New report from LA County Public Health
The Los Angeles County Department of Public Health has released its fifth annual report on mortality among people experiencing homelessness (PEH) in Los Angeles County. From 2021 to 2022, the most recent years of data available for the report, the overall mortality rate increased by just 2% from 3,215 per 100,000 people to 3,282 per 100,000 people. This is a welcomed plateauing of the mortality rate among people experiencing homelessness, which previously saw a devastating increase of 56% from 2019 to 2021.
The recent plateau in the overall mortality rate can be attributed largely to a leveling off of the rate of drug overdose deaths, the leading cause of death among PEH for the past six years, and a sharp decline in COVID-19 mortality. From 2021 to 2022, the distribution of doses of naloxone, an opioid overdose reversal medication, saw a two-and-a-half-fold increase in communities most affected by fentanyl overdoses, and the number of reported naloxone-induced overdose reversals nearly doubled. These efforts likely contributed to the rapid leveling-off of the overdose mortality rate in 2022.
Leading causes of death:
Overdose
Drug and alcohol overdose continues to be the leading cause of death among unhoused individuals in 2022, accounting for 37% of all deaths. Overdose was the leading cause of death among males and females, and among Whites, Latinx, and Blacks. Despite the recent leveling off of the overdose mortality rate among people experiencing homelessness, the percentage of overdose deaths involving fentanyl continued to rise through 2022 for all racial and ethnic groups and for both males and females, signifying. that the risk of fentanyl overdose is 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 12% of deaths. Coronary heart disease was the leading cause of death among those 70 and older, the second leading cause of death among males, and the third leading cause among females. After a gradual upward trend in coronary heart disease mortality from 366 per 100,000 people in 2014 to 445 per 100,00 people in 2020, the coronary heart disease mortality rate decreased in 2021—during the height of the COVID-19 pandemic—and then increased slightly in 2022 to 395 per 100,000 people.
Transportation-related injuries
In 2022 8% of deaths were from transportation-related injuries, which remained the third leading cause of death among unhoused individuals. The transportation-related injury mortality rate plateaued in 2022 after increasing steadily from 2014 to 2021. Assuming a relatively stable distribution of road traffic deaths among people experiencing homelessness over time, one of these deaths occurred approximately every other day over the course of 2021 and 2022. Ninety-five percent of those deaths were among pedestrians and cyclists and two-thirds occurred between 9 p.m. and 9 a.m.
Homicide
Homicide was the fourth leading cause of death, with a rate of 214 per 100,000 people in 2022, the highest rate since these trends have been monitored. The proportion of homicide deaths was more than twice as high among males compared to females and was two to three times higher among Black and Latinx unhoused people compared to White unhoused individuals. In 2021 and 2022, two-thirds of homicide deaths involved firearms.
Suicide
The overall suicide rate among people experiencing homelessness has remained relatively stable over time. However, from 2020 to 2022 the suicide rate almost doubled among unhoused people aged 18-29, and in 2022 this was the age group with the highest suicide rate. In 2021 and 2022, 5% of suicide deaths involved firearms.
COVID-19
The COVID-19 mortality rate peaked in 2021 when it was the fifth leading cause of death among people experiencing homelessness. In 2022, the COVID-19 mortality decreased substantially such that it was no longer among the top 10 causes of death among unhoused people that year.
