The Brief

The death rate for unhoused Angelenos remained relatively flat in 2023, and experts point to increased availability of anti-overdose medication being a potential factor, according to a report released Thursday by the L.A. County Department of Public Health.

The mortality rate rose just 1% in 2023, the most recent year for which data is available. That’s about 2,500 deaths of unhoused people in Los Angeles County that year, 45% of which were caused by drug overdoses.

On average, nearly seven people experiencing homelessness died each day in L.A. County in 2023.

In 2022, there were 2,374 unhoused deaths in L.A. County.

In previous years, there had been steep increases in deaths of unhoused people — a 56% increase between 2019 and 2021 — driven largely by a rapid rise in fentanyl overdoses. Since then, there have been efforts to make naloxone, a drug that can reverse the effects of opioid overdose, more widely available in libraries, jails and other spaces.

This year’s report credits expanded distribution of naloxone, known by the brand name Narcan, as likely helping prevent further dramatic increases. But drug-related deaths are still a major concern.

“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 county Public Health’s Bureau of Substance Abuse Prevention and Control, at a Thursday morning news conference.

Drug overdoses remain the leading cause of death for the region's unhoused population, and the drug overdose mortality rate among homeless Angelenos is nearly three times higher than it was in 2019.
Fentanyl was involved in 70% of drug-related fatalities in 2023, the report states, compared with 68% the previous year.

Coronary heart disease was the second leading cause of death, increasing significantly in 2023. Transportation-related injuries remained the third leading cause, with an unhoused pedestrian or cyclist dying about every other day.

The deadliest locations for unhoused Angelenos included downtown/Skid Row and Westlake/MacArthur Park, according to geographic analysis.

Reaction from county leaders

County government leaders appeared to be encouraged by some the findings in the report. Some said a plateau in the mortality rate is evidence that investments in housing and treatment for unhoused people were working.

Supervisor Hilda Solis said in a statement that she is well aware of the need for safe housing, mental health services and substance-use programs. Her district includes Skid Row and MacArthur Park.

“While it’s encouraging to see the overdose deaths and other major causes of death start to level off, we can’t stop here,” Solis said.

Supervisor Janice Hahn seems to agree.

"Getting people out of encampments and into shelters saves lives, and we should double down on harm reduction and preventing overdoses,” she said.

The Public Health Department offered more than a dozen recommendations for reducing homeless mortality in L.A. County, including expanding housing options for people who use drugs, increasing harm reduction services, improving access to cardiac care and collaborating with cities to curb traffic deaths.

By the numbers

Between 2013 and 2023, L.A. County’s homeless population nearly doubled to more than 75,000 people. In that time, the number of deaths of unhoused people increased every year, as did the overall mortality rate for the unhoused population.

That means as L.A. County’s unhoused population has grown, it also became even deadlier to experience homelessness in the region.

Overall, unhoused residents died at 4.5 times the rate of the general population in 2023. Their rate of drug overdose mortality was 49 times higher, and their rate of transportation-related death was 20 times higher.

Causes of Death

The top five causes of death have consistently been drug overdose, coronary heart disease, transportation-related injury, homicide and suicide, except in 2020 and 2021 at the height of the COVID-19 pandemic.

In 2023, those five causes made up 75% of all deaths among people experiencing homelessness in the region, according to L.A. County’s Department of Public Health.

1. Drug overdose

Drug and alcohol overdoses have been the leading cause of death since 2017, according to county data. The overdose mortality rate spiked dramatically between 2019 and 2022, before leveling off in 2023. Methamphetamine overdoses were the biggest cause of overdose death, followed by fentanyl.

“I think it's so important that we don't allow this data to let us become complacent,” said Trevor Lee, medical director of the harm reduction division at L.A. County’s Department of Health Services. “We are still in the midst of the worst overdose crisis in history, which is disproportionately affecting people experiencing homelessness.”

Health officials say increased distribution of naloxone, as well as other harm reduction, overdose prevention and substance use treatment services helped reduce the number of overdose deaths related to fentanyl and other opioids. In 2020, L.A. County service providers handed out 48,000 doses of naloxone. Last year, it was nearly 480,000 doses.

Still, the risk of fentanyl overdoses remains high among unhoused Angelenos who use drugs. The percentage of overdose deaths involving fentanyl increased to 70% in 2023, from 13% in 2018. That was similar to the previous year.

“It's so important that we interpret these results by identifying what's working and then doubling down on those efforts so that we can actually begin to see a decrease in deaths, because the plateau is not not good enough,” Lee said.

Methamphetamine was involved in 79% of overdose deaths. Most overdose deaths involve more than one drug, and more than half involved both fentanyl and methamphetamine in 2023, according to county officials. Cocaine was involved in 15% of overdose deaths, and heroin in 5%.

2. Coronary heart disease 

The second leading cause of death among L.A.’s unhoused population continues to be coronary heart disease, which accounted for 14% of deaths in 2023. The rate for this cause of death rose 22% between 2022 and 2023 — the largest increase recorded by L.A. County health officials since 2016.

The rate was nearly six times greater among unhoused L.A. County residents than in L.A. County generally.

Previous reports have pointed out that unhoused people in L.A. die from coronary heart disease at much younger ages than people who are housed. In 2022, the average age at death from coronary heart disease among the unhoused was 64, compared to 78 for all L.A. County residents.

3. Transportation-related deaths

In 2023, an unhoused pedestrian or cyclist was killed by a moving vehicle approximately every other day in L.A. County. But homeless Angelenos were 20 times more likely to die from transportation-related injuries than L.A. County residents overall.

People experiencing homelessness are more vulnerable to traffic deaths because they're more likely to live near roadways, according to the report. Transportation-related injury remained the third leading cause of death among all unhoused L.A. County residents and the second leading cause among unhoused women.

Traffic-related injuries caused 8% of all unhoused deaths in L.A. County in 2023, and the mortality rate associated with these deaths increased 50% compared with 2019.

County health officials recorded 347 traffic-related unhoused fatalities in 2022 and 2023. They found that the deaths were not concentrated in any specific location but spread out across L.A. County.

In 2023, 14% of all fatal traffic accidents reported to police involved unhoused victims, according to LAPD data.

4. Homicide

Homicide was the fourth leading cause of death among unhoused people in L.A. County in 2023. That year, 120 unhoused people were killed at the hands of another, a 25% decrease in the homicide mortality rate from a year earlier.

Unhoused Angelenos were 16 times more likely to die by homicide than the general population.

5. Suicide

The suicide rate among L.A.’s homeless population has remained relatively stable over time. Unhoused residents are eight times more likely to die by suicide than Angelenos in general.

Suicide rates have been consistently higher among younger people experiencing homelessness and among white and Latino people experiencing homelessness.

Recommendations

The L.A. County Department of Public Health had several recommendations to slow the mortality rate among unhoused people in the region.

They include:

• Ensure rapid access to housing and shelter.
• Expand harm reduction and overdose prevention outreach for residents at highest risk for overdose.
• Ensure that physical health, mental health and substance use treatment services are available and responsive to the needs of unhoused Angelenos.
• Work with municipalities and unincorporated communities to reduce traffic deaths among L.A. County residents experiencing homelessness.

Read the full report here.

California Attorney General Rob Bonta today announced an investigation into how and whether Elon Musk’s X and xAI broke the law in the past few weeks by enabling the spread of naked or sexual imagery without consent.

xAI reportedly updated its Grok artificial intelligence tool last month to allow image editing. Users on the social media platform X, which is connected to the tool, began using Grok to remove clothing in pictures of women and children.

“The avalanche of reports detailing the non-consensual sexually explicit material that xAI has produced and posted online in recent weeks is shocking,” Bonta said in a written statement. “This material, which depicts women and children in nude and sexually explicit situations, has been used to harass people across the internet. I urge xAI to take immediate action to ensure this goes no further.”

Bonta urged Californians who want to report depictions of them or their children undressed or commiting sexual acts to visit oag.ca.gov/report. In an emailed response, xAI did not address questions about the investigation.

Research obtained by Bloomberg found that X now produces more non-consensual naked or sexual imagery than any other website online. In a posting on X, Musk promised “consequences” for people who made illegal content with the tool. On Friday, Grok limited image editing to paying subscribers.

One potential route for Bonta to prosecute xAI is a law that went into effect just two weeks ago creating legal liability for the creation and distribution of “deepfake” pornography.

X and xAI appear to be violating the provisions of that law, known as AB 621, said Sam Dordulian, who previously worked in the sex crimes unit of the Los Angeles District Attorney’s Office but today works in private practice as a lawyer for people in cases involving deepfakes or revenge porn.

Assemblymember Rebecca Bauer-Kahan, author of the law, told CalMatters in a statement last week that she reached out to prosecutors, including the attorney general’s office and the city attorney of San Francisco, to remind them that they can act under the law. What's happening on X, Bauer-Kahan said, is what AB 621 was designed to address.

“Real women are having their images manipulated without consent, and the psychological and reputational harm is devastating,” the San Ramon Democrat said in an emailed statement. “Underage children are having their images used to create child sexual abuse material, and these websites are knowingly facilitating it.”

A global concern

Bonta’s inquiry also comes shortly after a call for an investigation by Gov. Gavin Newsom, backlash from regulators in the European Union and India and bans on X in Malaysia, Indonesia, and potentially the United Kingdom. As Grok app downloads rise in Apple and Google app stores, lawmakers and advocates are calling for the smartphone makers to prohibit the application.

Why Grok created the feature the way it did and how it will respond to the controversy around it is unclear, and answers may not be forthcoming, since an analysis recently concluded that it’s the least transparent of major AI systems available today. xAI did not address questions about the investigation from CalMatters.

“The psychological and reputational harm is devastating.”Rebecca Bauer-Kahan, Democratic Assemblymember, San RamonEvidence of concrete harm from deepfakes is piling up. In 2024, the FBI warned that use of deepfake tools to extort young people is a growing problem that has led to instances of self harm and suicide. Multiple audits have found that child sexual abuse material is inside the training data of AI models, making them capable of geneating vulgar photos. A 2024 Center for Democracy and Technology survey found that 15% of high school students have heard of or seen sexually explicit imagery of someone they know at school in the past year.

The investigation announced today is the latest action by the attorney general to push AI companies to keep kids safe. Late last year, Bonta endorsed a bill that would have prevented chatbots that talk about self harm and engage in sexually explicit conversations from interacting with people under 18. He also joined attorneys general from 44 other states in sending a letter that questions why companies like Meta and OpenAI allow their chatbots to have sexually inappropriate conversations with minors.

California has passed roughly half a dozen laws since 2019 to protect people from deepfakes. The new law by Bauer-Kahan amends and strengthens a 2019 law, most significantly by allowing district attorneys to bring cases against companies that “recklessly aid and abet” the distribution of deepfakes without the consent of the person depicted nude or committing sexual acts. That means the average person can ask the attorney general or the district attorney where they live to file a case on their behalf. It also increases the maximum amount that a judge can award a person from $150,000 to $250,000. Under the law, a public prosecutor is not required to prove that an individual depictured in an AI generated nude or sexual image suffered actual harm to bring a case to court. Websites that refuse to comply within 30 days can face penalties of $25,000 per violation.

In addition to those measures, two 2024 laws (AB 1831 and SB 1381) expand the state’s definition of child pornography to make possession or distribution of artificially-generated child sexual abuse material illegal. Another required social media platforms to give people an easy way to request the immediate removal of a deepfake, and defines the posting of such material as a form of digital identity theft. A California law limiting the use of deepfakes in elections was signed into law last year but was struck down by a federal judge last summer following a lawsuit by X and Elon Musk.

Future reforms

Every new state law helps give lawyers like Dordulian a new avenue to address harmful uses of deepfakes, but he said more needs to be done to help people protect themselves. He said his clients face challenges proving violation of existing laws since they require distribution of explicit materials, for example with a messaging app or social media platform, for protections to kick in. In his experience, people who use nudify apps typically know each other, so distribution doesn’t always take place, and if it does, it can be hard to prove.

For example, he said, he has a client who works as a nanny who alleges that the father of the kids she takes care of made images of her using photos she posted on Instagram. The nanny found the images on his iPad. This discovery was disturbing for her and caused her emotional trauma, but since he can’t use deepfake laws he has to sue on the basis of negligence or emotional distress and laws that were never created to address deepfakes. Similarly, victims told CNBC last year that the distinction between creating and distributing deepfakes left a gap in the law in a number of U.S. states.

“The law needs to keep up with what’s really happening on the ground and what women are experiencing, which is just the simple act of creation itself is the problem,” Dordulian said.

California is at the forefront of passing laws to protect people from deepfakes, but existing law isn’t meeting the moment, said Jennifer Gibson, cofounder and director of Psst, a group created a little over a year ago that provides pro bono legal services to tech and AI workers interested in whistleblowing. A California law that went into effect Jan. 1 protects whistleblowers inside AI companies but only if they work on catastrophic risk that can kill more than 50 people or cause more than $1 billion in damages. If the law protected people who work on deepfakes, former X employees who detailed witnessing Grok generating illegal sexually explicit material last year to Business Insider would, Gibson said, have had protections if they shared the information with authorities.

“There needs to be a lot more protection for exactly this kind of scenario in which an insider sees that this is foreseeable, knows that this is going to happen, and they need somewhere to go to report to both to keep the company accountable and protect the public.”

This article was originally published on CalMatters and was republished under the Creative Commons Attribution-NonCommercial-NoDerivatives license.

Los Angeles Metro's new chief of police says collaboration between sworn officers and unarmed responders will ultimately be what "makes or breaks" the public safety agency he is building for one of the nation's largest public transit systems.

“One needs the other to be effective in this model,” said Chief Bill Scott, who joined Metro in May after leading the San Francisco Police Department for eight years.

Scott spoke with LAist on Tuesday, saying the new Metro Department of Public Safety expects to begin hiring police officers this fall.

The interview came the same week Metro announced the establishment of the department’s “care-based services division,” which houses the neon green-clad ambassadors, homeless outreach and an emerging team of behavioral health responders under one central authority. Previously, those teams were spread across departments within the agency.

The background

Metro’s Board of Directors approved a plan in June 2024 to stand up its own in-house public safety department, replacing the decades-old system of outsourcing law enforcement to regional police agencies.

A year after the board approved the public safety overhaul, Scott joined Metro as the agency’s first chief of police and emergency management.

Before his time with the San Francisco Police Department, Scott served with the LAPD for 27 years.

Scott said Metro's Department of Public Safety has secured vendors to help recruit and vet new officers and hopes to have its recruitment strategy solidified by the spring. Scott said the department is working on agreements with police training academies and finalizing training curriculum.

“ There's a lot of moving parts to [our] plan, and we have a lot of foundational things that we have to get done fairly quickly,” Scott said. “Some of those are well on the way.”

Scott added that he supports initiatives that were already in place before he joined Metro, including the installation of taller fare gates and tap-to-exit.

Police recruitment remains a challenge

At some point in 2029, Metro hopes it will have a full force of around 400 sworn officers. As they are incrementally hired, Metro will whittle down the number of regional law enforcement officers it contracts.

Scott acknowledged that since the nationwide reckoning with policing in 2020, law enforcement agencies across the U.S. have reported issues with staffing.

Police agencies with more than 250 sworn officers reported a staffing drop of 6% from 2020 to 2025, according to a survey last year from the Police Executive Research Forum. Though the survey results indicate signs of improvement as large police agencies saw an increase in hiring in 2024 compared to 2023.

“ Our plan is to build enough excitement about what we're doing to get people to apply, and then we're able to pick people that are aligned with our values,” Scott said.

Internal Metro surveys show upward of 500 people already working for the agency, including bus and rail operators and ambassadors, are interested in becoming sworn officers, Scott said.

“If we get even 10% of those employees the first year, that’s a huge boost for what we’re trying to do,” Scott said. “To have that type of interest is really encouraging.”

The ‘care-based services division’

Part of the training sworn officers will receive from Metro includes how to work with the hundreds of unarmed personnel who round out the department.

Metro riders likely will be familiar with some of those teams. They have been working on the system for several years and include the ambassadors, who help with wayfinding and can administer opioid overdose-reversing drugs, and homelessness outreach workers.

One new team Metro is bringing on board will be made up of clinicians who respond to behavioral health episodes on trains and buses.

Once fully set up, Craig Joyce, a Metro executive and social worker who will lead the new care-based services division, said the department will be able to triage calls for help and send out appropriate teams.

“ If [the dispatcher] hears the words ‘mental health,’ perhaps they send out the crisis response team versus an ambassador team or versus a sworn officer set,” said Joyce, who previously worked on the agency’s homeless outreach efforts. “If there's a serious situation that's occurring, where there's a safety issue, but it's also a mental health [issue], a crisis response co-responder team could go out, where there's a clinician, a peer specialist, but also an officer to manage the safety side of things.”

The long-running debate over where to build a final resting place in Irvine for military veterans couldn’t get past the roadblock that has vexed stakeholders for years Tuesday — where to put it?

After about two hours of discussion, the Irvine City Council voted to table the topic after disagreement over even the parameters of how to go about finding a location for a columbarium, or a structure to inter urns carrying ashes, for veterans with ties to the city.

Councilmember James Mai proposed asking officials to develop a plan for a municipal columbarium, including eligibility preference given  to Irvine residents or those with strong ties to the city and those who served at Marine Corps Air Station El Toro. He asked staff to consider locations across the city for the structure, including  Bill Barber Memorial Park, Northwood Memorial Park and adjacent to the Flying Leatherneck Aviation Museum. But he also explicitly called for a 125-acre plot of land that used to be part of the Marine Corps Air Station El Toro to be excluded.

The land, also known as the ARDA site, is now part of Great Park but has long been lobbied for as a location for a veterans cemetery.

Mayor Larry Agran strongly opposed Mai’s proposed exclusion of the ARDA site, calling the idea “offensive.” Instead, he reiterated his longstanding call for a veterans cemetery at the location.

The council eventually voted 4-3 to table the proposal.

Orange County is home to an estimated 130,000 veterans, but the nearest cemetery dedicated to military personnel is the Riverside National Cemetery more than 40 miles away.

It isn’t the first time a final resting place for veterans has stalled in front of the Irvine City Council. Last year, plans for a veterans cemetery or columbarium were shut down on two separate occasions.

So why does it keep coming back?

For veterans in Irvine, the cemetery represents a broken promise.

When the marine base was shuttered in 1999, Irvine’s population was just over 130,000 and the Great Park idea was nonexistent.

Orange County lobbied for an airport. But for veterans and their families, the former marine base seemed like the perfect resting place where they could receive their last rites for service to their country — and some are still holding onto that hope with a staunch ally in Agran.

But in the years since the debates began, Irvine's population has more than doubled to more than 300,000, and Great Park has been transformed into a residential community for young families, with a $1 billion expansion underway that includes an amphitheater, retail and dining options. The area, residents say, has been transformed too much to also include a cemetery.

Also, the site eyed for a potential cemetery is near an elementary school and families — many of whom are immigrants — who live in the area say it’s bad luck.

But what about a resting place for veterans?

There’s political support, including from state leadership, for a cemetery in Orange County. A bill approved in 2014, AB 1453, calls on the state to build and maintain a resting place for veterans in the area.

After efforts to build it at the former marine base stalled over and over again, a group of fed-up veterans finally took their plans to Anaheim’s Gypsum Canyon.

That location quickly won support from city, county, state and federal leaders.

Construction at the Anaheim site is set to begin this year. However, Agran is convinced the cemetery actually will come to fruition in Irvine.