The homeless mortality rate in Los Angeles County plateaued in 2022, an increase of 2% compared to 2021, according to a new report released Thursday.
On Thursday, the county's Department of Public Health released its findings from its fifth annual report on mortality among people experiencing homelessness. The overall mortality rate increased by 2% from 3,215 per 100,000 people to 3,282 per 100,00 people.
According to DPH officials, this is a "welcoming plateauing" of the mortality rate among homeless individuals, which previously saw an increase of 56% from 2019 to 2021.
"There are staggering inequities in health outcomes between those who are housed and those who are homeless," Barbara Ferrer, director of DPH, said during an online media briefing. "People experiencing homelessness are 40 times more likely to die of an overdose, 18 times more likely to be a homicide victim and four times more likely to die of coronary heart disease than people in L.A. County's population as a whole."
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DPH officials noted that the recent plateau can be attributed largely to a leveling off of the rate of drug overdose deaths -- the leading cause of death among people experiencing homelessness for the past six years, and a sharp decline in COVID-19 related deaths.
From 2021 to 2022, the distribution of naloxone, an opioid overdose reversal medication, also helped reduce overdose deaths.
The report found that the leading causes of death for homeless individuals were cause by overdose, coronary heart disease, transportation- related injuries, homicide, suicide and COVID-19.
Drug and alcohol overdose continues to be the leading cause of death among unhoused individuals in 2022, accounting for 37% of all deaths. It was the leading cause of death of men, women, white, Latinos/Hispanic and Black homeless populations. While overdose related deaths leveled off, the percentage of overdose deaths involving fentanyl continued to rise through 2022.
"Efforts to increase access to naloxone and overdose prevention services have undoubtedly helped to bend this curve and provide a blueprint for reducing drug-related fatalities in this very high-risk population," Gary Tsai, director of the Bureau of Substance Abuse Prevention and Control for the county, said in a statement. "Given that the opposite of addiction is not sobriety, but rather meaningful connection, continuing to engage and build trusting relationships with our unhoused residents will be equally essential."
Coronary heart disease was the second leading cause of death, accounting for 13% of deaths, in particular for those over the age of 70. Coronary heart disease deaths has increased from 336 per 100,000 people in 2014 to 445 per 100,000 in 2020, followed by a decrease in 2021 and increased slightly in 2022 to 395 per 100,000 people.
In 2022, 8% of deaths were from transportation-related injuries; homicide was found to the fourth leading cause of death with a rate of 214 per 100,00 people; suicide rates among homeless individuals has remained relatively the same over the years but from 2020 to 2022 it almost doubled among unhoused people ages 18-29; and the COVID-19 mortality rate peaked in 2021, but fell drastically in 2022 and was no longer among the 10 causes of death among unhoused people that year.
"The mortality rates among people experiencing homelessness are a tragedy for our entire community," Supervisor Lindsey P. Horvath, chair of the Los Angeles County Board of Supervisors, said in a statement. "While it is welcomed news to see a plateau in the overall mortality rate of drug overdoses, we must continue to invest in solutions that reduce mortality. This report is a call to action to urgently bring people indoors and into permanent housing and services -- the only way to save lives and end this crisis."
In the report, DPH outlined various actions to help reduce the disproportionate burden of mortality among unhoused individuals, including but not limited to the following:
-- Ensure unhoused individuals receive access to housing options that provide general, behavioral and mental health services;
-- Sustain and expand the range of housing options for homeless individuals;
-- Sustain and expand harm reduction and overdose prevention, and response services, while prioritizing homeless individuals through legislation, regulation, local engagement and advocacy;
-- Increase street-based engagement and outreach, such as telehealth and mobile services; and
-- Working with cities and unincorporated areas to address streets and locations where transportation-related deaths involving unhoused individuals occur and create policy that can prevent future traffic deaths.
These annual reports use data from the county's Office of Medical Examiner and California state death records to estimate numbers of deaths among people experiencing homelessness, as well as data from the annual point-in-time homeless count and demographic survey to estimate numbers of people experiencing homelessness and their demographic characteristics. The next report, to be released in early 2025, will include data through 2023.
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