In US cities, growing number of lone deaths on the streets – Baltimore Sun

SANTA MONICA, Calif. — Their bodies were found on park benches, lying next to bike paths, crumpled under freeway overpasses and washed up on the sunny beach. Across Los Angeles County last year, homeless people died in record numbers, an average of five homeless deaths a day, most in full view of the world around them.

Two hundred and eighty-seven homeless people breathed their last on the sidewalk, 24 died in the alleys and 72 were found on the sidewalk, according to county coroner data. They represented a small fraction of the thousands of homeless people across the country who die each year.

“It’s like a wartime death toll in places where there’s no war,” said Maria Raven, an emergency physician in San Francisco who co-authored a study of the deaths of sans -shelter.

An epidemic of deaths on the streets of American cities has accelerated as the homeless population has aged and the cumulative number of living and sleeping outdoors has shortened life. The greater availability of fentanyl, a particularly fast-acting and dangerous drug, has been a major cause of the rising death toll, but many homeless people are dying young from chronic, treatable conditions such as heart disease.

Homelessness in America has become more deadly than ever, especially for men in their 50s and 60s, who typically make up the largest cohort of desperation. In many cities, the number of homeless deaths doubled during the pandemic, at a time when seeking medical care became more difficult, housing costs continued to rise and public health authorities were concerned. in the fight against the coronavirus.

Austin, Texas. Denver. Indianapolis. Nashville, Tennessee. Salt Lake City. These are some of the cities where officials and homeless advocates have said they are alarmed by the rising death toll.

But the crisis is most acute in California, where about 1 in 4 of the nation’s 500,000 homeless people live.

The process of counting homeless deaths is laborious, involving the cross-checking of homeless databases and death reports. But based on data from the handful of California’s 58 counties that report homeless deaths, experts said 4,800 is a conservative estimate for the past year.

In Los Angeles County, the homeless population increased by 50% between 2015 and 2020. Homeless deaths increased at a much faster rate, an increase of approximately 200% over the same period to reach nearly 2,000 deaths in the county last year.

“These are deeply lonely deaths,” said David Modersbach, who led the first public study of homeless deaths in Alameda County, across the San Francisco Bay.

In some cases, bodies go undiscovered for hours. Others are not claimed at the morgue despite efforts to reach family members. In San Francisco, where people sleeping in boxes, tents and other makeshift shelters are commonplace, the body of a homeless man who died on a median last spring lay there for more than 12 hours before being recovered. “The guy died here and no one noticed,” said a cardboard sign left at the scene.

Rough sleepers talk about the wear and tear it puts on the body, several untreated illnesses, and the loneliness of being surrounded by pedestrians who ignore you.

Billy, a metalworker and carpenter from New Jersey who now sleeps in the narrow lanes behind Venice Beach in Los Angeles, constantly feels the reminders of his previous jobs. At 50, he suffers from chronic pain following an accident while pruning trees, which he treats with a giant bottle of Aleve that he keeps in his backpack.

He overdosed on heroin twice, woke up both times with naloxone, and saw his friends disappear around him.

“I can name 30 or 40 people who died from overdoses, and most of them were part of my demographics,” said Billy, who didn’t want his last name released because he said it would. would embarrass her three adult children.

A Los Angeles County Department of Public Health study found that homeless people are 35 times more likely than the general population to die from a drug or alcohol overdose. They are also four times more likely to die of heart disease, 16 times more likely to die in a car accident, 14 times more likely to be murdered and eight times more likely to die by suicide.

California, brimming with money from pandemic budget surpluses, has poured record sums into the fight against homelessness. Governor Gavin Newsom announced a $12 billion homelessness program last year, which included funds to build 42,000 new homes.

Los Angeles County in 2017 voted overwhelmingly to increase its sales tax and generate a projected $3.5 billion over 10 years for homelessness programs. Since then, the county has housed 78,000 people.

Still, county officials say they can’t keep up: Although 207 homeless people find housing every day, 227 people become homeless every day, according to county calculations.

And once on the streets, mental health, addictions, and general medical well-being can spin out of control. Modersbach said he was struck by the number of homeless people dying of illnesses outside of hospitals or other clinical settings.

“Dying of heart disease, liver disease, respiratory disease – all by yourself – is quite shocking,” he said.

According to the study, of the 809 homeless deaths from 2018 to 2020 in Alameda County, a quarter were due to drug overdoses; half were from heart attacks, cancers, strokes and chronic diseases; and the rest came from accidents, suicides and homicides. In Sacramento County, at least three homeless people froze to death last year.

A key distinction among the homeless population today is the aging destitute.

Margot Kushel, a physician who specializes in homeless care, has tracked the rise in the average age of homeless people in the San Francisco Bay Area, from 30s three decades ago to 50s today. today.

But even this increase in age doesn’t tell the whole story of their vulnerability, she said. Homeless people in their 50s have geriatric symptoms: difficulty dressing and bathing, visual and hearing problems, urinary incontinence.

“Poverty is very tiring on the body,” Kushel said. “Fifty is the new 75.”

A quarter of the homeless people she started studying nine years ago have now died. The median age of death was 63, well below the average US life expectancy of 77.

Across California, homeless deaths are overwhelmingly male, and in particular black males who die on the streets at rates far out of proportion to their share of the general population. In Los Angeles County, men make up 67% of the homeless population but 83% of homeless deaths. In San Francisco, men in their 50s have the highest rates of overdose deaths among all age deciles.

Keith Humphreys, a Stanford psychologist, said the issue of death and despair in older men has been underestimated and understudied. He said society should ask itself the question: “Can we help men not to die so much?”

David Brown, 59, a former bus driver and fast food worker in San Francisco, currently enrolled in a rehabilitation program with the Salvation Army, describes the circumstances that left him on the street as the accumulation of misfortunes of a life. The knee problems from cramming his tall frame into the bus driver’s seat. Type 2 diabetes. The prison sentences he served for burglary. A lifelong struggle with alcoholism and drug addiction.

So many friends died in shootings during the crack epidemic in the 1980s and overdoses on the streets that he feels completely helpless.

“I don’t have anyone in my life,” he said.

Pamela Prickett, a sociologist who has studied death records in Los Angeles, said one measure of men’s isolation is that men’s bodies are not being claimed from the morgue at twice the rate of women. Unclaimed body rates, which have been rising since the 1970s, are highest among men in their 40s and 50s.

“There are more people who don’t marry or who divorce and don’t remarry,” Prickett said. “So we find a lot of loners.”

US Surgeon General Vivek Murthy said he’s seen a pattern of men ill-equipped to deal with life’s “triggers” such as illness and the loss of a job or spouse.

“As men get older, they tend to be less good at forming and maintaining relationships,” he said. “When people don’t have a safety net to catch them in the form of community and strong healthy relationships, they’re much more likely to end up battling substance use disorders, with mental illness and homelessness.”

Ivan Perez, 53, is a philosopher about what derailed his life. His wife’s miscarriage and their marriage falling apart. A marijuana habit that sank his career as a stockbroker. A prison sentence for an assault while he was stoned. Gambling.

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“Being alone, you kind of have no excuse to say it’s my wife’s fault, it’s my mom’s fault, it’s society’s fault,” Perez said.

For the past few months, he has been sleeping rough in a tent near the North Hollywood subway station. The soundtrack to his life, he said, is the whistle of trucks passing by his tent and the swoosh of street cleaners.

“There’s a certain posture you take when you’re homeless,” he said. “You lose your dignity.”

His goal, he says, was to live as long as his father, who died at 54½. It’s not far.

Perez recalled the hopes he had when he was younger of becoming an actor or playwright.

“I tried to do all the right things and it blew up in my face,” he said. “What a bad deal this life turned out to be.”

circa 2022 The New York Times Society

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