Deaths of homeless people in Orange County increased by 50 percent between 2020 and 2023, with fentanyl said to have played a key role, according to a county report released Monday, March 17.
The third annual report filed by the Homeless Death Review Committee found that deaths increased incrementally over the last decade and rose to “unprecedented heights” between 2021 and 2023. A 56% hike also occurred in the first year of the pandemic between 2019 to 2020.
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Formed in 2022 by Orange County Sheriff Don Barnes, the committee includes technical experts from private and public sectors led by the Orange County Coroner’s Office to identify trends in homeless deaths and their causes and prevent future deaths through policy recommendations and service changes. The latest report focused on data and trends related to homeless deaths in 2023, which reached 508 from a total of 338 in 2020.
“The whole point was not to point fingers at anybody,” Barnes said. “If we’re missing something in the system of care that’s being offered to the population, we need to identify the gaps. You can’t solve something if you’re not willing to be critical about it.”
Accidental deaths accounted for 60% of lives lost, with drug overdoses contributing to more than half.
Fentanyl-related overdoses, in particular, made up 220 of the 307 unintentional deaths, a significant hike compared to 12 deaths only five years prior. To combat these trends, the county’s Health Care Agency, Mental Health & Recovery Services has distributed overdose prevention kits and medications for reversing opioid overdoses, such as Narcan and Kloxxado, to the homeless community since 2022.
Barnes said the county’s main approach to preventing future deaths has been by addressing the problem of fentanyl overdoses and distributing medications such as Narcan. People who serve time at the Orange County jail also have access to “great programs” for people interested in quitting drugs or alcohol, he said.
According to the report, the increase in fentanyl-related deaths is consistent with trends seen in the broader Orange County population and nationwide. It also notes that drugs play a role in natural death trends, which have skyrocketed by 231% in the last decade. Methamphetamine use, for example, has been linked to long-term health impacts including a 32% increased risk for cardiovascular disease.
Another 32 people died from pedestrian accidents involving motor vehicles, which were the second most common cause of unintentional deaths. A large portion of these pedestrian deaths occurred in North Orange County; where Garden Grove had seven fatalities, the highest in the county, followed by six in Santa Ana and four in Anaheim. Visibility issues may be a factor, as roughly 90% of accidents happened outside a marked crosswalk and more than half took place between 8 p.m. and 6 a.m.
Roughly 87% of the pedestrians hit by a car were under the influence of drugs and/or alcohol, according to the report.
Homicide and suicide deaths, though much smaller in number, have also increased over the last decade. Compared to 2013, suicide deaths increased from 10 to 22 while homicides went from 4 to 7 deaths in 2023.
Thomas Fielder, a housing advocate and member of the Orange County People’s Homeless Task Force said the report does not address a critical issue around homelessness — which is access to affordable housing. The main causes of homelessness are linked to job loss, financial loss, and evictions, not drug abuse, he said.
“The main thing that’s changed is people on the street are being constantly harassed and arrested, they have no place to go. Police have been given leeway to jail them, arrest them, and tell them ‘you have to leave’. It’s forcing people to lose their contacts,” Fielder said
A chronic problem with homelessness is losing access to resources and service providers, he added. That, combined with intense shifts in weather from climate change, including heat waves and atmospheric rivers that sweep through areas, are likely contributing to higher reports of natural deaths.
He also argued that the death count referenced in the report reflects a “chronic undercount,” and many people who are homeless may not be included due to criteria labels.