A record 199 unhoused residents died in Sacramento County in 2021, up significantly from 137 the previous year, according to a report published on Monday.
Advocates said the findings in the Sacramento County 2022 Homeless Deaths Report should be a call to action for greater housing and health care options for the thousands of people countywide who live in tents, vehicles, shelters or on sidewalks and face a greater risk of premature death due to a lack of permanent housing.
“Many of these deaths would be preventable if there were the shelter, the affordable housing or treatment on demand,” said Bob Erlenbusch, executive director of the Sacramento Regional Coalition to End Homelessness, which publishes the annual findings.
The report found the leading cause of death was substance use disorder, which led to 49% of the fatalities, with methamphetamines playing a role in most of them. The second leading cause was injuries, from blunt force trauma to stabbings to gunshots, resulting in nearly 21% of the deaths.
Cardiovascular disease led to 6.5% of the total deaths, while COVID-19 killed 1.5%, according to the report, which is based on data from the Sacramento County Coroner’s Office.
Less than one fifth of the deaths were from natural causes, the report found.
Meanwhile, there were eight deaths from hypothermia in 2021, “more than all the cases of hypothermia from the previous 19 years combined,” according to the report. No deaths were linked to heat exposure last year.
Anthony Menacho, executive director of the nonprofit Sacramento Street Medicine, said the high number of fatalities shows Sacramento needs more resources from accessible cooling and warming centers to greater substance use services and housing.
“Any life, regardless of health insurance status or living status, is just as meaningful and precious as any other,” Menacho said. “And I think, most importantly for us, housing is health care.”
In response to the report, Janna Haynes, a county spokesperson, cited a recent news release that details the $181 million the county is spending annually on current and new programs “to mitigate the impacts of homelessness.” Those range from two new tiny home villages approved this summer in South Sacramento to spending $10 million to procure an additional 156 beds for substance use disorder residential treatment.
“The solutions to end homelessness are complicated and multi-faceted, and there is no ‘one size fits all,’" the county news release said, “but through the hard work and dedication of the County, our cities and our partners, we are committed to work with compassion and urgency to decrease deaths in our homeless population.”
In a written statement, Sacramento Mayor Darrell Steinberg said the report demonstrates “the urgent and critical need for a city county partnership.”
“Increased outreach to people and much greater access to not only housing, but mental health and substance abuse treatment is the only way we will address this crisis,” Steinberg added.
The City Council in August 2021 passed a comprehensive plan to establish homeless shelters and city-sanctioned camping and parking locations for unhoused people. A handful of sites have opened, though bureaucratic red tape and community opposition have stalled most potential sites, city officials and advocates have said.
The increase in homeless deaths took place as homelessness surged in Sacramento County, jumping 67% over the past three years to nearly 9,300 people, according to the 2022 Homeless Point-In-Time Count.
Pandemic contributes to unhoused deaths
Sacramento County wasn’t the only place to see a large rise in homeless deaths over the past year. San Francisco, Oakland and other communities across the United States saw similar increases, at least partly due to the COVID-19 pandemic’s strain on medical services, said Margot Kushel, who directs UC San Francisco’s Benioff Homelessness and Housing Initiative, which conducts research on homelessness.
With medical staff so overwhelmed with caring for COVID-19 patients, Kushel said there was “a dramatic decrease in access to and use of other health care services” for both housed and unhoused residents.
“This was definitely true with things like substance use treatment, mental health treatment, as well as all forms of primary care and emergency care,” she added. “People avoided the emergency department for fear of catching COVID.”
The Sacramento County homeless deaths report also includes demographic details and information on how homeless individuals died.
It showed Black residents continue to be overrepresented, accounting for 21.6% of homeless deaths despite making up only 11% of the county’s overall population.
Notably, most homeless people died far earlier than the average life expectancy, which was 76.1 years in the United States in 2021. The average age of homeless women who died was 48.2 years and 51.4 for homeless men, the report said.
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