LA County Just Proved Harm Reduction Saves Lives. Now Funding Is Being Cut.
Article excerpt
LA County's homeless mortality rate dropped 10% in 2023-2024, the first decline in a decade, driven largely by harm-reduction programs that provide services like needle exchanges and addiction support. Yet the county is now slashing funding for these same initiatives, threatening to reverse the gains. Public Health Department data shows the programs work, but budget pressures are forcing cuts to the very interventions credited with saving lives.
For the First Time in 10 Years, the Homeless Mortality Rate Dropped in LA County, Driven by Programs Now on the Chopping Block
Department of Public Health data from 2023 and 2024 show a 10% decrease in the mortality rate for LA County’s homeless residents. That’s a difference of about 300 lives. In the 10 years that this data has been recorded, this is the first time it has ever decreased.
This is a welcome shift, though the numbers have still not returned to their pre-pandemic levels, and looming funding cuts threaten to reverse all the progress that’s been made.
Baseline Homeless Mortality Rate is Far Higher Than the General Population
Even with this decrease, the mortality rate for homeless people in Los Angeles County is more than 4 times higher than it is for the general population. The overall mortality rate in Los Angeles County is 509 out of every 100,000. The mortality rate for homeless people specifically is 2,163 out of every 100,000.
In total, 2,208 deaths of unhoused people were recorded in the county in 2024, averaging out to about 6 homeless Angelinos losing their lives each day of the year.
It goes without saying that homelessness is hard on a person. One extremely telling statistic is that the rate of suicide is 13 times higher in the unhoused population than in the general population. It’s taxing both physically and mentally, and leaves people vulnerable to the extremes of climate and criminalization.
Homelessness can leave people isolated and unable to access healthcare in a timely manner, if at all. It’s no wonder, then, that homeless people across the country face a 60% higher mortality rate than people living in poverty, but with access to stable housing.
The report indicates that the leading causes of death among Los Angeles County’s homeless population were drug overdose (40%), coronary heart disease (14%), traffic injuries and other transportation-related deaths (11%), homicide (5%), and suicide (4%). In the traffic injury category, 95% of all deaths recorded occurred among pedestrians and cyclists.
Mortality from drug overdose, coronary heart disease, and homicide all decreased in 2024, while deaths from traffic injuries and suicide both increased slightly. Overdose deaths in particular saw a significant reduction, falling from 45% in the 2023 numbers down to 40% in 2024.
The decrease was seen across all age groups except those 65 and older, with the greatest decreases occurring in the 18- to 24-year-old age group.
Will This Trend Continue?
In the 2 years before the 2024 data was taken, the mortality rate was still increasing, but much more slowly when compared to the explosive 56% growth seen over the course of the 2 years before that. The 20% decrease that’s showing up in the data now is the welcome culmination of the efforts of many different people and organizations. However, it could become just a blip on the radar if the services that are saving people’s lives are disrupted by funding cuts.
County health officials have credited the decrease to the county’s improved approach to providing overdose prevention services as well as mental health and substance use treatment programs. These services, particularly those with a harm reductionist approach, are the same ones that are under heavy scrutiny in the current political environment and likely to face cuts. The report states that there is already a projected $323 million funding gap for the 2026/27 fiscal year. How many more lost lives will that translate to?
“Housing paired with the services people need saves lives. This report shows that when communities invest in prevention, housing, health care, and compassionate outreach, real progress is possible,” said Second District Supervisor Holly J. Mitchell.
“While the decline in deaths among people experiencing homelessness is encouraging, our work is far from over,” Mitchell continued. “Now is not the time for the federal government to disinvest from proven strategies that help end homelessness. We must continue strengthening collaboration, protecting critical funding, and expanding services to prevent people from perishing on our streets and to ensure everyone has the support they need to find and maintain stable housing.”
When We Know How to Save Lives, Cutting Funding is More Than a Budget Matter
During the same time period this data covers, there was a 21% reduction in the number of deaths attributed to drugs and alcohol. Since overdose is the leading cause of death in this community, accounting for 40% of all deaths in the report, this is an extremely significant difference.
Harm reduction strategies are largely to thank for this marked decrease, and they’re also the homeless services most frequently on the chopping block due to political posturing. The thing is, when we see results like this stemming from harm reduction programs, we’ve proven that they work. Cutting funding to them isn’t a neutral budget move or a difference of opinion, it’s a targeted action that will lead to more deaths of unhoused people.
When politicians pull funding from overdose prevention services and harm reduction centers, they’re voting for more dead homeless people. And most of the time, they try to pretend they’re taking the moral high ground for doing so.
We need to recognize what’s really at stake in these political conversations that are dressed up as boring budget meetings. These programs save lives, and not having access to them will cost people their lives when they never needed to lose them. If it weren’t for a few seemingly innocuous line items on the fiscal agenda, they could have been saved.
“Six lives lost every day is not just a statistic, it’s a heartbreak. While I’m encouraged to see a reduction in deaths for the first time in years, we cannot accept a reality where people are dying on our streets,” said Third District Supervisor Lindsey P. Horvath. “This progress shows that prevention, housing, and services work. As federal and state funding cuts loom, we must be more coordinated and innovative than ever, stretching every dollar to protect lives and accelerate progress.”