LA County Acts to Address Rising Homeless Mortality Rate

All photos by Los Angeles County

Concerned about the rapidly growing number of deaths among Los Angeles County’s homeless population, the Board of Supervisors voted to conduct an in-depth assessment of their health needs with the goal of improving treatment outcomes and decreasing the mortality rate.

A newly released report by the LA County Department of Public Health (DPH) found the number of deaths among people struggling with homelessness has steadily increased every year from 536 in 2013 to 1,047 in 2018. The report also found that the overall mortality rate among the homeless population is more than double the rate of the general population, and that the leading causes of death were alcohol and substance use-related (27%), injuries and violence (24%) and coronary heart disease (22%).

Acting on a motion by Supervisors Mark Ridley-Thomas and Hilda Solis, the Board responded by directing DPH to collaborate with other County departments and agencies to conduct an in-depth assessment of how people experiencing homelessness access health, mental health and substance use services, and determine ways to intervene to prevent premature deaths.

“This report is tragic and reflects a true state of emergency on the streets of our community,” Supervisor Ridley-Thomas said. “It is unconscionable and inhumane for society to continue to turn a blind eye to this plight. That’s why we recommended that the Board act with urgency and purpose to direct the Department of Public Health to examine and execute strategies that lead to a rapid reduction in these disturbing numbers.”

“Homelessness can have a devastating impact on a person’s health and well-being, and we need to better understand the underlying causes that contribute to our County’s high mortality rate among those who are experiencing homelessness,” said Supervisor Hilda L. Solis. “Children, single mothers, our friends and neighbors represent the people who are struggling to find a warm, safe bed every night. We cannot abandon them. We must recommit ourselves every day to identify innovative solutions that can help prevent premature deaths among our most vulnerable residents.”

The DPH report found that people experiencing homelessness have a far shorter lifespan than the general population – their average age at death is 51, compared to 73 for the general population. Also, the report found that people experiencing homelessness are 26 times more likely to die from drug/alcohol overdose, 11 times more likely to die from transportation-related injuries, 10 times more likely to die from homicide, five times more likely to die from suicide, and three times more likely to die from coronary heart disease than the general population.

“This alarming increase in homeless deaths requires immediate action to improve the care for our most vulnerable populations,” LA County Public Health Director Dr. Barbara Ferrer said. “As we work hard to secure housing for those experiencing homelessness, we have a civic and moral obligation to prevent unnecessary suffering and death. We need to start this work by speaking directly with those experiencing homelessness to better understand how to align our support.”

“Homeless deaths are increasing at a rate that is outpacing the overall growth in the homeless population, resulting in 2-3 homeless deaths per day on average,”  Chief Medical Examiner-Coroner Dr. Jonathan Lucas said. “We will continue to work closely with public health and others to learn as much as we can in order to drive prevention strategies.”

In response to the motion, DPH in coordination with the Departments of Health Services and Mental Health, the Medical Examiner-Coroner, County Chief Executive Office and Los Angeles Homeless Services Authority, will:

• Conduct a health needs assessment of people experiencing homelessness to understand their experiences accessing health, mental health, and substance use services and engaging in treatment, by deploying staff to speak directly with people across Los Angeles County (County), including at the 2019 Care Harbor Free Clinic, in encampments, at select shelters and access points, and at various convenings countywide that have been facilitated and led by people who have experienced homelessness to discuss their healthcare needs, concerns, and the challenges they face in accessing these services;

• Review information from various sources, including mortality and morbidity data, program data, and interviews with homeless service providers and outreach team members, to inform the County’s understanding of the current health care delivery system utilized by people experiencing homelessness; and

• Report back to the Board of Supervisors, in writing, within 120 days with a set of recommendations, informed by findings from this assessment, on steps that can be taken to decrease mortality among people experiencing homelessness and improve treatment outcomes.