Report: 809 Homeless Dead in Alameda County

More than 800 people died while they were homeless in Alameda County between 2018 and 2020. This is according to an inaugural report released last week by the Alameda County Health Care Services (HCSA) for the Homeless program.

The report shows a dramatic 89 percent increase in the number of annual homeless deaths over those three years (195 in 2018, 246 in 2019, and 368 in 2020) and examined the cause of death, and disparities in race and gender.

HCSA said it developed the report out of a growing consciousness nationwide of the role that local governments have in preventing and reducing deaths in the unhoused and how to implement policies and practices to reduce the impact on their families, friends, caregivers, and the community. 

“We believe no one should die alone or unknown in homelessness,” said HCSA Agency Director, Colleen Chawla. “A responsible and just community must work to be closely aware of the deaths of all its members and strive to learn meaningful ways to improve program planning and shape policy.”

The report was first presented to the Board of Supervisors on April 11 and shared with homeless advocacy groups including EveryOne Home. The plan is to carry out a Homeless Mortality Report on an annual basis.

“The report will aid in the efforts to forge multiple touchpoints across the homelessness system of care, including housing, health clinics, hospitals, emergency room, behavioral health, social services, outreach, and criminal justice,” said David Modersbach, Grants Manager with HCSA. “Health care and homeless services providers will have the access to analyze the data and create recommendations for policy and practice changes that contribute to the reduction of preventable deaths among people experiencing homelessness. “ 

The report noted that in the mid-county region of Hayward, Alameda, San Leandro, San Lorenzo, and Castro Valley there were 188 deaths reported. Some 44 of those deaths happened in Castro Valley while 40 occurred in San Leandro. Of those deaths, a third (62) happened in a hospital, 12 percent (24) happened on the street, 9 percent (17) happened in a nursing facility, with the rest occurring in an encampment, at a friend’s house, or outdoors somewhere.

An additional 250 persons known to be housed after the recent experience of homelessness died during this period, according to the report. The analysis also revealed that 598 persons with recent experience of homelessness, but with unknown housing status at the time of death, died. While the report spans 2020, only six COVID-19-related deaths were confirmed.

Other key findings from the report include:   

• 77% of homeless deaths occurred among men, and 23% were women. 

• 66% of homeless deaths occurred in non-medical settings - streets, sidewalks, parks, vehicles, shelters, encampments, railroads, transit, motel, and other locations.  

• 50% of homeless deaths were due to acute/chronic medical conditions, led by heart and cardiovascular disease, cancer, liver disease, cerebrovascular disease, respiratory disease, and others. 

• 41% of total homeless deaths were African American/Black persons. 

• 34% of deaths occurred in medical facilities such as hospitals, nursing facilities, or in jail. 

• 23% of deaths were due to drug overdose.

“This sobering report confirms the magnitude of the health impacts and other challenges people face when homeless,” said Kerry Abbott, Director, HCSA’s Office of Homeless Care and Coordination. “In conjunction with the recent Point-in-Time Count, it will inform our work and our efforts to reduce premature deaths among unhoused residents.”

To obtain the count, the team gathered data from the Alameda County Medical Examiner’s Office and the County Coroner’s Office and matched it against the death certificate records in the California Electronic Death Registration System.

The report recommends establishing a countywide Homeless Mortality Task Force to regularly review and analyze homeless mortality data, trends, and cases, and make recommendations to county leaders. The report also suggests continuous improvement of data collection, especially regarding overdose data and associated toxicology reporting.