For the first time in a decade of tracking homeless deaths in Los Angeles County, fewer people have died on the streets and in shelters, the Department of Public Health reported Tuesday.
The drastic drop in overdose deaths reduced the homeless death rate from all causes by 10% in 2024, the most recent year for data analyzed by the county.
But drug overdoses remained the leading cause of death, followed by heart disease and car accidents.
The annual analysis found 2,208 deaths by 2024. That was 300 fewer than last year but still more than six deaths a day and more than four times the death rate for the state as a whole.
The decline reinforced the upward trend of the past two years, which saw only modest increases.
Before that, the rate increased by 56% in two years.
Health officials attributed the improvement to drug overdose prevention and mental health and substance abuse treatment, but warned that the trend could be hampered by expected cuts to those services.
“At a time of significant reductions in federal and state funding for homeless services and supports, we are at risk of losing valuable space and seeing an increase in the number of vulnerable people losing their lives,” said public health director Barbara Ferrer in a statement released with the report.
Drug overdoses accounted for 40% of all homeless deaths, down from 45% the previous year. Followed by heart disease, 14%; road accidents 11%; murder, 5%; and suicide, 4%. The remaining 27% were a combination of other natural causes, accidents and unknown causes, said Will Nicholas, director of the health department’s Center for Health Impact Evaluation.
Although the number of all homeless deaths is small, suicide is 13 times more common than the general population.
The 21% drop in drug and alcohol-related deaths reflected a similar, albeit steeper, decline across the county’s population. As a result, while drug overdoses have declined slightly as the leading cause of death for the homeless, the staggering gap in the population has only widened. Excess deaths increased 46 times among homeless people, up from 40 the year before.
Gary Tsai, director of the Substance Abuse Prevention and Control Bureau, said most of the reduction came from fentanyl-related deaths.
He recommended regional investment in risk reduction services, access roads and recovery-oriented housing.
“I think our efforts to ensure wider availability of Naloxone is also helping and one of the main reasons for that decline,” Tsai said, referring to the drug that reverses drug overdoses.
Moving people off the streets into temporary or permanent housing has been responsible for a 12% drop in heart disease deaths, Tsai said.
“Housing is a major determinant of health outcomes including heart disease,” he said. “If a person is accommodated in a house, one of his needs is already taken care of. He can spend his time on other things. It can be in his life. If they don’t have houses, there is a series of things they have to deal with.”
“We have staff trying to reach people in all areas, be it temporary housing, permanent housing or the streets,” said Nicholas. “The street is tough. You’re more likely to get attention if you’re in a permanent or minor position.”
Homeless people are also at greater risk of road accidents. Nicholas said his team learned through collaboration with the Department of Transport in the province that about 30% of all those who died on the roads were homeless people.
The 315 deaths in 2024 were 25% more than the previous year and accounted for nearly 30% of all road deaths across the region, Nicholas said. The challenge in finding solutions is that the areas are so spread out. Instead of trying to deal with specific areas, “we will look for similarities in the situation of those different areas that may be compatible with global strategies,” said Nicholas.
The health department compiles an annual report from records provided by the Los Angeles County medical examiner supplemented by state death certificates. Following the guidelines of the US Department of Housing and Urban Development, it includes people living in sheltered and unsheltered areas but not formerly homeless people living in supportive housing.
In addition to the raw numbers, the county calculated 100,000 deaths using an average of 2024 and 2025 in the annual point count by the Los Angeles Homeless Services Authority.
The report outlined recommendations to maintain momentum. They ranged from the broad – ensuring access to affordable housing and medical insurance – to the more specific – providing suicide prevention training for shelter workers.
But the sustainability of those efforts is at stake.
After a decade of dramatic growth, homelessness programs are now facing a period of dwindling resources. Last month, the Los Angeles County Board of Supervisors responded to rising costs by cutting $200 million from homeless programs that are largely funded by Measure A’s half-cent sales tax.
Hoping to minimize the impact on temporary and permanent housing as much as possible, the administration cut $27 million from outreach and diversion programs and cut two-thirds of the county’s program that takes people off the streets and into shelters.
That reduction in space is combined with a 50% cut in Gov. Gavin Newsom’s proposed budget for the upcoming fiscal year for the Homeless Housing and Assistance Program, much of which pays for the operating costs of homeless shelters and housing providers and temporary rental subsidies.
The Trump administration wants to end funding for homeless programs that seek to house people before dealing with issues like drug addiction or mental health, a policy the district views as a cornerstone of its approach.
