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San Diego County sees a record number of homeless deaths: 574 and counting


Preliminary data from the county Medical Examiner’s Office indicate 2022 will see a record number of deaths among the region’s rising homeless population, occurring at a time when the county has declared homelessness and fentanyl to be public health crises.


The unofficial 574 deaths mark a 7 percent increase from the 536 deaths reported in 2021 and a significant increase from the 357 deaths reported by the Medical Examiner’s Office in 2020.


While this year’s number is a record high, the actual number likely is higher, said Chuck Westerheide Jr., public safety group communications officer with San Diego County.


Westerheide said the Medical Examiner’s Office does not investigate most deaths from natural causes, including deaths in hospitals where many homeless people likely died.


The record number of deaths comes at a time when the county is seeing more people becoming homeless for the first time and the number of people living without shelter in downtown San Diego reaching a record high.


The San Diego Regional Task Force on Homelessness this year began releasing monthly reports that show the number of people who fall into homelessness is outpacing the number of homeless people who find housing. On average over a 12-month period, the task force found 13 people fell into homelessness for every 10 who found housing.


A group of advocates gathered near Balboa Park for a vigil to remember homeless deaths on Wednesday, National Homeless Person’s Memorial Day, held on the longest night of the year.


“This is our sixth and final tent vigil for 2022 to honor at least 1,427 houseless residents of San Diego County who have died in the years 2020, 2021 and 2022,” said Martha Sullivan of the grassroots group San Diego Housing Emergency Alliance.


Westerheide cautioned that the 574 deaths reported so far this year are unofficial and could change, as about half of the Medical Examiner’s cases are not closed, and the status of whether a person was homeless could change.


The Medical Examiner’s Office is backlogged with investigations and about a year behind in closing cases. Officially, the office has closed cases that occurred in just the first quarter of 2022. Those cases found 139 deaths of homeless people, with 50 from accidental overdoses.


Unofficially, the Medical Examiner’s Office found 128 deaths of homeless people were from drug use. With almost 300 cases still pending, that number may go up. In 2021, the county reported 203 deaths just from fentanyl, more than double the previous year.

The preliminary data also shows life on the street is hazardous for other reasons. The county reported 41 deaths of homeless people from vehicle accidents, with most of those pedestrians who were struck by cars.



Violence, including self-inflicted, led to deaths. The county reported 11 homicides and 17 suicides. The method of most homicides was not disclosed by the county with the exception of one death by stabbing.


Deaths by suicides included six from hanging, one from a gunshot wound to the head, and others from a stab wound or from jumping from high places or in front of a vehicle.


Among deaths by illnesses, five succumbed to cancer and 22 from cardiovascular disease. An additional 20 deaths were alcohol-related.


In a breakdown of locations, the city of San Diego had the most deaths with 343. The high number reflects the fact that the city has the largest concentration of homeless people in the county, and it appears to be increasing.


A monthly count of homeless people sleeping in tents, sidewalks and in vehicles in downtown San Diego found a record high of 1,706 people in November, up from a previous record of 1,660 in October.


Of the 343 deaths in the city of San Diego, 87 occurred in the 92101 ZIP code in downtown and 75 were in the 92103 ZIP code that covers Hillcrest, Bankers Hill and Mission Hills.


Oceanside had 50 deaths, Chula Vista 25, Escondido 24, El Cajon 22, National City and Vista 16, La Mesa 15 and La Jolla 11.



Among the speakers at Wednesday’s vigil was Nathan Smiddy of A New PATH (Parents for Addiction Treatment and Healing).


“I want to shatter the stigma of drug use, specifically within the unsheltered population,” he said, addressing what may be the single largest cause of death among homeless people.


“A lot of people think just because unsheltered people use drugs, it’s because they have a substance use disorder,” he said. “And that’s not always the cause. What I see and what a lot of people don’t see is that people are just trying to survive.”


Smiddy said some homeless people often use drugs to stay awake because they are afraid to fall asleep. Among those people are women who fear sexual assault, he said.

Smiddy acknowledged that there are homeless people who do have substance use disorders, but many do not.


“What I would say ... would help is if these people’s basic needs were met, like housing, food, hygiene,” he said. “I think their substance use would decline if their needs were met.”


As with past vigils, the Wednesday event featured 19 tents that spelled out “#EndCriminalization” on one side and “Housing Not Handcuffs” on the other.

Speakers also included attorney Coleen Cusack, who does pro bono work for homeless people.


Cusack remembered her client David Wilson, a homeless man who lived in his vehicle and who died in July 2021. Cusack said he often defended himself in cases, and he had 876 citations related to his homelessness when she met him.


“David only occupied a parking space in San Diego, but, oh, how that irritated the powers that be in San Diego,” she said.


She described him as a nice man who suffered from a variety of disabilities that made it unlikely for him to hold a job.


“He was a very polite, affable man who loved to talk,” she said about Wilson.


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