Coronavirus and deaths of homeless people, England and Wales: deaths registered up to 26 June 2020

• Of deaths involving the coronavirus (COVID-19) in England and Wales registered up to 26 June 2020, 16 were identified as people who were homeless.

• Of these, all 16 were identified in England and none were identified in Wales.

• Most of the 16 identified deaths were of men, and the mean age at death was 58 years for males.

• London (6 out of 16) and the North West (3 out of 16) were the regions with the highest numbers of identified deaths involving COVID-19 among people who were homeless.

• These data have been developed rapidly; the official statistics of homeless deaths from all causes for 2020 will be published in late 2021.

• The definition of homelessness in these data is similar to that used in the official statistics of deaths of homeless people, although people at risk of homelessness and other vulnerable groups may also be captured because of the respective policies of the UK government and Welsh Government during the pandemic.

• No estimates have been made for unidentified homeless deaths through the capture-recapture method.

This article provides timely data on the number of identified deaths involving the coronavirus (COVID-19) of people who were homeless. These have been developed rapidly based on available data. The official statistics of homeless deaths for 2020 is currently due to be published in late 2021 because of reporting lags associated with many deaths of homeless people. These lags are usually not present for COVID-19 deaths, enabling estimates of deaths involving COVID-19 of homeless people in a more timely manner.

A summary of the most important information is given in this section, while Section 4 provides additional information.

Reporting lags and coroners

Official estimates of homeless deaths are published with a considerable lag, as many deaths of homeless people are investigated by a coroner¹ given the cause of death, resulting in a delay in the data becoming available. These lags are not present for deaths involving COVID-19, which do not need to be reported to a coroner, as provisioned in the Coronavirus Act 2020, enabling estimates of deaths involving COVID-19 of homeless people in a more timely manner. Some deaths of homeless people involving COVID-19 may still be investigated by a coroner for other reasons and therefore will only be identified later. As such, the estimates in this article are unlikely to be complete.

Deaths where a coroner's inquest is required can take several months to be registered. Definitive estimates of deaths of homeless people in 2020 will likely not be published until late 2021. When looking at deaths of those identified as homeless in 2018 registrations, 90% were investigated by a coroner.

Definition of homelessness and method of identification

The data have been compiled by searching COVID-19 death registration data for indications that the person was homeless at the point of death. These include the reported place of residence or place of death indicating homelessness such as "no fixed abode" or a known homeless shelter. During the pandemic, some homeless people were sheltered in hotels and bed and breakfasts, as part of the respective policy initiatives of the UK government and Welsh Government. For both England and Wales, the addresses of these establishments were included in the search method, in the same way as for known homeless shelters. Some accommodation types, such as private rented and student accommodation, are not included.

As in the annual publication, an upper age cut-off of 75 years was applied to avoid accidental inclusion of elderly people in some institutional settings.

Identified deaths, not estimated deaths

The method used to identify homeless deaths in these data is similar to the one as used in the official statistics on homeless deaths. However, in the official estimates of homeless deaths, an additional estimate of unidentified deaths is made using a statistical method called capture-recapture modelling. This allows for the likelihood of more deaths of homeless people being present in the data but not identified.

In this article, we have not made any allowance for unidentified deaths of homeless people involving COVID-19. As such, the figures are similar to the "identified deaths" figures in the official statistics, not the "estimated deaths". Both these measures are already published for previous years.

The definition of a death involving COVID-19 is consistent with our official statistics on COVID-19 deaths, published weekly. That is, COVID-19 was mentioned on the death certificate, either as an underlying cause or a contributory factor.

Notes: Things you need to know about this release

1. Coroners are government officials, usually lawyers, who can investigate deaths, including if the cause of death is unknown or to establish the identity of the person.

Of deaths involving the coronavirus (COVID-19) in England and Wales registered up to 26 June 2020, 16 were identified as of people who were homeless. These 16 are a subset of the official number of deaths involving COVID-19 in England and Wales registered up to 26 June 2020, as reported weekly in our official statistics release. The Stay at home guidance, and additional support policies for rough sleepers during the pandemic, were introduced roughly three months before 26 June or one calendar quarter of the year; we accordingly made comparisons with a calendar quarter figure from previous years.

In 2018, there were 541 deaths of homeless people identified in England and Wales (see Section 2 for an explanation of identified deaths). There is no evidence of seasonality in homeless deaths, so a reasonable estimate of identified homeless deaths from all-causes in a calendar quarter of 2018 would be around 135. Official estimates of homeless deaths from all causes in 2019 will be published in late 2020, and deaths in 2020 will be published in late 2021.

The 16 identified deaths involving COVID-19 of people who were homeless are similar in scale to the quarterly averages over the five-year period from 2014 to 2018 of identified deaths while homeless from alcohol-specific causes or suicide, which are 13 and 16 respectively (Figure 1). However, the figure of 16 deaths involving COVID-19 identified in these data may be an underestimate of the true number (see Section 2).

Analysis by age and sex

Most of the identified deaths were of males. The sex ratio broadly compares to the latest deaths while homeless analysis where most of the deaths in 2018 were among men (641 estimated deaths; 88% of the total). Details of the deaths among females are not given in this article because of the low numbers, which could identify individuals.

For deaths in England and Wales involving COVID-19 in the general population, as at the weekly deaths publication on 7 July 2020 (with deaths registered up to the week ending 26 June 2020), the mean age at death was 79 years for men and 82 years for women. The average age at death of homeless males, for deaths involving COVID-19, was 58 years - considerably lower than the average age at death involving COVID-19 of the general population.

The latest figures on deaths of homeless people reported the mean age at death was 45 years for males and 43 years for females in 2018. Average age at death involving COVID-19 among the homeless population was higher than the 2018 average age at death of people who were homeless. This is a similar pattern to wider society, as mortality from COVID-19 is higher among older people.

Figure 2: The average age at death involving COVID-19 was higher than the 2018 average for those who were homeless and for the general population

Mean age at death, deaths involving the coronavirus (COVID-19) and all causes, general population and homeless people, by sex, England and Wales, 2018

Source: Office for National Statistics – Coronavirus and deaths of homeless people

Notes

1. Figures are for deaths registered, rather than deaths occurring.
2. Figures may include deaths of non-UK residents.
3. The mean age of deaths involving the coronavirus (COVID-19) while homeless of females has been suppressed because of the low number of occurrences found in our data.

Download the data

Analysis by region

London (6 out of 16) and the North West (3 out of 16) were the regions of England with the highest numbers of identified deaths involving COVID-19 among people who were homeless. This is consistent with the annual publication of Deaths of homeless people in England and Wales in that London and the North West have the highest numbers of identified deaths from all causes of people who were homeless in 2018, with 110 (20% of the total) and 77 (14% of the total) identified deaths respectively. There were no identified deaths involving COVID-19 of people who were homeless in Wales - Wales also had the fewest identified deaths of homeless people from all causes in 2018.

Section 2 provides important information on the interpretation of the data in this release. This section provides additional information and should be considered alongside Section 2.

Definition of homelessness in this article

The definition of people who were homeless that is used for this publication is a statistical definition. This is similar to the definition used in the Office for National Statistics (ONS) Deaths of homeless people in England and Wales official statistics publication, which mainly includes people sleeping rough or using emergency accommodation such as homeless shelters and direct access hostels, at or around the time of death.

In this article, in line with government support policies for rough sleepers during the pandemic in England and Wales, the definition of homelessness used is slightly broader than in the ONS Deaths of homeless people official statistics as it includes a wider set of people housed in emergency accommodation because of the pandemic.

Definitions of homelessness exist for different purposes, and there are variations of this across the UK. Therefore, comparisons of these figures will not be possible with other regular homeless publications.

Policy context

In England, the UK government had an 'Everyone in' policy. The basic principles are to:

• focus on people who are, or are at risk of, sleeping rough and those who are in accommodation where it is difficult to self-isolate, such as shelters and assessment centres

• make sure that these people have access to the facilities that enable them to adhere to public health guidance on hygiene or isolation, ideally single-room facilities

• utilise alternative powers and funding to assist those with no recourse to public funds who require shelter and other forms of support because of the coronavirus (COVID-19) pandemic

• mitigate their own risk of infection, and transmission to others, by ensuring they are able to self-isolate as appropriate in line with public health guidance

In Wales, the Welsh Government's policy, supported by both statutory and non-statutory guidance and additional funding, was that everyone who was, or was at risk of, sleeping rough or who was in inappropriate temporary accommodation be provided with emergency shelter and support. This explicitly included those who have no recourse to public funds. This included the use of hotels, bed and breakfasts, university accommodation, and other holiday accommodation.

Identification of homelessness in death records

The number of deaths in this article is based on individual death registration records for England and Wales where the deceased was stated to be homeless or the place of residence or place of death indicated that to be case - no capture-recapture estimation methodology as in the ONS's annual figures on deaths of homeless people was used.

The deaths are for England and Wales. The registered address and place of death on the death records were searched using particular words to identify homelessness. For instance, the use of "no fixed abode", the registered address or place of death being known homeless hostels or shelters, or known other emergency accommodation (including bed and breakfasts and hotels) used by local authorities as part of the respective policies of the UK government and Welsh Government.

In England, addresses of accommodation used by local authorities were obtained from the 10 combined authorities and the Greater London Authority, where homeless populations are known to be largest. Some combined authorities responded with a single list of addresses, while in some instances each local authority within the combined authority was contacted individually. We asked for a list of all the homeless shelters, direct access hostels, bed and breakfasts, and hotels used for the homeless and rough sleepers since the start of the pandemic in each local authority or area.

Given the benefit of publishing this article as quickly as reasonably possible, not all local authorities in England were able to respond within the requested timescale for information on addresses of temporary accommodation of individuals, which could then be linked to addresses on death certificates. Therefore, some deaths of people who were homeless involving COVID-19 may not be identified.

In Wales, the Welsh Government provided a centralised list of the holiday accommodation that have been used to house those who were, or were at risk of, sleeping rough and those who are in inadequate temporary accommodation (including sofa surfers). This includes hotels, bed and breakfasts, and other types of holiday accommodation.

While most addresses have been provided by the combined authorities in England and by the Welsh Government for Wales, not every address used to house people who were homeless will have been identified. This is because there are other forms of accommodation that have been used to house people who were homeless, such as private rented accommodation, for which we did not acquire a list of addresses. Therefore, it is unlikely that every death will be identified. In England, some hotels used to house homeless people during the pandemic were not used exclusively for this purpose. In Wales, some accommodation was shared with key workers; however, no deaths involving COVID-19 were identified in these accommodations.

This list of addresses of additional emergency accommodation for rough sleepers during the pandemic was combined with the already established list of homeless shelters used for the annual deaths while homeless publication to form the basis of the accommodation search.

We collated a search of all deaths registered with a mention of COVID-19. That is, where COVID-19 or suspected COVID-19 was mentioned anywhere on the death certificate, including in combination with other health conditions. If a death certificate mentions COVID-19, it will not always be the main cause of death but may be a contributory factor.

Comparability of the data

During times of rapid change, there is an increased need for timely and detailed data. This publication provides a timely but not comprehensive figure of deaths involving COVID-19 of individuals who were provided with emergency accommodation or had no fixed abode, including those who were homeless. The article uses figures from the ONS yearly publication of Deaths of homeless people in England and Wales to add context to the figures presented here; it does not directly compare them. The figures displayed within this article should not be directly compared to regular homelessness statistics produced in England or in Wales and the UK or any subsequent homelessness COVID-19 deaths publications.

The data presented in this article are of lower quality than the annual publication of official statistics, and they should be treated with caution. Other regular homelessness publications are based on administrative data sources such as the Homelessness Case Level Information Collection (H-CLIC) in England or rough sleeping statistics, which use a "snapshot" approach on a single night. Therefore, comparisons of these figures will not be possible with other regular homeless publications that employ different methods.

Regular homelessness statistics for England and for Wales come from a variety of different sources:

• Ministry of Housing, Communities and Local Government's (MHCLG's) rough sleeping in England statistics

• MHCLG's statutory homelessness statistics (H-CLIC)

• Welsh Government's homelessness statistics

• Welsh Government's Rough Sleeper Count

• ONS' Deaths of homeless people in England and Wales

These five publications have methodological differences. Therefore, comparisons between these publications and the figures displayed within this article should not be made.

Statutory homelessness and rough sleeping are the two main concepts of homelessness that are collected in each country and are published as official statistics. However, because of devolution, legislation and administrative data collection systems are different in each country. Any comparisons made between regular homelessness publications in each UK country should be treated with caution.

The MHCLG and London councils have published management information about the number of people sleeping rough or at risk of sleeping rough¹ who have been provided with emergency accommodation, as part of the UK government's 'Everyone in' policy during the coronavirus pandemic. These data provide the latest snapshot for May 2020.

The Welsh Government also published management information. These data covered the period from 13 April to 28 June 2020.

For more information about comparisons that can and cannot be made between regular homelessness statistics across the UK, please visit the Government Statistical Service (GSS) Harmonisation team's homelessness interactive tool.

Notes: Measuring the data

1. This includes people coming in directly from the streets, people previously housed in shared night shelters and people who had become vulnerable to rough sleeping during the pandemic. The information provided is management information, not official statistics, and local authorities continue to hold the most recent information.