There is no war in the United States but Report shows “a wartime death toll”.

On public benches, next to bike routes, under freeway overpasses, and even on the beach.

Public benches, bike paths, and freeway overpasses were all places where their bodies were found.

Last year, the unsheltered died in historic numbers in Los Angeles County, with an average of five deaths per day, most of them in full view of the public.

According to records from the county coroner, 287 homeless persons died on the sidewalk, 24 perished in alleys, and 72 were discovered on the pavement. They were a small part of the thousands of homeless persons who die each year across the country.

“It’s like a wartime death toll in places where there is no war,” says Maria Raven, co-author of a study about homeless deaths.

As the homeless population has aged and the cumulative toll of living and sleeping outside has shortened lives, an epidemic of deaths on the streets of American cities has escalated. The increased availability of fentanyl, a particularly fast-acting and lethal substance, has contributed to the rising death toll, but many homeless people are dying young from curable chronic conditions such as heart disease.

Being homeless in America has become more dangerous than ever, particularly for males in their 50s and 60s, who normally make up the largest cohort of despair. During the pandemic, the number of homeless deaths in many cities increased, at a time when getting medical help grew more difficult, housing expenses continued to rise, and public health officials were focused with fighting the coronavirus.

Officials and homeless groups in places such as Austin, Denver, Indianapolis, Nashville, and Salt Lake City have expressed concern about the increased number of deaths.

However, the problem is most acute in California, where one in every four of the country’s 500,000 homeless individuals lives.

The procedure of counting homeless fatalities is time-consuming and involves cross-referencing homeless databases and death reports. Experts say 4,800 is a low estimate for last year based on statistics from the handful of California’s 58 counties that report homeless deaths.

Between 2015 and 2020, the homeless population in Los Angeles County increased by 50%. Deaths among the homeless have increased at a much quicker rate, with about 2,000 deaths in the county last year, an increase of nearly 200 percent over the previous year.

In rare situations, bodies go uncovered for hours. Despite attempts to contact family members, others remain unclaimed at the morgue. The body of a homeless man who died on a road median last spring lingered for more than 12 hours before being collected in San Francisco, where people sleep in cardboard boxes, tents, and other improvised shelters. A cardboard sign left at the scene read, “Guy lay dead here & no one noticed.”

Homeless persons are 35 times more likely than the average population to die from a drug or alcohol overdose, according to research by the Los Angeles County Department of Public Health. They are also four times more likely to die from heart disease, sixteen times more likely to die in a car accident, fourteen times more likely to be murdered, and eight times more likely to commit suicide.

California has put record amounts of money into combatting homelessness, thanks to pandemic budget surpluses. Last year, Governor Gavin Newsom unveiled a $12 billion homelessness package, which included funding to build 42,000 additional housing units.

In 2017, Los Angeles County residents decisively approved a sales tax increase that will produce $3.5 billion over ten years for homelessness initiatives. Since then, the county has grown to accommodate 78,000 inhabitants.

Despite this, county officials claim they are unable to keep up: while 207 homeless persons find shelter every day, the county estimates that 227 people become homeless every day.

Mental health, drug misuse, and general medical well-being can all spiral out of control once on the street. David Modersbach, who led the first public study of homeless deaths in Alameda County across the Bay from San Francisco expressed surprise at the number of homeless persons dying of diseases outside of hospitals or other medical facilities.

“To die of heart disease, liver disease, respiratory diseases — on your own — is pretty shocking,” he said.

According to the report, one-quarter of the 809 homeless deaths in Alameda County between 2018 and 2020 were due to drug overdoses, half were due to heart attacks, cancer, strokes, and chronic illnesses, and the remainder were due to accidents, suicides, and homicides. Last year, at least three homeless people in Sacramento County died from exposure.

The graying of the homeless is a significant characteristic among today’s homeless population.

The average age of homeless people in the San Francisco Bay Area has risen from the mid-30s three decades ago to the mid-50s now, according to Margot Kushel, a doctor specializing in homeless care.

But, she added, that increase in age does not convey the whole picture of their vulnerability. Geriatric symptoms are common among homeless persons in their 50s, including difficulty dressing and bathing, vision and hearing issues, and urinary incontinence.

“Poverty is very wearing on the body,” Dr. Kushel says. “Fifty is the new 75.”

Almost a fourth of the homeless people she studied nine years ago are no longer alive. The typical age of death was 63, far below the 77-year average in the United States.

Homeless deaths are overwhelmingly among men in California, particularly Black men, who are dying on the streets at rates significantly higher than their proportion of the overall population. Men make up 67 percent of the homeless population in Los Angeles County, but 83 percent of homeless deaths. Men in their 50s have the greatest rate of overdose deaths among all age groups in San Francisco.

The subject of mortality and despair among older men, according to Keith Humphreys, a Stanford psychologist, is undervalued and understudied.

Men’s remains go unclaimed at the morgue at twice the rate of women’s, according to Pamela Prickett, a sociologist who has researched death records in Los Angeles. Men in their 40s and 50s have the greatest rates of unclaimed bodies, which have been rising since the 1970s.

“There are more people not getting married or getting divorced and not getting remarried,” Ms. Prickett adds. “So we find lots of loners.”

The US surgeon general, Vivek Murthy, said he had noticed a pattern of men being unprepared to deal with “triggers” in life such as illness and losing a job or a marriage.

“As men get older they tend to be less good at building and maintaining relationships,” he explains. “When people do not have a safety net to catch them in the form of community and strong healthy relationships, it’s much more likely they end up struggling with substance use disorders, with mental illness and homelessness.”

Image Credit: Getty

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