The city can tell you exactly how many people quit smoking last year. It can estimate how many New Yorkers had sex with more than three people. And, thanks to a controversial initiative begun last year, it’s hoping to soon have a count of people living on the streets. Councilmember Christine Quinn says if all that’s possible, we ought to also be able to track how many homeless people die. And she’s introduced a bill that would force the city’s health department to do just that.
Quinn’s bill would require health officials to submit monthly reports to the City Council with data on the number of deaths of homeless people, the locations where they died, their age and gender, and what killed them–including indications of cold or heat exposure.
To Quinn’s thinking, all the city has to do is take note of each person whose death certificate has no address. To officials involved in the process, that suggestion is utterly naïve. “It’s always been a question: How many homeless people die?” sighs medical examiner’s office spokesperson Ellen Borakove. “And it’s a question we can’t answer with any precision.”
Currently, when a body is found on the streets, it goes to Borakove’s office, where doctors conduct an autopsy and missing-persons detectives try to identify it. If the body remains unclaimed and unidentified after two weeks, Rikers Island inmates bury the person at Hart’s Island, near the Bronx. In such instances, there would be no address listed on the death certificate. Under Quinn’s system, that death would be logged as homeless–along with the death of any person actually confirmed as homeless.
But the health department says there are all sorts of other circumstances where a death certificate address is left blank, like the common scenario in which a certificate is simply filed too hastily.
“Homelessness can be difficult to define and measure,” epidemiology director Kelly Henning said during a February 12 hearing. “The death certificate, which is completed by physicians and funeral directors, is not suited for the level of precision described in this bill.” Henning suggested the department may be able to devise a system for monitoring annual deaths, rather than the monthly reports Quinn wants, but offered no details.
Quinn’s legislative director, Jeremy Hoffman, says the bill’s backers are willing to consider alternatives, as long as the health department comes up with them. Hoffman’s wary of what he considers a common Bloomberg administration ploy: Shoot down a council proposal on technical grounds, but fail to offer workable solutions. “If they don’t like this mechanism, they should propose another,” says Hoffman. “If we’re going to count the live homeless, you should count the ones who have died, too.”