The Los Angeles County Department of Public Health announced Tuesday deaths amongst people experiencing homelessness (PEH) increased to a record 1,267 in 2019 and drug overdose was the leading cause with the greatest increase. In 2018, there were 1,114 deaths among people experiencing homelessness.

This is a second annual report on mortality among people experiencing homelessness in L.A. County and includes new data for 2019 and part of 2020. In 2020, the overall mortality rate increased only slightly due to an even greater increase in the total number of PEH. However, the drug overdose mortality rate increased substantially during the same period.

Drug overdoses have been the leading cause of death among PEH in L.A. County since 2017 and the overdose rate increased by 84% between 2016 and 2019. For the combined years of 2017 to 2019, PEH were 36 times more likely to die of drug overdose than people in the general population. For each of those years the overdose rate was highest among white PEH, but while the rate among whites has remained stable over time, the overdose death rate among Black and Latinx PEH has increased substantially.

Methamphetamine was the drug most frequently involved in overdose deaths in 2019, but fentanyl-related deaths increased significantly that year, and then doubled again during the first seven months of 2020. An early look at homeless mortality in 2020 revealed that COVID-19 had a smaller direct impact on the homeless population compared to the general population, but that overdose deaths, particularly those involving fentanyl, have increased significantly among PEH in LA County since the pandemic.

The top five leading causes of death among PEH also include coronary heart disease, traffic injuries, homicide and suicide. PEH are 4 to 17 more likely to die from these four causes compared to the general population.

“This report is tragic and reflects a true state of emergency on the streets of our community,” said Supervisor Hilda Solis, co-author of the 2019 motion addressing rising homeless mortality. “Our number one duty as elected officials is to protect the health and well-being of the residents we serve, irrespective of their income and housing status. In a civil society, it is unacceptable for any of us – elected or otherwise – to ignore the shocking needs documented in this year’s homeless mortality report.”

“This alarming increase in homeless deaths, particularly those from drug overdoses, requires immediate action,” said Barbara Ferrer, PhD, MPH, MEd, Director of Public Health. “As we work hard to secure housing for those experiencing homelessness, we have a civic and moral obligation to prevent unnecessary suffering and death. Public Health and our Division of Substance Abuse Prevention and Control are committed to doing everything we can to reduce drug-related deaths among people experiencing homelessness and all residents of our County.”

Public Health is taking immediate steps to minimize drug-related mortality among PEH populations:

– Expansion of harm reduction services such as syringe exchange programs and distribution of naloxone and fentanyl test strips.

– Increasing access to supportive housing for PEH receiving SUD services.

– Launch of Los Angeles County Methamphetamine Task Force to take a coordinated and comprehensive approach to addressing the methamphetamine crisis.

– Workforce training to promote the use of Medications for Addiction Treatment.

– Development of a resource guide and mobile-friendly web application to facilitate access to substance use disorder treatment services.

The Department of Public Health is committed to promoting health equity and ensuring optimal health and well-being for all 10 million residents of Los Angeles County. Through a variety of programs, community partnerships and services, Public Health oversees environmental health, disease control, and community and family health. Nationally accredited by the Public Health Accreditation Board, the Los Angeles County Department of Public Health comprises nearly 4,500 employees and has an annual budget of $1.2 billion. To learn more about Los Angeles County Public Health, visit www.publichealth.lacounty.gov.