US streets: where many homeless go to die

While the homeless population is soaring in the United States, the mortality rate among them is also rising. Alameda County in California is looking into the deaths of more than 800 homeless people from 2018 to 2020 and how they happened.

According to a "homeless mortality report" issued last Tuesday by the county's Health Care for the Homeless Program, 403 of 809 deaths were due to medical conditions, led by heart disease, followed by cancer, liver disease, cerebrovascular disease, respiratory disease and others. A quarter of the deaths were caused by drug overdoses, making drug overdose the leading single cause of death among the homeless.

The report found the death rate rose significantly for the homeless: 195 homeless people died in 2018, compared with 368 in 2020, a rise of nearly 90 percent.

Accidental injuries caused 10 percent of the deaths, homicides caused 7 percent and suicides 4 percent. COVID-19 had no major direct impact on the homeless, with just six deaths from the virus reported in 2020, the report.

According to the figures the average homeless person in Alameda County dies at the age of 52, while the average resident in the county lives until the age of 75.

Seventy-seven percent of the people who died were men. Sixty-six percent of deaths were outside a medical setting, such as in the street, in a park, or in a vehicle, shelter, encampment, motel, or other location. More than 140 people died on the street.

The report estimated that the 809 deaths during that three-year period represent about 10 percent of the 8,022 homeless people estimated to live in the county, 4.4 times higher than the general population's death rate.

State program

It is the first homeless mortality report for Alameda County, home to more than 1.5 million people in cities that include Alameda, Oakland, Fremont, Piedmont, Berkeley and Pleasanton. The report reveals that most of the deaths, 56 percent, happened in Oakland. On the day after the report was issued, Berkeley was awarded $16.2 million in grant funding through a state program that aims to house the homeless.

"A responsible and just community must work to be closely aware of the deaths of all its members, strive to learn from those deaths, implement policies and practices to reduce preventable deaths, and work to reduce the harm that preventable deaths create for families, friends, caregivers and the community," the authors of the report said.

Alameda County Board of Supervisors President Keith Carson said the county plans to increase efforts to prevent these deaths.

"We increasingly have more teams going to encampments that include mental health and drug and alcohol specialists," he said.

In California, the country's most populous state, deaths in homeless communities have risen throughout the San Francisco Bay Area, which has been put in the national spotlight as the affluent region experiences a worsening in homelessness.

Activists in Santa Clara County, the heart of the Silicon Valley, reported 250 deaths among homeless people between December 2020 and November 2021. The number rose 55 percent from two years ago, compared with 161 in 2019 and 196 in 2020, said the Silicon Valley Interreligious Council, which has hosted annual memorials for homeless people for years.