New public health report shows sharp rise in mortality among people experiencing homelessness

A new report from the Los Angeles County Department of Public Health suggests that the mortality rate among people experiencing homelessness has increased by 55 percent, from 2,056 per 100,000 in 2019 to 3,183 per 100,000 in 2021, the most recent years of data analyzed in this report.

This is the fourth annual report produced by the Department of Public Health on mortality among people experiencing homelessness in Los Angeles County. It utilizes data from the 2022 homeless count, which was suspended in 2021 due to the pandemic, to resume the estimation of trends in mortality rates.

Drug overdose was once again the leading cause of death for people experiencing homelessness, accounting for 37 percent of all deaths among unhoused individuals in 2020 and 2021 combined, or about two deaths per day on average.

“This report underscores the enormous destruction fentanyl is causing our communities. To know that people experiencing homelessness are 39 times more likely to die of a drug overdose compared to the overall population of LA County is yet another painful reminder of the harm our unhoused neighbors experience, and why we must continue to move with urgency to address the crisis on our streets,” Los Angeles County Supervisor Lindsey Horvath said in a statement.

“We need to get people inside, in treatment, and supported with wraparound services. We also need to expand the availability of Narcan for all who serve the public to use as a vital, life-saving tool,” Horvath said.

Fentanyl has been driving overdose deaths since the start of the pandemic, with the percentage of overdose deaths involving the synthetic drug almost tripling from just 20 percent in 2019 to 58 percent in 2021. Fentanyl deaths almost always involve combinations of drugs. For instance, 71 percent of all fentanyl deaths in 2021 among people experiencing homelessness also involved methamphetamine.

Overdose mortality rates are higher among white males experiencing homelessness. From 2019 to 2020 overdose rates increased substantially across all racial and ethnic groups and among both men and women, but 2021 saw a continued sharp rise only among the white, male demographic.

The second leading cause of death continues to be coronary heart disease, although the coronary heart disease mortality rate decreased in 2021 after increasing from 2017 to 2020. Coronary heart disease deaths accounted for 14 percent of all deaths among persons experiencing homelessness in 2020 and 2021 combined or about five deaths per week on average.

The third leading cause of death was traffic injuries, which increased by 47 percent from 2019 to 2021, accounting for 8 percent of all deaths of people experiencing homelessness in 2020 and 2021 combined, which equates to about three deaths per week on average.

The homicide rate, which has also risen among people experiencing homelessness since 2017, increased by 49 percent in 2021 compared to the previous year. Homicides were the fourth leading cause of death in 2020 and 2021.

Data from 2022 will be presented in January 2024.


Scott fell in love with Santa Monica when he was much younger and now, after living and working in five different countries, he has returned. He's written for the likes of the FT, NBC, the BBC and CNN.