Unhoused Utahns Are Dying at Ten Times the Rate of the General Population
In 2023, Utah conducted its first-ever analysis of the mortality rate in the local homeless population. The study’s goal was to provide information to better guide programs and policy changes. The results are now in.
To produce its report, the Utah Department of Health and Human Services (DHHS) analyzed records from the DHHS Office of Vital Records and Statistics (OVRS) to uncover mortality rates, leading causes of death, and other demographic mortality characteristics affecting unhoused Utahns. This data was compared to mortality data from housed Utahns to uncover discrepancies that need to be addressed.
Death Rates Soar for Unhoused Utahns
Unsurprisingly, Utahns who were experiencing homelessness at the time of their death had a much higher mortality rate than people who weren’t- ten times higher, in fact, when adjusted for age. In raw numbers, there were 216 deaths of unhoused people recorded during the studied period from January 1 to December 31, 2023. In the general population, there were 21,816, which actually represents a relative death rate that is disproportionately high for unhoused people since, right now, the vast majority of Utahns are housed.
Homeless Utahns are also dying younger than their housed neighbors. The mean age of death for housed Utahns is 72, but for unhoused Utahns, that number drops to just 56. Homeless people in Utah are dying an average of 16 years younger than their sheltered counterparts.
The difference within specific age groups is even more stark. Among Utahns aged 22 to 45, unhoused people had a mortality rate 22 times higher than the housed population. What’s more, homeless Utahns in the age bracket of 35 to 44 had a higher mortality rate than housed people over the age of 65.
Causes of Death
Chronic diseases like diabetes, heart disease, and pulmonary disease are a leading cause of death for people in both categories. Still, homeless people tend not to live long enough to reach the most fatal phases.
Chronic disease was the cause of death in 59% of cases for housed Utahns and 33% of cases for unhoused Utahns. Accidents, suicides, and homicides were responsible for half of all deaths of homeless people in Utah. For housed people, only 11% of deaths were from these causes.
Unhoused Utahns are also disproportionately affected by the substance use epidemic, with 35% of deaths recorded as being related to substance use. Most of those deaths were considered accidental.
There could be many reasons why substance use deaths are high compared to the 5% of deaths among the housed population recorded as substance use related. Unhoused people may turn to substances for many reasons, including the following:
- Cope with the circumstances of being homeless
- Self-medicate when access to medical care is nonexistent
- Stay awake enough to protect themselves and their belongings
- Relax enough to actually get some sleep on the streets
Homeless people also face significantly more barriers to treatment for substance use than the general population, suggesting that many more housed substance users can modify their behavior before it turns deadly.
These Deaths Are Preventable
Unhoused Utahns are dying younger and at a faster rate than their housed counterparts. Many of these deaths can be prevented with something as simple as access to stable housing. Housing is healthcare, housing is a human right, and housing can prevent a lot of these premature deaths.
The study’s authors have several suggestions for ways to move forward with the health and well-being of every Utah resident at the forefront. These suggestions include:
- Increasing the amount of low-barrier housing available to homeless and housing-insecure Utahns. Keeping in mind that each barrier keeps people out – people who have every likelihood of dying prematurely without access to this housing- we should aim to keep barriers as low as possible. Housing options should also include medical respite care, case management, and wrap-around services that can help with other issues once housing is in place.
- Increasing access to low-barrier primary healthcare services, including voluntary substance use treatment services. These services should be geared toward serving the housed population and the unique needs of unhoused people in Utah.
- Improving access to harm reduction services that provide life-saving tools like Narcan to prevent overdose, test strips that can detect the presence of fentanyl and xylazine, and syringe services that provide clean equipment and dispose of used needles to minimize infection risk to the user and the public.
More Data is Still Needed
The final recommendation of this report is that the state continue to commission reports like this in the future. This was the first of its kind in Utah and groundbreaking in a way, but it also had its limitations. There were several issues DHHS wanted to take a closer look at but didn’t have enough data to draw conclusions from, including heat and cold-related deaths and discrepancies in death rates among unhoused people of different races. These could all be topics of further study in additional reports that could paint a more complete picture of mortality rates among unhoused people in Utah.
This survey also only separated data from people who were known to be homeless at the time of their deaths. There is a lot more data to be collected on the overall effects of periods of homelessness at other times during a person’s life. It was also limited by the data collection done by OVRS, for example, concerning sex and gender. While the Point-In-Time Count collects self-reported gender identities directly from survey respondents, OVRS data listed only sex at birth. Better data would allow a more careful examination of mortality rates among unhoused transgender people, who are known to face increased instances of violence.
Overall, this study offered a great place to start for Utah agencies, and it has a lot of room to improve in the future. Hopefully, it will continue to refine its data and become a respected source of guidance for state programs that can improve the lives and longevity of many who live within the state.
