Utah’s homeless dying 10 times the rate of state’s general population

People hang out outside St. Vincent de Paul Dining Hall, which offers meals to people in need, especially those experiencing homelessness, in Salt Lake City on Saturday, May 25, 2024. (Photo by Spenser Heaps for Utah News Dispatch)

In 2023, 216 people died while homeless in Utah.

Out of 21,816 deaths reported in the state that year, people experiencing homelessness in Utah had 10 times the rate of death compared to the rest of Utah’s population. And, on average, Utah’s homeless died 16 years younger.

Those are some of the top takeaways from a new report released by the Utah Department of Health and Human Services. The homeless mortality report is the first of its kind — after the state, in late 2022, only began collecting through vital statistics records whether a Utahn was experiencing homelessness at their time of death.

Previously, heartfelt candlelight vigils held in Utah’s dark winter months would make an effort to track and grieve deaths in the state’s homeless community. Those vigils grieved 74 in 2023 , 159 in 2022 , and 117 in 2021 .

While those vigils helped highlight the issue and create a space for community grieving, there’s now a more scientific effort underway to track deaths of Utah’s most vulnerable. And the first year of available data show there were many more falling through the cracks.

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“We hope this report honors those who died while experiencing homelessness by raising awareness of their tragic loss of life,” authors of the report wrote. “We also intend that this report will provide data to inform policy and service provider programs on how to improve the health of those experiencing homelessness.”

The report was written by state epidemiologist Leisha Nolen, housing insecure populations epidemiologist Tyler Riedesel, and deputy state epidemiologist Amanda Smith. Their aim was to better understand leading causes of death for Utah’s homeless populations.

The report found:

• The mean age of death among people experiencing homelessness was 56 years of age, compared to 72 years of age in the general population.
• People experiencing homelessness age 35 to 44 had a higher rate of death than those in the general population who were older than age 65.
• Accidents, suicides and homicides made up a much larger percentage of deaths in people experiencing homelessness (50%) compared to the general population (11%).
• Chronic diseases such as heart disease, diabetes, and pulmonary disease were a leading cause of death for both people experiencing homelessness and those in the general population. However, chronic disease accounted for 33% of deaths among people experiencing homelessness compared to 59% of deaths in the general population.
• People experiencing homelessness are disproportionately affected by the country’s substance use epidemic. Substance use related deaths, which were mostly accidental, accounted for 35% of deaths in people experiencing homelessness compared to only 5% of deaths in the general population.

The report also listed a variety of policy suggestions to help prevent deaths among Utah’s homeless, including:

• Support developing more “low barrier” housing options for those experiencing homelessness, or housing that’s easily accessible. That housing, the report notes, “should include medical respite care and housing that includes wraparound services and case management.”
• Make sure all Utahns have access to medical treatment by supporting “low barrier primary healthcare and substance use treatment service options that are skilled in serving not only the general population but those who are experiencing homelessness.”
• Create an advisory group of “healthcare funders and providers, managed care plans, and stakeholders to evaluate and fund best practices in delivering healthcare to people experiencing homelessness in urban, suburban, and rural communities.”
• “Improve collaboration between organizations” focused on harm reduction and homeless services “to better improve access to naloxone, fentanyl and xylazine test strips, syringe services, and other life-saving harm reduction tools.”
• “Establish a homelessness mortality review process to better understand the circumstances that contribute to these deaths and identify strategies to prevent further fatalities.”

Most of these deaths are “preventable,” Riedesel told Utah News Dispatch on Friday.

The report’s findings weren’t necessarily surprising, he said, but the 16-year age disparity for the average age of death for someone experiencing homelessness compared to the rest of the state’s population was eyebrow raising.

“It was more extreme than I thought we would find,” he said.

In September 2022, the Utah Department of Health and Human Services’ Office of Vital Records and Statistics added a question to vital statistics records that funeral homes and death investigators at medical examiners offices fill out for every death they record. That checkbox simply asks whether someone was experiencing homelessness at the time of their death.

Now, after the first full year of that information being collected, Riedesel said the data will help shed more light on the challenges and dangers people experiencing homelessness face – as well as help inform policy decisions.

“This is game changing for understanding health in people experiencing homelessness,” he said.

Because health care systems don’t track health data on people experiencing homelessness in a standardized way, evaluating their health has been “hard,” he said.

“But this is our first step,” he said. “Mortality is a good baseline for people’s health, and we’ll go from there.”

In the future, Riedesel said state officials plan to suggest a standardized definition of homelessness that the broader healthcare system can use “so we can start to get more robust data, not only around mortality but around health.”

Riedesel and Nolen were slated to present the report’s findings to the Utah Homeless Services Board on Thursday, but the board fell behind schedule and delayed the briefing until its next meeting in September.

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