The number of homeless people dying in Los Angeles County has leveled off, with data showing a 1% mortality rate increase in 2023 compared to an alarming increase of 56% from 2019 to 2021, according to a new report from the county’s Department of Public Health.
The department released its sixth annual report on deaths among homeless people on Thursday, March 6, which showed a slight increase from 2022-2023 and a widening mortality gap compared to the general population.
The report also showed mortality rates higher at 3,326 deaths per 100,000 people in 2023, slightly above the 3,282 deaths per 100,000 in 2022, cited in last year’s report.
Homeless people were 4.5 times more likely to die than the L.A. County population taken as a whole. This represents an increase from 3.8 in 2022, mostly due to a drop in the overall death rate in the county, the report found. Among White people who are homeless, the mortality rate was seven times greater than White residents in the general population.
Homeless mortality rates were slowed by a leveling off of drug overdose deaths from 2022-2023.
This was attributed to the distribution of naloxone, a medication spray that reverses opioid overdoses such as from fentanyl, a deadly opioid that has become the drug of choice among addicts. Distribution of the antidote spray increased three-fold from 2021-2023.
The primary sources of fentanyl and fentanyl-related substances are Mexico and China, according to the U.S. Drug Enforcement Administration. President Donald Trump has stated he wants to stem the flow of the drug from these countries in part by using tariffs on imported goods.
Other efforts to reduce deaths from fentanyl and methamphetamine — such as overdose prevention education, and mental health and substance abuse treatment services — contributed to lowering the rate of death among the homeless in 2023.
Treatment of substance use is key to slowing and eventually reducing homeless deaths because alcohol and drug overdoses are the No. 1 cause of mortality among unhoused people, accounting for 45% of all deaths.
“Despite the continued plateau in drug-related overdoses among people experiencing homelessness, we are still facing the worst overdose crisis in history,” said Dr. Gary Tsai, director of the Bureau of Substance Abuse Prevention and Control in the county’s health department.
“Now more than ever, we must continue our efforts to provide lifesaving services to high-risk populations and foster the trust needed to continue reducing drug-related fatalities,” Tsai said.
The percentage of drug-related deaths from fentanyl not mixed with other substances decreased in 2023. “The increased access to naloxone has been incredibly important,” he said.
In a surprising find, coronary heart disease was the second leading cause of death among the homeless, accounting for 14% of deaths in 2023. Heart disease deaths increased by 22% from 2022 to 2023, the largest increase in the cohort since 2016.
Vehicles striking homeless pedestrians and cyclists was the third leading cause of death, occurring at a rate of 251 deaths per 100,000 people, a rate described as “high but stable.”
In 2023, a homeless person was killed by a moving vehicle in L.A. County every other day, the report found.
Homicides, the fourth-leading cause, dropped by 25%, something the report called “a welcome reduction.” Likewise, suicide deaths, the fifth-leading cause of homeless fatalities, remained stable. The report noted that suicide deaths were higher among the younger population and also among White and Latino people.
“While it’s encouraging to see the overdose deaths and other major causes of death start to level off, we can’t stop here, said L.A. County Supervisor Hilda Solis. “Representing communities like Skid Row and MacArthur Park, I know all too well the need to provide safe housing, mental health services, and substance use programs that can save lives.”
Supervisor Holly Mitchell said homelessness is a matter of life or death. “The plateau in mortality rates lets us know that maintaining rapid housing services, robust preventive and treatment services, and investing in poverty alleviation helps save lives and keeps people from becoming unhoused in the first place.”
The county Department of Public Health produced the report using data from the L.A. County Office of the Medical Examiner, California state death records, and the L.A. County point-in-time homeless count and demographic survey.
To reduce homeless deaths and get more people off the streets, the health department recommended better access to shelters and permanent housing, expanding overdose prevention programs for high-risk populations, and working with cities and unincorporated communities to reduce traffic deaths among the homeless.
To view the full report online, go to: http://publichealth.lacounty.gov/chie/