2021 HOMELESS MEMORIAL
Annual memorial honors lives of those who spent time on the streets BY HANNAH HERNER On Dec. 18, homeless service providers, government officials and friends gathered at Riverfront Park to honor the 194 people in the homeless community that died this year. Some were in housing by the time they passed, and others weren’t. The number is up from 128 last year, and hovered around 100 in the years prior. Lindsey Krinks, co-founder of Open Table Nashville, which puts on the event, says “part of that is because our reporting is getting better and part of that is because things are getting worse on the streets.”
The average age of death was just 53 years old, and the oldest person to die on the streets this year was 73, still four years younger than the average life expectancy in the United States. Forty-one of them had sold papers for The Contributor at one point or another. Bobby Watts, executive director of the National Health Care for the Homeless Council, which is headquartered in Nashville, shared that ceremonies around Homeless Persons’ Memorial Day originated in Nashville in 1986, before it became a national ob-
servance in 1990. “There are 194 that we know about. The question is how many people died experiencing homelessness that we don’t know about? One thing we do know is that many of them died too early many of them died in conditions that could and should be prevented,” he said. He added, “What it takes is all of us making sure we’re caring for people one-to-one as individuals and that we make sure that our society’s systems are working for all of us. Because it’s not re-
ally working for any of us. If we have people dying on the streets, we’re not a healthy country, we are not a healthy city. If we have people who are dying prematurely because they don’t have health care, we are falling fall short of our potential and our responsibility. Nashville, we can do better. Nashville, we must do better. We must hold those accountable and help those in power, who have the purse strings, who can change laws, who change systems — we have to make them do it. That’s our responsibility.”
These 194 names were each read aloud. Each name was also written on a small white f lag, carried by the group up to Public Square Park and stuck in the ground. A jar of slips of paper with notes to the deceased was gathered, to be buried at the Hills of Calvary indigent burial site. One hundred and ninety four names, 194 little white flags, and 194 people lost, each with some time taken away due to experiencing homelessness. The hope is for housing to give some of that time back.
Q&A: Rachel Biggs
Cities across the country look to improve data around homeless mortality BY HANNAH HERNER Something that is assumed with all data around homelesness is that people are undercounted. The population is fluid and hard to track, but it’s also because cities often don’t have a system to get accurate data. This is especially true for homeless mortality. A spinoff of the National Health Care for the Homeless Council, headquartered in Nashville, Homeless Mortality Data Workgroup put together a toolkit that was released in 2020. The toolkit confirms that it’s rarely the local government, and definitely not the national government, that collects this data on how many people who’ve experienced homelessness we lose each year. This data by and large relies on homeless service providers, community advocates and religious organizations. Only two percent of counties keep a count at all, it says. In Nashville, the list is an informal amalgamation. Getting reports for each person from the medical examiner’s office to make the data more complete costs money and time, and the cause of death remains largely incomplete. Still, homeless service providers collaborate on a shared google sheet each year. Rachel Biggs, chair of the Homeless Mortality Data Workgroup, explains how this data can improve. Can you tell me about why the mortality work group got started? Homeless mortality was a topic that just kept coming up — talking about if we had better data to talk about how many people die while experiencing homelessness. We have some really good reports out of Boston and out California that have been doing homeless mortality recording for decades.
that hadn't really started doing homeless mortality counts and are wanting to get started. And so it's a great place to learn from some of the technical experts — from epidemiologists or folks that have really good relationships with their medical examiner's office or coroner's office, and then help the localities that were just getting started to figure out a way to start this work because it is a pretty big undertaking.
But what we were talking about in the [NHCHC] policy committee was that we wanted to have more local data for our own localities to talk about homeless mortality and use that data in our policy and advocacy works. Because we knew that if we were able to really bring to light the huge disparity in terms of life expectancy for someone experiencing homelessness versus someone that is housed, we could use that to advocate for the things that we know end homelessness, like affordable housing, living wage and access to health care. What’s the purpose of the group? The purpose of the group was really to bring together the expertise of localities that were doing the work to help other localities
Do we know at this point how COVID affected the homeless population? In all of this work, when we're talking about documenting homeless mortality, or documenting how many people experience homelessness, we acknowledge that it's always going to be an undercount of the issue. And so right now trying to find the data to understand the impact of COVID on experiencing homelessness has been challenging, because we do have such a different way of documenting homeless mortality across the country. One of the things that we have been speculating on, and perhaps seen in early reports is more looking at the impact of COVID on lack of ability to access services and what that means for homeless mortality. So not necessarily COVID-related deaths, but the impact of COVID and accessing essential services and what that meant for people who are more vulnerable out on the street and having early mortality due to the lack of access. Things were closed down or transportation was limited or people were fearful to go into congregate settings or into health care facilities because of concern with contracting COVID, and what that meant for impacting
December 22, 2021 - January 5, 2022 | The Contributor | NASHVILLE, TENNESSEE | PAGE 11
homeless mortality. So we're still looking at that and the impact of COVID more broadly than just COVID deaths among the homeless population. So if we know how the mortality is happening in this community, what could help something like life expectancy for this group to go up overall? Across the board, housing is the number one thing that we can do to improve life expectancy consistently. Other recommendations after housing improvements, like expanding the ratio of street medicine teams, and looking at ways to better reinforce street medicine and treatment in non-clinical settings… Doing more of that would go a long way in reaching people, connecting them most importantly to housing but other health services. I think expanding and improving substance disorder services for people experiencing homelessness is a big finding, making sure we really invest in syringe exchange services [and] naloxone distribution to prevent overdoses [are] big findings as well. Having put out that toolkit, are there other goals or big projects that you're working on with this group? Standardization is a big one. We are looking at updating the toolkit. We want this to be something that's continually updated. And hopefully we'll have another version of it released in the coming months. We're still working to come up with some really big national level policy priorities out of the national homeless mortality data workgroup, so that'll be a next step for us.
