobacco, it seems street sleepers should apply common sense when it comes to what unaccounted for factors may seriously damage their health. Staying warm and dry with moderate indulgences and a balanced diet should help anyone live longer - and old age, after all, is only a number.

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