Deaths among unhoused LA County residents fell in 2024, marking first decline on record

For the first time since Los Angeles County began tracking the data, fewer unhoused residents died on the streets in 2024, according to a report released Tuesday.

About 2,208 people experiencing homelessness died in the county that year, 300 fewer than the previous year, according to the report from the county Department of Public Health.

The report also showed the mortality rate — which is the number of deaths per 100,000 unhoused residents — decreased by 10%.

“This is our seventh year putting this report out. It’s the first time we’ve seen this reduction,” said Will Nicholas, director of the department's Center for Health Impact Evaluation at a Tuesday news conference.

“I’m hoping that we can use that energy to keep the rates heading in the right direction, heading down,” he said.

Health officials credit the decline in large part to a drop in drug overdose deaths.

Gary Tsai, director of the county's Substance Abuse Prevention and Control division, said a range of county services have contributed, including expanded field-based treatment, recovery-oriented housing, and distribution of naloxone, a medication that can reverse the effects of an opioid overdose.

There was a 21% decrease in the drug overdose death rate among unhoused residents, according to the report.

Still, an average of six people experiencing homelessness died each day in L.A. County throughout 2024. People without stable housing face mortality rates over four times higher than the general population.

Authorities note that number is still too high.

"These disparities reflect systemic barriers — lack of safe housing, limited access to culturally responsive healthcare, unsafe environments, and the ongoing effects of trauma, discrimination, and social inequities," Barbara Ferrer, director of the L.A. County Department of Public Health, wrote in the report.

She said she expects the work to get harder, with major state and regional funding reductions to some homeless services this year.

“Just as we are beginning to see positive momentum on homeless mortality reduction, we are at risk of losing precious ground,” Ferrer continued.

County health officials made several recommendations in the report, including providing more access to shelter and housing, mental health and substance use treatment services.

Drug overdose deaths 

The annual report relies on state death records, county medical examiner data and population estimates from the region’s annual point-in-time homeless count.

More than 75,000 people were estimated to be experiencing homelessness in L.A. County in 2024, according to the Los Angeles Homeless Services Authority’s official count that year.

Despite some decreases, drug overdose remained the leading cause of death among people experiencing homelessness in Los Angeles County and accounted for 40% of all deaths among that population.

In 2024, 884 unhoused people died of drug overdoses in L.A. County. That was down from 1,140 deaths in 2023, according to the report.

Unhoused residents were 46 times more likely to die of drug overdose than the general population. The report notes the overdose death rate is still about twice as high as it was in 2019.

Many of the deaths involved fentanyl, a synthetic opioid, but for the first time they accounted for a lower percentage than in the previous year — 59% in 2024 and 70% in 2023, according to the data.

Most overdose deaths involve multiple drugs, according to the county. The percentage of deaths in which methamphetamine was a factor remained relatively steady — 80% in 2024 and 79% in 2023.

Overdose deaths involving only methamphetamine rose from 19% in 2023 to 27% in 2024.

Tsai warned Tuesday that federal changes to Medicaid, known in California as Medi-Cal, could put the reduction in deaths, as reflected in the report, at risk.

L.A. County’s substance use treatment system expanded significantly after the county implemented a Medi-Cal waiver nearly a decade ago, he said, and the 2025 federal budget law known as the One Big Beautiful Bill Act could cause some to lose eligibility.

Tsai noted, however, that people with substance use disorders are exempt from the work requirements under the new law, and said the county is working to make sure that population is aware of the exemption ahead of January 2027.

Other causes of death

The Public Health Department is tracking other leading causes of death for unhoused residents. In 2024, the rates for coronary heart disease and homicide among unhoused Angelenos went down, while transportation-related deaths and suicides went up.

• Coronary heart disease: The second leading cause of death among L.A. County’s unhoused population continued to be coronary heart disease, which accounted for 14% of unhoused deaths in 2024. The previous year, it was 15%.
  
• Transportation-related deaths: Traffic-related injury remained the third leading cause of death among all unhoused L.A. County residents, accounting for 11% of those fatalities. That’s up from 8% the previous year. After a two-year plateau, the traffic injury mortality rate increased by 25% to 315 deaths per 100,000 unhoused people. About 230 unhoused pedestrians or cyclists were killed in traffic collisions in 2024. They were 24 times more likely to die from traffic-related injuries than the overall L.A. County population.
  
• Homicide: Homicide was the fourth leading cause of death among unhoused people in L.A. County in 2024. That year, 105 unhoused people were victims of homicide, according to county data. That’s compared to 124 the previous year. Unhoused Angelenos were 14 times more likely to die by homicide than the general population.
  
• Suicide: The suicide rate among L.A.’s homeless population increased by 21% in 2024. County data show 80 unhoused L.A. County residents died by suicide in 2024. That was 4% of all recorded deaths among unhoused residents, up from 3% the previous year. Unhoused residents were 13 times more likely to die by suicide than Angelenos in general.

Public Health recommendations

The Department of Public Health made several recommendations to prevent premature deaths and continue slowing the mortality rate among unhoused people in the region.

They included:

• Ensuring access to affordable housing and health insurance.
• Ensuring that housing options support harm reduction, overdose prevention and substance use treatment.
• Expanding comprehensive primary and preventive care services for unhoused people.
• Conducting a detailed analysis of 2024 traffic injury deaths among unhoused residents to inform policy interventions. 
  

Officials said the expansion of shelter beds in L.A. County over the past several years has contributed to declining deaths.

“The more we can get people inside, the better we’re gonna do on mortality,” Nicholas said, noting that it's usually easier to connect people with services when they have a place to live.

In a statement released Tuesday, Los Angeles Mayor Karen Bass credited her administration's Inside Safe program with driving the decline. That program moves unhoused people from tent and RV encampments into temporary shelter.

"There is no doubt that Inside Safe, by bringing thousands of people inside and reducing street homelessness by 17.5 percent, has saved lives and helped drive this decline," Bass said.

Read the full report here.