3. Results from Los Angeles County 2000-2007:

a. Number of Homeless Deaths

The Los Angeles County Coroner’s office reported 2,815 homeless deaths from January 1, 2000 to May 28, 2007.

As an average, this is more than one per day for the nearly 7.5 year period.

b.          Comparison of Data
The range of homeless deaths spans from a low of 270 in 2002 to a high of 551 in 2006. The largest increase occurred between 2002 and 2003 when deaths increased from 270 to 393, a 45.5% increase in one year. Predictions indicate the year 2007 will experience a decline in homeless deaths. Through five complete months of 2007 there have been 180 homeless deaths recorded, just 32.6% of the previous year’s total over a 12 month span. If 2007 does show a decline in numbers, it will be the first time since 2002 that Los Angeles County has seen a decrease in homeless deaths.

c.           Demographic Characteristics

• Gender: As shown in Figure 1, of the 2,815 homeless deaths, 2,406 (85%) of them were male, and 409 (15%) were female.

• Ethnicity: The racial/ethnic makeup of these deaths shows that 1,151 (41%) were Caucasian, 868 (31%) were Hispanic, 717 (25%) were African American, 33 (1%) were Asian, 26 (1%) were American Indian, and 29 (1%) were of other ethnicities.  These figures are shown in Figure 2.

• Age: As shown in Figure 3, the average age of death was 48.1 years, falling far short of the 77.2 year life expectancy of the average American. The age range of these homeless deaths was 0-89. The age distribution shows there were 95 (3.3%) deaths in the zero to 24 years-old age group, 918 (32.6%) deaths in the 25 to 44 age group, 1,575 (56.0%) deaths in the 45 to 64 age group, and 225 (8.0%) in the 65 and over age group.

The average life span of the deceased homeless in Los Angeles County covered just 62.3% of the life expectancy of a person living in the United States.

d.          Leading Known Underlying Causes of Death: See Table 1 & Figure 4:

• Cardiovascular: The primary cause of death among the 2,815 homeless was cardiovascular problems, accounting for 686 (24.4%) deaths. Again, it is important to note: without access to official death certificates, the primary underlying cause of death (such as alcohol and/or substance abuse) in these cardiovascular cases is unknown.
• Unknown:  Unknown causes of death ranked second in the listing we were provided.  The high death rates and low life expectancy highlighted reported here constitute an extremely serious health disparity for the homeless population group.  Public health authorities  should monitor, report on and plan for the health of homeless persons to a far greater extent than is currently the case.
• Substance Use:  The second most common cause was acute intoxication, which accounted for 619 (22.0%) of deaths. The leading substances abused were: heroin, cocaine, morphine and alcohol.
• Trauma:  The third most common were trauma related. In a preliminary review of a coroner's list of causes of death (without access to death certificates), we found that 502 deaths (or 17.8%) were caused by some type of trauma, many of which were related to violent acts or suicides.

See Appendix II for causes of death by year.

Figure 4:  Causes of death:

Table 1: Leading Underlying Causes of Death
[Note: LACEH&H used the typology developed by the epidemiologists for the Seattle/Kings County report]

e.      Geographical Distribution

The largest concentration of Los Angeles County’s homeless deaths occurred within the City of Los Angeles (1,277 or 45 %). Although no other area compares to these figures, there are many neighborhoods with significant homeless mortality numbers. For example, Long Beach is second on the list, with 154 homeless deaths, followed by Santa Monica with 111, Pasadena with 55 and Hollywood with 48 [see Table 2]. Virtually every single neighborhood has at least a few homeless deaths on its record, which clearly shows that this is not just a phenomena of “Skid Row,” but extends throughout the county. [See Figure 5].

Table 2: Number of Homeless Deaths by Neighborhood 2000-2007

Figure 5: Homeless Deaths by Neighborhoods

f.           Seasonal Distribution: See Figure 6
Homeless deaths were fairly evenly distributed among the four seasons of the year, and do not appear to be weather-related. Winter was classified as the period of December 23 to March 20, and claimed 770 lives, or 27% of the total deaths.  Spring (March 21 – June 20) was the second most deadly season, with 696 deaths [25%] over the seven year span. There were 687 deaths [24%] during the summer (June 21 – September 23) and 660 [23%] during the fall (September 24 – December 22). These numbers do not include the period of May 29, 2007 to the present – when an additional 23-27% of the homeless deaths will occur.

• Number of Lost Years Due to Early or Untimely Deaths

The 2,815 homeless people in our study were expected to live 211,878 years based on the average life expectancy of their gender and ethnicity. They only survived 135,528 of those expected years. A statistical analysis of the number of years homeless people lived in comparison to the number of years they were predicted to live according to life expectancy revealed that their lives were cut short by 76,350 years.  On average a homeless person’s life is 36% shorter than a housed person’s life.

One of the most startling facts is that for homeless Latinas, their lives were 49% shorter than expected. Their lifetimes were cut in half by homelessness. African American females’ lives were 42% shorter than expected and Caucasian females lives were 40% shorter than expected. Latino’s lives were 42% shorter than expected, while Asian males’ lives were 40% shorter (See Appendix I).

Table 3: Years of Life Lost by Ethnicity

Total:                         211,878                      135,528                     76,350

Table 4: Years of Life Lost by Gender

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