Data Insight: Causes of death among people experiencing homelessness in Wales

This ADR Wales Data Insight presents findings from research into the underlying causes of death among people experiencing homelessness in Wales.

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Currently, the main source of information on this topic in Wales comes from annual estimates produced by the Office for National Statistics. The purpose of the analysis in this Data Insight was to explore the potential of linking administrative data to provide a supplementary source of information on deaths among people experiencing homelessness. It uses data acquired by ADR Wales on people who have sought assistance from a local authority homeless service. 

Causes of death identified among people approaching homeless services are compared to similar studies in Wales using administrative data. The nature and extent of underlying causes of death were found to differ between studies, particularly deaths due to accidents and suicide. 

Findings illustrate how researchers define homelessness, as well as how the settings in which administrative data is collected can influence evidence generated about this group of people.

What we found

• Combined, accidents, cancers, and heart disease accounted for 59% of deaths among people approaching statutory homeless services, compared to 55% in ONS estimates and 39% in other studies
• Though accidents were the most frequently reported cause of death across all studies, the levels of reporting varied
• Deaths due to suicide showed the most significant variation between studies
• Illness-related deaths, rather than external causes, were generally more prevalent in data from statutory homeless services and other studies compared to ONS estimates.

Why it matters

To ensure efforts to prevent and end homelessness are having an impact, policymakers and practitioners need to have a baseline understanding of homelessness, including the issues people face. Findings presented in this Data Insight illustrate that how we define homelessness and go about enumerating causes of death—particularly where we look for people experiencing homelessness—impact our understanding of the health challenges facing this diverse group of people. 

However, adopting very broad definitions of homelessness potentially hide important variations in the causes of death among sub-groups of people - for instance, those with histories of rough sleeping. Rather than advocating for a single approach to measuring causes of death among people experiencing homelessness in Wales, adopting multiple approaches, each of which provide insight into the different groups that make up this diverse and dynamic population, should be adopted. 

This Data Insight provides a case study of how linking to statutory homelessness data could be used to generate insights into the health of people experiencing homelessness in Wales, including their deaths. Findings are also of direct relevance to linking statutory homelessness data in England to wider government and health agency data, which is being considered by the Ministry of Housing, Communities and Local Government.

The scope of our analysis has been limited by the availability of data from a single local authority area acquired by ADR Wales in 2018. In July 2024, Welsh ministers agreed a new strategic direction for homelessness data collection in Wales, toward an individual-level approach. When this new national data collection is implemented, and more importantly deposited in the SAIL Databank for use by the wider research community, it will facilitate national monitoring of deaths among people who have approached statutory homelessness services in Wales.