Big Spike in OC Homeless Deaths Alarms Advocates

The number of deaths among Orange County’s homeless population has skyrocketed over the past decade, driven largely by a surge in fatal overdoses, according to a Voice of OC analysis of county Sheriff-Coroner data.

From 2005 through the end of 2015, the annual number of homeless deaths in the county tripled — going from 53 per year to 164, the data show.

And most of this startling jump in deaths occurred while the number of homeless  has actually gone down in recent years, according to county estimates based largely on homeless counts.

Homeless deaths jump

The spike in deaths has been driven mainly by drug and alcohol overdoses, which grew nearly fivefold from 2005 through 2014 and accounted for nearly two-thirds of the increase. In 2005, nine homeless people died from overdoses — a decade later the number had climbed to 43, the data show.

Homeless overdose deaths

Beyond overdoses, the data show significant increases in homeless people dying from chronic diseases, homicide and being hit by a car or train.

Homeless cause of death increases

(Click here for the full coroner’s dataset in Excel format.)

Altogether, Orange County saw a 209 percent increase in homeless deaths.

But during the same period, homeless deaths in neighboring San Diego County – which has about the same population as OC – only went up 25 percent.

Advocates for homeless people call the Orange County numbers alarming and unacceptable.

“I think we’ve done a fairly tragic job of seeing to the health of the homeless,” said Dwight Smith, who runs Isaiah House, a home for homeless staffed by Catholic Worker volunteers.

Paul Leon, CEO of the Illumination Foundation, an Irvine-based homeless services organization, said the increases in deaths are yet another indicator of how much further the county still has to go to address chronic homelessness.

“Access to care is still not available for this population,” Leon said. “There [are] not enough mental health programs, [and there are] definitely not enough substance abuse programs to direct the individuals that really need the help.”

Orange County remains one of the few large metropolitan areas nationwide without a permanent year-round homeless shelter. And though there has been progress on that front, with county supervisors last year buying a shelter site in Anaheim, officials continue to be criticized for what critics say is a largely passive and fractured approach to the problem.

Most recently, homeless advocates sharply criticized county leaders for failing to follow through on promises to provide extra shelter beds for homeless people during El Niño storms.

The advocates acknowledge that not all of the health problems of homeless people can be addressed, especially when it comes to issues like drug overdoses, which have also become an epidemic in the general population.

The county saw a 61-percent increase in overall overdose deaths between 2000 and 2012, which mirrored a nationwide trend. Growing addiction to prescription painkillers and heroin has driven much of the increase.

But even in the face of such daunting odds, significant progress can be made, Leon said.

“We probably can’t get them [all] in time,” Leon said, referring to homeless drug users. “But I bet ya a lot of them — with little bit of effort — their lives could have been saved.”

As an example of the kind of innovative approaches needed, Leon said his group received a grant to find the most frequent and costly homeless hospital users and offer them housing and support services for two years.

The program cost about $700,000 but saved $35 million, Leon said. And of the 36 people placed in permanent housing, 35 are still there, he added.

Orange County Health Care Agency officials declined to be interviewed for this article. Instead, they addressed questions through an emailed statement.

The statement listed their recent efforts, which include assigning two full-time staff members to do mental health outreach to homeless people in the Civic Center, buying an emergency shelter site in Anaheim, and improving social services outreach.

Health Care Agency Director Mark Refowitz also pointed to Leon’s Illumination foundation as having provided “some critical successes of recuperative care.”

(Click here for the county’s statement.)

As for what’s driving the increase in homeless deaths, the county’s current homelessness chief, Karen Roper, had no answers.

“It is difficult to comment on the data and the conclusions for a couple of reasons: 1) I do not know the causes of death; 2) I am not a doctor or nurse that could give a qualified opinion on causes of death even if I had the cause of death information,” Roper, who serves as executive director of OC Community Resources, said in the county statement.

Roper is apparently unaware that the data, which is made publicly available by coroner’s office, includes detailed information on the causes of death. 

County supervisors Lisa Bartlett, Andrew Do, Todd Spitzer, Shawn Nelson, and Michelle Steel also did not respond to interview requests made through a county spokeswoman.

Advocates say it’s critical for supervisors to learn as much as they can about the issue, and for their constituents to keep the pressure on.

“I would challenge any of the Board of Supervisors to go out” in the field and ask tough questions, said Leon, who said he would join them.

Successful examples of programs, advocates said, can be found in UtahPhiladelphia, and San Diego County.

They also said a good starting place for the county would be analyzing the deaths data, with an example being this report by the city of Philadelphia. County officials said they had not yet done an analysis, but that one is in the works.

“I think that would be very important for the county to analyze this data, to determine the reasons for the increase in the risk for mortality for people who are homeless, and to implement interventions to” reduce that risk, said Eve Garrow of the ACLU of Southern California.

How we treat homeless people also speaks to what kind of community we want to live in, she added.

“What are we doing? People are living out on the streets and people are dying out on the streets,” Garrow said. “Is this the society we want to have?”

Update (Feb. 4 at 4:47 p.m.): The story has been updated to include death increase figures for San Diego County.

Nick Gerda covers county government for Voice of OC. He can be reached at

  • Jacki Livingston

    Who wants to know why?????

    Okay, kids, here is the 411. There is a MediCal category known as the 53, and that is for people who are mentally ill and they end up in a facility, then once they are cleaned up, fed and given meds for a few days, they are then released. They are not sent to other programs, or followed up with. Nononono. They are handed a bag, with two weeks worth of their medications, no matter what they are, and then kicked to the curb. I used to have this caseload, so I know. I had files that I never sent to closed cases, because I knew that in a couple of weeks, he would be busted walking naked down the center divider of Harbor Blvd, screaming that he was Elvis, back from the dead. Problem is, the patients take those meds, and they either share them with their buddies to get high, or they sell them to get dope to get high, or they take way too many with a bottle of cheap rock gut booze…to get high. And that, boys and girls, is how it works.

  • LFOldTimer

    Maybe if the Federal government destroyed the poppy fields in Afghanistan instead of looking the other way the quantities of heroin on the US streets would fall precipitiously making is much less readily accessible to the homeless population. Plus, it must be super cheap if homeless people can buy it. Our “War on Drugs” is about as successful as “Changing Hearts and Minds” in Iraq and implementing democracy over there. We killed Saddam who kept the terrorists at bay and now the foreign terrorists have infiltrated and taken over. And people can’t understand why respect for America has plummeted. My heart goes out to all the families of those 5000 brave servicemen who gave their lives for Bush, Cheney and Rumsfeld

    • Paul Lucas

      Very little opium comes to the USA from Afghanistan. The bulk of heroine in the US comes from mexico and South n Central America.

      • LFOldTimer

        Oh, ok. So I guess it’s okay for the Feds to turn a blind eye to the poppy fields in Afghanistan then from the other sides of their mouths declare a shock ‘n awe ‘war on drugs’. ha. And I think more heroin derived from Afghan poppies comes into America than you believe. They say that about 90% of the world’s heroin supply contain the ingredients from the Afghan poppy. Mexico doesn’t produce quality heroin like China White. If drones can find terrorists in Afghanistan don’t you think it would be pretty easy to find opium fields and destroy them? Opium crops are pretty hard to hide from air surveillance. Then why is the poppy industry thriving in Afghanistan? hmmm? Think about it. I think much more heroin derived from the Afhan poppy plants makes it to the US streets than what you suspect. A good heroin junkie much prefers the white stuff from the east as opposed to the black tar from down south. Do your research.

        • Paul Lucas

          Our troops actually protect opium fields in Afghanistan. Have done so since we invaded. The opium industry in Afghanistan dates back thousands of years. The Soldiers protect the opium fields to keep the peace in Afghanistan. They both turn a blind eye to the opium trade as well as participate in it to raise revenue for black ops. The only place where opium is grown legally for the medicinal market is in India which has been the sole producer of opium for medications since the Opium wars between China and England.

          • LFOldTimer

            Oh, so if you sell pot on a US streetcorner you go to jail for a couple years. But if you own a poppy farm in Afghanistan which produces enough opium to make tons of heroin that kills thousands of users our troops protect your crop. I get it. How’s that ‘war on drugs’ working out, btw? Why even station DEA over there if we protect the poppy fields? ha. The agents signed up to stop drug trafficking, not to protect and promote it! It’s getting to the point that it’s getting practicallly impossible to differentiate between the good guys from the bad guys anymore. No wonder the Nation is getting flushed. Stop the world! I want to get off! Oh, thanks for the history lesson, btw…as if that justifies it! ha.

          • Paul Lucas

            the DEA facilitates the sales of opium to make revenue for the intelligence agencies. They’ve been doing that since before 9-11 and invading that place.

          • LFOldTimer

            It’s a completely different world from the one I remember. Now instead of being sworn to the US Constitution government officials are sworn to the ones who run their agencies. No idea how they sleep at night. More symptoms of a dying empire.

  • Paul Lucas

    The people who directly and intentionally created the epidemic of opiate addiction, now heroine addiction Purdue Pharm; and others in the legislature such as Lou Correa are the same people who have stood in the way of full legalization of medicinal cannabis. Thanks Lou!!