News Release


*For Immediate Release:*

March 6, 2025

 

*New Public Health Report Shows Homeless Mortality Rate Plateaued for Second Consecutive Year in 2023 *

"Report Highlights that Preventative Work Must Continue "

The Los Angeles County Department of Public Health today released its sixth annual report on mortality among people experiencing homelessness in Los Angeles County. In 2023, the most recent year of data available for the report, there were 2,508 deaths among people experiencing homelessness. While the mortality rate remained high, at 3,326 deaths per 100,000 people, 2023 marked the second consecutive year of a plateau in the homeless mortality rate, which previously saw a devastating increase of 56% from 2019 to 2021.

From 2022 to 2023, the mortality rate increased by 1%, after increasing by 2% from 2021 to 2022.  The continuation of the plateau was due in large part to a leveling of drug overdose mortality from 2022 to 2023.[1] [ #_ftn1 ] The distribution of naloxone, an opioid overdose reversal medication, increased three-fold from 2021 to 2023. This effort and other harm reduction, overdose prevention, mental health and substance use treatment services likely contributed to the leveling of the overdose mortality rate in 2023.

*Leading Causes of Death *

_Overdose _

Drug and alcohol overdose continued to be the leading cause of death among unhoused individuals in 2023, accounting for 45% of all deaths. Overdose was the leading cause of death among males and females, and among White, Latino, Black, Asian, and American Indian/Alaska Native people experiencing homelessness. In parallel with the recent leveling of the overdose mortality rate, the percentage of overdose deaths involving fentanyl also began to plateau in 2023. However, 70.4% of overdose deaths involved fentanyl, so the risk of fentanyl overdose is still very high among unhoused people who use drugs.

_Coronary Heart Disease_

The second leading cause of death continues to be coronary heart disease, accounting for 14% of deaths in 2023. The coronary heart disease mortality rate increased by 22% from 2022 to 2023, the largest increase recorded in coronary heart disease mortality since 2016. This increase was seen among males and females and among White and Latino people experiencing homelessness, but not among Black people experiencing homelessness. Regardless, a one-year increase does not constitute a trend so Public Health will continue to actively track the 2024 data before drawing conclusions about recent trends in coronary heart disease mortality in this population. 

_Transportation-related injuries _

In 2023, transportation-related injury remained the third leading cause of death among people experiencing homelessness. Among females it has remained the second leading cause. A plateau in the rate of these deaths which began in 2022 has continued into 2023, but the rate remains high, at 251 deaths per 100,000 people, representing a 50% increase compared to 2019. In 2023, on average, a person experiencing homelessness was killed by a moving vehicle in LA County approximately every other day.  95% of those deaths were among pedestrians and cyclists.

_Homicide _

The rate of homicide, still the fourth leading cause of death, decreased by 25% from 213 deaths per 100,000 people in 2022 to 159 deaths per 100,000 people in 2023. This was a welcomed reduction, but the first since 2019 when the rate was at 120 deaths per 100,000 people. The decrease in 2023 was particularly notable among Black people experiencing homelessness, among whom the percentage of deaths from homicide decreased from 8% in 2022 to 4% in 2023.  

_Suicide _

The rate of suicide, still the fifth leading cause of death, has remained relatively stable over time. Suicide rates have been consistently higher among younger people experiencing homelessness and among White and Latino people experiencing homelessness.  

_COVID-19 _

After peaking in 2021 at 204 deaths per 100,000 people, the COVID-19 mortality rate among people experiencing homelessness has rapidly declined. The rate continued to decline in 2023.   

_Mortality rates of people experiencing homelessness compared to the general LA County population _

In 2023, people experiencing homelessness were 4.5 times more likely to die than the LA County population as a whole. This is an increase in the mortality gap from 3.8 in 2022 that is due to a decrease in the LA County overall 2023 mortality rate. In 2023, the mortality rate among White people experiencing homelessness was seven times greater than among White people in the general population. The mortality rate among Latino people experiencing homelessness was 4.8 times the rate among Latinos in the general population.  The rate among Black people experiencing homelessness was 2.7 times the rate among Black people in the general population. 

*Methodology and Data Used*

These annual reports use data from the LA County Office of the Medical Examiner and California state death records to estimate numbers of deaths among people experiencing homelessness, as well as data from the annual LA County 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 2026, will include data through 2024.

2023 was the first full year of implementation of a new procedure for recording homelessness in the State Electronic Death Reporting System (EDRS). A special analysis in this year’s report shows this improved accounting mechanism may have helped increase the identification of homeless decedents not referred to the LA County Medical Examiner because they died of natural causes in hospitals and nursing homes.

“As the County continues to grapple with the worst overdose crisis in its history, the plateau in the mortality rate among people experiencing homelessness is a clear reminder of the challenges we continue to face in tackling this crisis,” said *Hilda L. Solis*, Los Angeles County Chair Pro Tem and Supervisor for the First District. “While it’s encouraging to see the overdose deaths and other major causes of death start to level off, we can’t stop here. 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. The safety and well-being of our most vulnerable residents depend on our continued commitment to compassionate, data-driven solutions.”

“This report reinforces that shortening the timeframe people experience homelessness is a matter of life or death, which is why we need to urgently achieve Functional Zero across LA County," said Los Angeles County Supervisor for the Second District, *Holly J. Mitchell*. "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.”

“Homelessness is deadly. And while this plateau is better than an increase, even one person dying on our streets is one too many,” said Los Angeles County Supervisor for the Fourth District,* Janice Hahn*. “Getting people out of encampments and into shelters saves lives and we should double down on harm reduction and preventing overdoses.”

“Our ability to improve health outcomes among people experiencing homelessness depends on understanding what focused actions are needed to reduce the disproportionate burden of mortality among this vulnerable population,” said *Barbara Ferrer*, Ph.D., M.P.H., M.Ed., Director of the Los Angeles County Department of Public Health. “We must continue and expand the implementation of the strategies recommended in the report to significantly reduce the disproportionality in mortality rates and ensure the health and well-being of all Los Angeles County residents experiencing homelessness.”

“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. “Expanding access to treatment, overdose prevention, and harm reduction services has been vital to this progress, but our work is far from over. 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.”

*Recommendations *

In collaboration with community partners, Public Health recommends the following actions to help reduce the disproportionate burden of mortality among unhoused individuals:


* Ensure rapid access to housing and shelter that are responsive to the needs of LA County residents experiencing homelessness.
* Expand harm reduction and overdose prevention outreach, engagement, and response, prioritizing LA County residents experiencing homelessness at highest risk for overdose.
* Ensure that physical health, mental health, and substance use treatment services are available and responsive to the needs of LA County residents experiencing homelessness.
* Collaborate with municipalities and unincorporated communities to reduce traffic deaths among LA County residents experiencing homelessness.

To view the full report online, visit:

[link removed] [ [link removed] ]

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[1] [ #_ftnref1 ] The drug overdose mortality rate increased from 2021 to 2022. Our earlier reporting of a plateau in overdose mortality in 2022 has been revised after an unusually high number of unexplained causes of death in our provisional death file for 2022 were belatedly assigned causes (mostly drug-overdoses) after a backlog of medical examiner cases requiring toxicology testing was cleared. There were far fewer unexplained causes of death in our 2023 provisional death file.   


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