Utah releases first-ever report on homeless mortality, recommendations for saving lives

SALT LAKE CITY — The Utah Department of Health and Human Services released a one-year summary of mortality among people experiencing homelessness in Utah — the first official report of its kind for the state.

The report shows that in 2023 there were 216 deaths of people experiencing homelessness and 21,816 deaths recorded in Utah’s general population. When compared to the general population, those experiencing homelessness had 10 times the rate of death and were found to die, on average, 16 years younger.

A lack of national review or standardized data collection for homeless mortality has created a barrier in calculating the extent that those experiencing homelessness are dying. The National Homeless Health Care Council identified 68 cities and counties that recorded the deaths of people experiencing homelessness in 2018, with 68 jurisdictions that found at least 5,807 people without homes who died that year. Using rough estimates and the proportions from 27 cities to the national Point In Time count, the council estimated that between 17,500 and 46,500 homeless deaths occurred in 2018.

Nationally, the deaths of those experiencing homelessness are often recognized in an annual Homeless Persons Memorial Vigil usually held on the longest night of the year — the winter solstice. Previous vigils held by Salt Lake City recorded 73 deaths in 2023, 159 deaths in 2022 and 117 in 2021. The names gathered and read during the community vigil are often contributed by service providers, advocates and the public.

Information regarding the mortality rate of those experiencing homelessness in Utah has been continuously raised. The report was created, in part, because “homeless service providers, homeless advocates, media partners and Utah’s continuums of care continue to request information about mortality within Utah’s people experiencing homelessness,” it states.

In September 2022, the Utah Office of Vital Records and Statistics added a question on whether an individual was experiencing homelessness at the time of their death to gather data for the report. The report collected responses from Jan. 1-Dec. 31, 2023, and was adjusted further using 2023 Point In Time count data and 2022 American Community Survey U.S. Census Bureau data.

“We hope that by producing this report, those who requested to know more about mortality in people experiencing homelessness in Utah will begin to have their questions answered, and policymakers and service providers can use this as a tool when they want to make informed, data-driven decisions. We also hope and intend this report will honor those who passed away by bringing awareness of their deaths through the data we have collected and analyzed,” the authors wrote.

Key highlights in the report include:

• People experiencing homelessness are disproportionately affected by the nation’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.
• 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 aged 35–44 had a higher rate of death than those in the general population who were older than age 65. The mean age of death among people experiencing homelessness was 56 years of age.
• Accidents, suicides, and homicides made up a much larger percentage of deaths in people experiencing homelessness (50%) compared to the general population (11%).
• The highest mortality rates for people experiencing homelessness were among Tooele, Utah, Salt Lake and Weber counties.

Tyler Riedesel, report author and epidemiologist, called the numbers “sobering” and many of the deaths “preventable.” He added that the report served “as a good benchmark” as efforts to address the homelessness crisis in Utah move forward.

Recommendations made in the report for policymakers and service providers include:

• Supporting the development of low-barrier housing options for those experiencing homelessness, including medical respite care and housing with wraparound services and case management.
• Supporting low-barrier primary health care and substance-use treatment service options that are skilled in serving not only the general population but also those who are experiencing homelessness to make sure all Utahns have access to treatment.
• Convening an advisory group of health care funders and providers, managed care plans and stakeholders to evaluate and fund best practices in delivering health care to people experiencing homelessness in urban, suburban and rural communities.
• Improving collaboration between organizations that provide harm-reduction services and homeless services to improve access to naloxone, fentanyl and xylazine test strips, syringe services, and other lifesaving harm reduction tools.
• Establishing a homelessness mortality review process to better understand the circumstances that contribute to these deaths and identify strategies to prevent further fatalities.