Wait....isn't all death by definition "bad"?
What is a Good Death?
That depends. Death can be tragic, distressing, world-ending. But a death that is peaceful and painless - that takes into account the wishes of the patient and their caregivers and affords the dying person dignity, opportunities to exercise choice, and the chance to express themselves as they need and want, could be perceived as "good."
A "good" death means something different to different people. For some, a good death is a journey - a true Odyssey - rather than a single moment. Others say a good death offers opportunities for reconcilitation, pursue unresolved dreams, and spend time with family, friends, and those who are significant to them. Another person might decide that a good death means dying at home, with family close to him/her. Death is no less individual than life.
The journey towards death is as much about getting to know yourself as any other part of life. Learning to recognise your needs – be they medical, emotional or spiritual – is something that may become more acute when you are closer to death. Some say that being able to identify these needs is a central part of what it means to die well.
What do you say?
Equal in death?
In an ideal world, yes - all people would have access to a Good Death. In reality though, it depends who you are asking. The truth is that race, gender, nationality, sexuality, immigration status, disability, religion, and socioeconomic status can dramatically affect our - and our loved ones' - experience of how we die. The stories we tell ourselves about death come from the experiences we have had in our lives and these stories in turn affect our expectations and fears around dying. The resources that are available to us in terms of access to and cultural competence of providers, consumer education, choices around funerals and the ways we prepare for death, mourn, and inter and memorialize our dead are also deeply shaped by our demographic labels.
Homelessness and Death
Those who are unhoused in the US are particularly penalized - lacking a permanent address and often harmed by discriminative interactions with health providers, many are forced to neglect routine medical care, miss opportunities for early treatment of serious disease, and face higher risk of violent, solitary or unmedicated death. Often, next of kin are unrecorded, details of the person's life (beyond that they were homeless) unknown, services provided by strangers, and opportunities to memorialize the deceased minimal.
Mortality rate
According to aei.org, the mortality rate for people experiencing homelessness (PEH) in the US increased by about one-third during the COVID-19 pandemic. In 2022, 16% of people who were homeless in 2010 had died, compared to 6% of the housed poor and 4% of the overall housed population.
Official count
The US government doesn't officially count the number of people who die while experiencing homelessness, and their housing status is rarely recorded. However, in 2018, 68 cities and counties recorded at least 5,807 deaths of people experiencing homelessness.
Sudden death
A study from UC San Francisco found that people experiencing homelessness are 16 times more likely to die suddenly from heart attacks and other causes than the general population.
Average age of death
The average age of death for people experiencing homelessness is around 50 years old, which is similar to the age at which Americans died in 1900. In contrast, non-homeless Americans can expect to live to age 78.