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Los Angeles County health officials have reported a modest increase in homeless deaths for the second year in a row.
However, the mortality rate for homeless people is persistently high, with an average of 6.9 deaths per day in 2023, covered by the latest report. Overall, homeless people died in four and a half hours of the entire population.
During that year, 2,508 people died on the streets and in shelters, an increase of 5.6% from the previous year. Due to an increase in homeless counts over that period, the mortality rate (calculated as 3,326 deaths per 100,000) increased at 1.3%. This is improved from the 2.1% increase in 2022.
Mortality from drug and alcohol overdose decreased slightly, but remained the leading cause of all deaths accounting for 45%. Of these, 70% were involved in the synthetic opioid fentanyl. Coronary artery disease is the second leading cause, accounting for 14% of deaths. This increased by 22%. Transportation accidents remained stable in third place overall, but are the second major cause for women. On average, one homeless person died in a vehicle accident every other day. Murders fell 25% in fourth place.
Men were more likely to die from all causes than women, accounting for 68% of the population, but 82% of deaths. Sixty-two percent of deaths were among those under the age of 55, a phenomenon caused by a high overdose rate in the younger group. The mortality rate was 19% of the population, but was the highest among white people, accounting for 32% of all deaths. Blacks and Latinos each had fewer deaths than their population.
During a news briefing on Thursday, Dr. Gary Tsai, County Director of the Department of Drug Abuse Prevention and Control, said additional contributions to leveling could raise awareness of the risk of fentanyl and even the decline in the number of fentanyl users due to death.
However, he noted that there were no sharp changes that could indicate that they were important factors.
“Newly homeless people know that they can increase the risk of overdose,” Tsai said.
The 6th report on homeless mortality by the Los Angeles County Department of Public Health described current trends as plateaus. This is thought to be due to a triple increase in distribution of Naxalon, an overdose reversal drug from 2021 to 2023, and some improvements in other mental health and substance use treatment services. He said that around 479,000 Naxalons were distributed in 2024.
The report contains 17 recommendations that fall into four categories. Fast access to homes and shelters. Expansion of overdose prevention. Physical, mental health, substance use treatment; collaboration with local governments and non-embedded communities to reduce traffic deaths.
The calculation of homeless mortality is inherently unstable. This relies on an annual fluctuation in the homeless population with built-in errors and incomplete measures to identify the deaths of homeless people.
Deaths are drawn primarily from the records of accidental and violent incidents of Los Angeles County Medical Examiners. Other deaths are obtained from searching the state database of death certificates.
The year-over-year increase in 2023 may have been bulged due to improved state data, thanks to the addition of a homeless checkbox. State data contributed 12% of identified deaths, more than last year.
This year’s report also includes footnotes that the first 2022 findings of overdose rate leveling had to be revised upwards as the toxicology test backlog later determined at publication was drug-related. A smaller backlog could change the results for 2023, but not so much.
The number of homeless people is averaged over two years to estimate the medium-term number. This year’s report used the three-year average as the 2021 count was cancelled during the Covid-19 pandemic.
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