Deaths among people experiencing homelessness in Los Angeles County decreased for the first time since tracking began more than a decade ago, driven largely by a significant drop in fatal drug overdoses, according to a report released Tuesday by the county Department of Public Health.
The report found 2,208 deaths among unhoused individuals in 2024 — 300 fewer than the previous year — with the mortality rate falling 10% from 3,326 deaths per 100,000 people to 2,994 deaths per 100,000. It marks the first decrease since the county began monitoring homeless mortality in 2014.
The improvement was fueled primarily by a 21% decline in drug overdose deaths, which remain the leading cause of death among the homeless population, accounting for 40% of all fatalities.
Gary Tsai, director of Substance Abuse Prevention and Control for LA County, credited expanded treatment and harm reduction services for the turnaround.
"For the PEH population, specifically, when we've seen the increases in prior years, we did allocate our resources to expand field-based services, to expand recovery-oriented housing options, to expand outreach services, as well as harm reduction services," Tsai said, referring to people experiencing homelessness. "In 2024, we had the greatest decrease in overdose deaths in LA County history."
Tsai pointed to a "continuum of services" spanning prevention, harm reduction, treatment and recovery housing that officials believe drove down the numbers. He also noted that reduced potency of fentanyl in the drug supply may have played a role, though county health officials lack definitive data on that factor.
Despite the progress, county leaders expressed concern that looming federal funding cuts could reverse the gains.
"At a time of major reductions in federal and state funding for homeless services and supports, we are at risk of losing precious ground and seeing an increase in the number of vulnerable people losing their lives," said Barbara Ferrer, director of the LA County Department of Public Health.
Tsai warned that proposed changes to Medicaid eligibility under HR1 could jeopardize access to substance use treatment. Since California implemented a Medicaid waiver in 2017, the county has leveraged federal dollars to significantly expand treatment services.
"When you have a situation like HR1 where individuals may lose eligibility, that does jeopardize their access to substance use services," Tsai said. He noted that substance use populations are exempt from proposed work requirements and co-pays, but said the county is working to ensure people understand those exemptions before implementation in January 2027.
"We absolutely want to ensure access to services. Fundamentally, that's one of the reasons why we believe that there have been reductions in overdose deaths since 2024, and we think it's important for us to maintain those gains," he said.
The report revealed persistent disparities. While mortality rates decreased among Black, White, male and female homeless individuals, rates remained flat among Latinx people experiencing homelessness.
Board Chair and First District Supervisor Hilda L. Solis called the disparity troubling.
"I am especially concerned that Latina/e/o/x residents experiencing homelessness are not seeing the same improvements reflected in this data," Solis said. "That reality tells us County departments must continue working together to strengthen our outreach, health services, and housing efforts so they reach those who remain most at risk."
The decrease followed a two-year plateau in the mortality rate from 2021-2023, which came after a devastating 56% increase from 2019-2021. Even with the improvement, unhoused individuals died at 4.2 times the rate of the general LA County population in 2024.
Not all indicators improved. Traffic injury deaths among homeless individuals rose 25%, with over 95% of those fatalities involving pedestrians and cyclists. Suicide deaths increased 21% after remaining stable for five years.
Third District Supervisor Lindsey P. Horvath emphasized the need for continued vigilance.
"Six lives lost every day is not just a statistic — it's a heartbreak," Horvath said. "As federal and state funding cuts loom, we must be more coordinated and innovative than ever, stretching every dollar to protect lives and accelerate progress."
The report is the seventh annual assessment of homeless mortality in LA County. The next report, covering 2025 data, is expected in early 2027.