Six homeless people will die today in LA County, and over 2,000 will die by the end of the year.
Among our homeless population in 2024, drug overdoses alone killed 884 people. One hundred five were murdered. Eighty died by suicide.
Meanwhile, the Fire Department responded to nearly 17,000 fires linked to homeless encampments, roughly a third of all fires in LA over the past six years.
And three weeks ago, the Department of Public Health announced an outbreak of the flea-borne disease typhus, which has previously been linked to encampment conditions.
Two unhoused people bundled in warm clothing sit on a street next to their belongings. If 2,200 members of any other identifiable population were dying annually in LA County at four times the general mortality rate, we would call it what it is: a public health emergency.
Los Angeles has spent billions on homelessness and produced a system that cannot account for its own spending, let alone its results. In March 2025, an independent audit commissioned by a federal judge reviewed $2.4 billion in city homeless spending and found it virtually impossible to trace where the money went.
Proposition HHH, the $1.2 billion bond measure voters approved in 2016 to build 10,000 housing units, has completed fewer than half that number at over $700,000 per unit.
The spending failures reflect a deeper strategic one.
For years, LA has organized its entire homelessness response around Housing First — the principle that permanent housing must come before anything else. But permanent supportive housing takes years to build, can cost over $1 million per unit, and has plainly failed to keep pace with the crisis.
Even worse, Housing First does not require recovery from addiction as a condition of housing — ensuring that for thousands of people, the underlying cause of their homelessness is never addressed.
It is no surprise that so many who are housed return to the streets. While we waited for units that never got built, 45,000 people remained unsheltered, and thousands died.
This is not merely an administrative or strategic failure. It’s a leadership failure.
At Wednesday’s gubernatorial debate, Xavier Becerra gave Gov. Gavin Newsom an “A for effort” on homelessness, and no other Democrat candidate gave him less than a B despite the visible disorder, disease, violence, and death on LA streets.
The public health emergency case is overwhelming. At least one in four unsheltered individuals in LA County self-reports severe mental illness.
Official surveys put substance use disorder at a similar rate — but the real proportion could be closer to half.
Encampments lack sanitation, expose residents to extreme heat and violence, and create the conditions for disease outbreaks that have triggered emergency declarations elsewhere.
In 2017, San Diego declared a public health emergency after a hepatitis A outbreak linked to homelessness killed 20 people. Shelter tents went up within days. Mass vaccinations began. More than 70 percent of outbreak cases had already occurred before the declaration was issued — the emergency broke the paralysis.
LA County lost more than a hundred times San Diego’s death toll last year alone.
A public health emergency declaration would give the county the authority its current approach lacks. The county could rapidly deploy emergency shelters on unused and underused government land.
It could concentrate mental health professionals and addiction treatment resources at centralized sites — rather than scattering them across 4,000 square miles of encampments.
It could operationalize SB 43, which is already on the books, to mandate treatment for those gravely disabled by addiction and mental illness.
And with emergency shelter capacity in place, the county could finally remove the practical and moral barrier to enforcing public camping laws, and move unsheltered individuals off our streets and toward recovery, stability, and dignity.
LA County should lead by declaring this public health emergency, and then demanding that the California Office of Emergency Services, the US Department of Health and Human Services, and FEMA follow suit.
The state and federal governments are ready to act. Allowing people to succumb to addiction, violence, and death on our streets while we “align funding” is beneath the city of angels.
This is an emergency. It’s time we treat it like one. Is Housing First the hill LA County wants 2,200 people a year to die on?
Tomás Sidenfaden is running for the Los Angeles County Board of Supervisors in the Third District.
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