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Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Alameda County Homeless Mortality Report
Calendar Year 2024
Executive Summary
A responsible and just community must work to be closely aware of the deaths of all its
members, strive to learn from those deaths and implement policies and practices to
reduce preventable deaths, support equitable and appropriate end-of-life services, and
work to reduce the harm that preventable deaths create for families, friends, caregivers,
and the community. A just community will review places and moments of death to ensure
that people do not die alone and experience death in as peaceful a manner as possible.
Alameda County Health’s Health Care for the Homeless (ACHCH) program and
Community Assessment, Planning, and Evaluation (CAPE) have carried out Alameda
County’s homeless mortality report annually since 2020.
This report for calendar year 2024 is based on identifying homeless deaths through data
matching across County homeless services utilization lists, community and clinical
reporters, and California Comprehensive Death File (CCDF) records in the California Vital
Records Business Information System.
Key Findings in the 2024 Alameda County Homeless Mortality Report
In calendar year 2024, 332 persons were determined to have died in homelessness in
Alameda County. In addition, there were 275 deaths of persons with a recent experience of
homelessness but were housed at the time of their death, and 38 persons with a recent
history of homelessness but whose housing status at the time of death was not possible to
determine.
The number of annual homeless deaths grew considerably between 2018 and 2020 and
continues to remain at a very high level through 2024. Between 2018 and 2024, 2,177
Alameda County residents have died while experiencing homelessness.
Alameda County Homeless Deaths by Homeless Status (2018-2024)
Year homeless at time death, but housed at time of death, but unknown
2018 195 57 190
2019 246 91 198
2020 368 102 211
2021 343 145 162
2022 351 266 95
2023 342 300 101
2024 332 275 38
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Alameda County Homeless Deaths By Housing Status (2018-2024)
2018-2024 Homeless Deaths by Region of Last Residence
Year Berkeley/
Albany
(Hayward, Alameda,
San Leandro,
Oakland/
Emeryville
South County
(Fremont, Union
City, Newark)
(Livermore,
Dublin,
2019 22 62 126 25 11
2020 30 83 211 24 20
2023 29 70 205 27 11
2024 23 78 195 33 3
Total 185 467 1,258 190 77
2024 Homeless Deaths by City of Last Known Residence
City of Last
Known Residence 2018 2019 2020 2021 2022 2023 2024 Total
Oakland 104 127 211 211 206 203 190
Hayward 22 25 37 31 25 27 29
Berkeley 20 20 30 28 32 28 23
Fremont 15 20 17 21 21 19 29
San Leandro 9 11 18 9 9 23 20
Alameda 3 9 11 8 11 9 15 66
195
246
368 343 351 342 332
57
91 102 145
266 300 275
190 198
211
162
95 101
38
0
50
100
150
200
250
300
350
400
2018 2019 2020 2021 2022 2023 2024
Known to be
homeless at time of
death
Homeless within 5
years of death, but
housed at time of
death
Homeless within 5
years of death, but
unknown housing
status at death
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Castro Valley 10 9 8 3 8 9 7 54
Livermore 2 3 9 8 8 8 6 44
Union City 0 3 4 6 6 8 1 28
Newark 3 2 3 7 5 3 23
Pleasanton 2 4 7 5 3 1 1 23
Emeryville 1 4 3 4 4 2 5 23
Dublin 1 3 4 1 2 2 2 15
San Lorenzo 2 0 0 1 4 2 1 10
Albany 1 2 0 0 0 1 0 4
3
47
63 58
87 74
18-24 25-34 35-44 45-54 55-64 65+
Alameda County Homeless
Decendents by Age Group (2024)
Female
67
20%
Male
265
80%
Alameda County Homeless
Decedents by Sex (2024)
2
10
14
14
52
114
126
Pacific Islander
Multiracial
Asian
Unknown/Withheld
Hispanic/Latino/a/x/e
White
African American/Black
Alameda County Homeless
Decedents by Race/Ethnicity (2024)
experiencing homelessness
54 Years
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Mortality rate: The age-adjusted mortality rate for people experiencing homelessness in
Alameda County in 2024 was 2,663 homeless deaths per 100,000, or 5.0 times that of the
general population of Alameda County. For many leading causes of death, mortality rates
continue to be many times higher for people experiencing homelessness than the general
population.
Unattended deaths: Seventy-six percent (252) of homeless deaths took place outside of a
medical setting (e.g., hospital or nursing facility), instead occurring outdoors; on streets or
sidewalks; in shelters, encampments, vehicles; other’s residences; and other locations.
The percentage of unattended deaths continues to grow. Forty-five percent of homeless
acute/chronic disease-related deaths (58 out of 130) occurred in these “unattended”
settings, up 61% from last year.
Disparities by race/ethnicity and gender: African Americans/Blacks account for 41.2% of
deaths among people experiencing homelessness, and 41.3% of the homeless population,
despite making up only 9.1% of Alameda County's general population. Men represent for
80.0% of deaths among people experiencing homelessness and 66.6% of the homeless
population, despite making up only 49.8% of Alameda County's general population. The
median age at death among people experiencing homelessness is 54 years, compared to
75 years in the general population, a difference of 21 years.
41.2%
1.1%
3.2%
15.9%
2.8%0.6%
31.5%
43.0%
1.5%2.7%
19.6%
5.3%
1.6%
26.3%
9.1%
0.3%
34.0%
23.7%
5.3%
0.8%
26.2%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
50%
African
American/
Black
American
Indian/
Alaska Native
Asian Hispanic/
Latino/a/x/e
Multiracial Pacific
Islander
White
Race/Ethnicity Measures of Deaths and Population (2018–2024)
% of Deaths of People Experiencing Homelessness at Time of Death by Race/Ethnicity
% of People Experiencing Homelessness by Race/Ethnicity
% of Alameda County General Population by Race/Ethnicity
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Characteristics of Homeless Deaths in 2024
• Drug overdose: Thirty- eight
percent of all homeless
deaths in 2024 (128) were
directly due to unintentional
or unknown intent drug
overdose (hereafter called
‘drug overdose’). The
number of drug overdoses
among people experiencing
homelessness has
continued to be high. Sixty-
eight percent of drug
overdose deaths took place in outdoor settings. People experiencing homelessness
have 54 times the drug overdose death rate of the general population. People
experiencing homelessness or with a recent history of homelessness comprised 55%
of all overdose deaths in Alameda County in 2024.
• Acute/chronic medical conditions: Thirty-nine percent of the homeless deaths in
2024 (130) were due to acute/chronic medical conditions, led by heart and
cardiovascular disease and followed by cancer, cerebrovascular disease, diabetes,
respiratory disease, liver disease, HIV and others. Forty-five percent of acute/chronic
disease-related deaths were unattended, occurring outside of medical/clinical
settings.
• Accidental injuries (excluding drug overdose) accounted for 28 (8.4%) homeless
deaths, the large majority being pedestrians and cyclists hit by automobiles (13),
followed by falls and struck by trains. Homeless pedestrians/bicyclists are 34 times
more likely to be killed by cars than the general population.
• Homicide accounted for 18 (5.4%) deaths of people experiencing homelessness,
mostly due to shootings and stabbings taking place in the street and outdoors. The
death rate for homicide among people experiencing homelessness is 20 times that of
the general population.
• Suicide: Ten people experiencing homelessness took their own lives in 2024, a rate 10
times that of the general population.
• Shelter residents: Sixty-five persons were known to be residing in homeless shelters at
the time of death in 2024. Fifty-nine percent of them died of acute/chronic diseases,
34% of drug overdoses, and the remaining by suicide, accident, and homicide. The
percentage of shelter overdoses continued to increase from 17% in 2021 to 34% in
2024.
34
62
97 102 110
134 128
2018 2019 2020 2021 2022 2023 2024
Alameda County Homeless
Drug Overdose Deaths (2018-2024)
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
• Encampments: At least 30 people were indicated in death certificates to have died in
homeless encampments in 2024. Eighty-three percent of them died of drug overdoses,
the remaining dying from acute/chronic diseases, homicide, exposure or an accident.
• Vehicle dwellers: At least 24 persons were reported as having died inside their vehicle
of residence in 2024. Of them, 59% died of drug overdoses, 29% of acute/chronic
disease, and the remainder by homicide and accidental injury. An unknown number
died in other locations but may have been living in their vehicle at the time.
• COVID-19: There were no 2024 deaths directly attributed to COVID-19 among people
experiencing homelessness.
• Hospice-eligible deaths: Through chart review of the homeless deaths, ACHCH
determined that at least 61 (18.4%) of all homeless deaths appeared to be “hospice-
eligible” or “expected” deaths due to terminal illness. 45% of all acute/chronic disease
deaths appeared to be “hospice eligible”. Of the 45 “hospice eligible” deaths, 31%
were unattended. Of the 42 “hospice eligible” deaths that occurred in hospital, only
two had chart information indicating that they were receiving palliative or hospice care
services at death.
Alameda County Number of Homeless Deaths by Group Cause (2018-2024)
Group Cause of Death 2018 2019 2020 2021 2022 2023 2024 Total Total %
Acute/chronic disease 96 114 179 152 154 138 130 963 44.2%
Drug overdose/
substance abuse-related 49 76 105 109 122 141 139 741 34.0%
Accidental injury 21 27 34 31 33 21 195
Homicide 16 15 28 22 22 23 144
Suicide 10 9 16 9 10 9 73
Unknown (R99) 3 5 6 20 10 10 61
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Alameda County Number of Homeless Deaths
by Specific Underlying Cause (2018-2024)
Cause 2018 2019 2020 2021 2022 2023 2024 Total Total %
Unintentional or undetermined
intent overdose 36 61 97 102 110 134 128 668 30.7%
44
36
18
24
12
11 13 23 8 10 5 4 74 3.4%
10
7 11 15 9 7 9 13 71 3.3%
7
9 11 7 7 10 7 7 58 2.7%
5
5
7
3
4 4 4 4 4 3 2 25 1.1%
1 3 3 6 6 2 2 23 1.1%
0
2
1
1
0 0 0 1 1 1 1 4 0.2%
malformations and 0 1 1 0 1 0 0 3 0.1%
Total 195 246 368 343 351 342 332 2,177 100.0%
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Alameda County Age-Adjusted Mortality Rates by Cause of Death,
Homeless vs. General Population (2024)
Cause of Death Homeless
Deaths
Homeless
Age-Adjusted
Mortality Rate
General
Population
Deaths
Population
Age-Adjusted
vs. General
Mortality
Drug overdose, unintentional or undetermined intent 128 1,024.4 344 18.9 54.2
Heart disease 44 379.9 2,013 100.1
All other diseases 36 314.2 1,690 84.6
Cancer (malignant neoplasms) 24 173.7 2,178 108.0
Homicide 18 137.5 117 6.9
Pedestrian or bicyclist crash, unintentional or undetermined 13 89.0 49 2.6 34.1
All other injuries (not drug overdose, homicide, suicide, or 12 94.8 295 16.0 5.9
Suicide 10 87.4 163 9.0
Diabetes mellitus 7 56.6 343 17.1
R99 (ill-defined, unknown cause or
missing code) 7 48.4 28 1.5 32.2
Sequelae of drug and alcohol abuse
& dependence 7 61.8 80 4.1 14.9
Cerebrovascular disease 5 29.8 840 41.6
Chronic lower respiratory disease (CLRD) 5 43.4 347 17.1 2.5
Chronic liver disease and cirrhosis 4 26.0 163 8.5
All other communicable diseases (not HIV or COVID-19) 3 30.6 212 10.5 2.9
HIV 2 16.8 27 1.4
Hypertensive renal disease/essential hypertension 2 12.3 278 13.8 0.9
Pedestrian or bicyclist struck by
train, unintentional or 2 18.9 8 0.5 40.5
Alcohol poisoning 1 7.7 7 0.4
Alzheimer's, Parkinson's, and other dementias 1 4.6 1,204 59.4 0.1
Exposure 1 4.6 4 0.2
All other causes 0 0.0 17 0.9
Pregnancy; perinatal; congenital
malformations and chromosomal 0 0.0 58 4.0 0.0
COVID-19 0 0.0 97 4.8
* A mortality rate ratio of 1.0 indicates equal mortality rates between the homeless and the general population. A rate
ratio greater than 1.0 indicates a higher rate of mortality among people experiencing homelessness. For example, people
experiencing homelessness have a rate of drug overdose death 47.8 times that of the general population.
Alameda County Homeless Mortality Report Calendar Year 2024 Executive Summary
11/30/2025 https://www.achch.org/alameda-county-homeless-mortality.html
Next Steps
This Alameda County homeless mortality report focuses on data and accurately
enumerates deaths among our unhoused communities.
Alameda County Homeless Mortality Data Dashboard: Instead of publishing a detailed
annual homeless mortality report and analysis, Alameda County Health Care for the
Homeless (ACHCH) and Community Assessment, Planning, and Evaluation (CAPE) staff
produces this Executive Summary and directs the public to an online, public-facing, user-
driven, and filterable data dashboard for homeless mortality data which will allow
providers and the public to analyze countywide homeless mortality data.
https://www.achch.org/alameda-county-homeless-mortality.html.
Specific homeless mortality data questions or requests can be sent to achch@acgov.org.
Press inquiries should be directed to hcsa-pio@acgov.org.
Acknowledgments
This report was produced by the Alameda County Health’s Health Care for the Homeless
(ACHCH) program and Community Assessment, Planning, and Evaluation (CAPE). Matt
Beyers and Yilak Fantaye, CAPE, provided epidemiological direction and guidance. David
Modersbach, ACHCH, provided analysis, content and writing. Special thanks to Wilma
Lozada, ACHCH, for the record review and to Julia Raifman and Patric Prado from CAPE.
We depend upon and deeply thank our community of providers and community members
who supported this effort and our collective efforts to reduce mortality, improve health and
end homelessness in Alameda County.
Alameda County Health Care for the Homeless
1404 Franklin Street #200
Oakland CA 94601
510-891-8950
www.achch.org
Alameda County Health Care for the Homeless program is supported by the Health Resources and Services
Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) as part of an award
totaling $4,552,466 and other non-federal funding sources. The contents are those of the author(s) and do
not necessarily represent the official views of, nor an endorsement, by HRSA, HHS, or the U.S. Government.
For more information, please visit www.HRSA.gov.