Overview by Teresa Paterson, Intern Fall 2021
A recent study published in the American Journal of Public Health shows that deaths among people experiencing homelessness (PEH) in Los Angeles County almost doubled from 2015 to 2019, increasing from 741 to 1,267 over the course of 5 years.
The study used Point-in-Time homeless counts (extremely flawed data, but all the public information that advocates have available) to obtain data on changes in numbers of PEH in the County, as well as additional demographic surveys to have a breakdown based on age, gender, and race/ethnicity. They then used medical examiner data in order to estimate general mortality trends among PEH as well as cause-specific mortality trends compared to the general LA County population.
Based on this data, the study found PEH had an almost 3 times higher risk of mortality compared to the general population of LA County. This disparity was even higher when looking at specific causes of death: PEH were 35 times more likely to die of drug overdoses; 15.3 times more likely to die of traffic injury; 14.3 times more likely to die of homicide, and 7.7 times more likely to die of suicide. Additionally, while the study found that White PEH had a higher mortality rate than Black PEH, they also stated that Black people accounted for 34% of homeless compared to 9% of the general population. The authors suggest that both the over-representation of Black people among PEH and their lower mortality rate compared to White PEH were likely a result of racism and discrimination – Black PEH were more likely to become homeless due to socioeconomic conditions tied to systemic racism while White PEH were more likely to accumulate a combination of mental, behavioral, and physical conditions over time before becoming homeless.
Having a better understanding of mortality trends among PEH is crucial for governments to create and implement more effective public health policies that address the dangers of homelessness. LA County used the results of this study to inform the establishment of a homeless mortality prevention initiative. The study demonstrated that drug overdoses increased by 69% from 2015-2019, becoming the leading cause of death in 2017. Given the increased risk of drug overdoses, the initiative decided to prioritize policies that improved substance use disorder services and increased interim and permanent housing options for people receiving treatment for substance use disorder.
If governments want their policies to truly address the needs of PEH in their community and to prevent deaths, they must have accurate data and knowledge of the dangers PEH face as a result of homelessness. Homelessness is a matter of life or death; this study drives home the serious health impacts homelessness has on PEH and the urgency for governments to take immediate action to end homelessness.
- Want to do more in your community to track homeless deaths? Check out this amazing toolkit created by a coalition of practitioners and advocates