For the first time in the decade that the Los Angeles County Department of Public Health has been tracking mortality rates among the county’s unhoused population, the latest annual death count is lower than it was the year before. In 2024, mortality for Angelenos who died without housing fell 10 percent compared to 2023, which the health department attributes to a 21-percent decrease in overdose deaths among the same population.
LACDPH announced the news March 10 with the publication of its latest annual report, which covers data from 2015 through 2024. The death data for LA’s housing crisis have broadly followed the same trajectory as national overdose mortality: increasing dramatically at the beginning of the COVID-19 pandemic, leveling off through 2022 and 2023, and decreasing in 2024. (LACDPH does not yet have data for 2025, but for national overdose mortality the sharp decrease seems to be leveling off.)
Despite the recent turnaround, county residents without housing are dying at a rate 46 times greater than that of the general LA population. About 40 percent of these deaths are attributed to overdose.
LACDPH makes six recommendations for strategies to further reduce overdose deaths among people experiencing homelessness, referred to in the report as PEH: harm reduction-friendly housing options; lower-barrier entry to treatment, for those eligible but not receiving it; expanded outreach services; accessible medications for opioid use disorder (MOUD); peer services; and lastly policy changes to make “the continuum of substance use-related services more accessible” to people without stable housing—specifically, overdose prevention centers as well as MOUD access during incarceration and upon re-entry.
Fentanyl-involved deaths for this population decreased, from 70 percent of the overdose deaths in 2023 to 59 percent in 2024. But deaths in which methamphetamine was the only drug detected increased, from 19 percent to 27 percent. The authors noted that meth-only deaths were “more common among older PEH” Which would also make sense in the context that the over-65 demographic was the only group whose overdose mortality did not decrease in 2024.
After drug overdose, the second leading cause of death continues to be coronary heart disease (CHD). In 2024 the CHD rate decreased overall, and among both Black and white demographics—but it increased among those identifying as Latino/e (the term used by the Los Angeles Homeless Services Authority in its “Point in Time” surveys, which is where the LACDPH’s demographic data come from). All-cause mortality also decreased among both Black and white people—but held steady among Latino/e people. And the 21-percent drop in overdose mortality was not evenly experienced across Black, white and Latino/e groups—their respective decreases were 29 percent, 28 percent and 11 percent.
All of which may help contextualize the graph below. Of all substances currently associated with the overdose crisis, meth is the most conducive to getting overcounted.
The report comes against a backdrop of the Trump administration systematically defunding providers that support “Housing First,” the evidence-based approach of offering housing services to everyone who needs them—rather than considering people ineligible if they’re currently using drugs, or imposing other preconditions that are discriminatory or unrealistic for someone who doesn’t already have stable housing.
LACDPH Director Dr. Barbra Ferrer wrote in the report’s introductory message that the agency is “currently facing major reductions in federal and state resources,” with a projected shortfall of $323 million for the coming year. Though at no point in the 70-page report does anyone use the term “Housing First,” LACDPH does call for “harm reduction, overdose prevention and substance use treatment services [to be] readily accessible to people in all permanent and interim housing settings,” as well as for people to “not lose their housing due to substance use.”
Though LACDPH makes continuous references to the importance of centering people with lived experience—“inviting [them] into the planning process and treating their insights as essential”—it’s not immediately clear whether the report itself was created with input from anyone currently homeless. The authors are very consistent in describing people currently experiencing homelessness as “PEH,” but switch to “lived experience” when describing the people who should get a seat at the table. And at one point the report states that its recommendations were developed in collaboration with various local agencies, community providers and advocates, “and formerly homeless individuals.” The LACDPH did not respond to Filter’s short-notice inquiry.
Top image (cropped) via United States Department of Housing and Urban Development Office of Policy Development and Research/Russ Allison Loar/Creative Commons 4.0. Inset graphics via Los Angeles County Department of Public Health.