LA County homeless mortality rates remain high but stable, report says

The Los Angeles County Department of Public Health (DPH) described the death rates among the county’s unhoused and homeless population as “high but stable.” 

The L.A. County DPH report, which was released on Thursday, revealed that death rates among the unhoused population have plateaued for a second consecutive year. Despite this, Latinos are still one of the most disproportionally affected groups.

2,508 people experiencing homelessness died in 2023. Drug and alcohol overdoses accounted for 45% of all deaths, continuing to be the leading cause of death among the county’s homeless population. This data comes after the county has increased the distribution of the overdose-reversal medication naloxone, according to a county report. Overdose was the leading cause of death among male and female Latinos. 

“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, L.A. 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.” 

She also referenced some of the communities in the City of L.A. that have been synonymous with high crime and drug rates. 

“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,” Solis added.

One of the most revealing data points was the mortality rates of people experiencing homelessness compared to the general L.A. County population. In 2023, people experiencing homelessness were 4.5 times more likely to die than the county population as a whole. Racial and ethnic differences were also alarming. The mortality rate among Latino people experiencing homelessness was 4.8 times the rate among Latinos in the general county population. Similarly, the rate among Black people experiencing homelessness was 2.7 times the rate among Black people in the general population. 

“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, director of the Los Angeles County Department of Public Health.

But despite this, it is also important to acknowledge that for a couple of years now, mortality rates among Latino people experiencing homelessness have also been consistently lower and declining more than rates among whites.  

In 2024, Will Nicholas, director of the DPH Center for Health Impact Evaluation, spoke of the decreasing rates and clarified that this is only because the number of Latinos that fell into homelessness from 2020 to 2022 increased by outstanding rates, due to the economic hardship caused by the COVID-19 pandemic. “As you can imagine, if the total population increases, then your mortality rates also go down. These new entries to homelessness in this population were largely more healthy, younger and many were living in cars,” Nicholas said in 2024.

One of the drugs killing the most homeless people is methamphetamine, which has been involved in the highest percentage of overdose deaths, reaching 78.5% in 2023. However, as the report stated, most overdose deaths involve multiple drugs and the recent rapid increase in overdose mortality among persons experiencing homelessness can be attributed to the increasing involvement of fentanyl, a highly potent synthetic opioid that can be lethal in small doses.

“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.”

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. 

In collaboration with community partners, CDPH also listed several recommendations and actions that could help reduce the disproportionate rate of mortality among unhoused individuals. 

Some of the recommendations included ensuring rapid access to housing and shelters, expanding harm reduction and overdose prevention outreach, engagement and response, while prioritizing residents experiencing homelessness at the highest risk for overdose, ensuring that physical health, mental health, and substance use treatment services are available and responsive and collaborating with municipalities and unincorporated communities to reduce traffic deaths among L.A. County residents experiencing homelessness.

“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 L.A. County residents experiencing homelessness,” Ferrer said. 

These annual reports use data from the LA County Office of Medical Examiner and California state death records to estimate the number of deaths among people experiencing homelessness, as well as data from the annual L.A. County point-in-time homeless count and demographic survey to estimate the numbers of people experiencing homelessness along with their demographic characteristics. 

The next report is expected to be released in early 2026 and will include data through 2024.

To view the full report online, visit publichealth.lacounty.gov/chie.