Members of the homeless population who spend their nights outdoors have a much higher mortality rate than those who sleep in shelters, but the reasons aren’t what you might think, according to a new study.

“It’s a hard life being homeless in the first place,” said Old Brewery Mission CEO Matthew Pearce. “It’s doubly or triply hard to be homeless and not benefit from the services that a community might offer.”

 The study, which was conducted by researchers at Harvard University, followed nearly 450 “rough sleepers” –homeless people who live outside – over 10 years.

The survey found the mortality rate was three times higher than those who regularly stayed in shelters, with an average age of death of 53.

The researchers concluded that only one in 134 deaths could be attributed to the cold, with chronic illnesses such as cancer and heart disease being the biggest killer.

The study’s findings didn’t come as a surprise to Eric Latimer,  a researcher at the Douglas Hospital who works with Montreal’s homeless population.

“People within the shelters are in touch with personnel who talk to them and can help them access services,” he said. “To reduce cancer mortality, cancer needs to be detected fairly early and receive treatment for it. These people will typically not seek primary care in a timely way.”

Pearce said some homeless avoid shelters because they can’t get through the night without drugs or alcohol. He advocated for the creation of a wet shelter, where homeless people could drink.

A plan for a wet shelter has been met by approval by the City of Montreal and the provincial government is studying the benefits.

“The wet shelter is a service for those people and has proven its worth in other locations across Canada and North America,” said Pearce. “I think it should the light of day in Montreal.”

Pearce also said more can be done to reach rough sleepers.

“It’s incumbent upon the service providers to organize services in such a way that we don’t leave these people languishing,” he said.