Homelessness, Mortality, and Social Exclusion.

Homelessness is associated with elevated mortality rates and premature death. Previous research has focused on the cause of death rather than the details surrounding these deaths. We conducted a qualitative analysis of records from the Los Angeles County Department of Medical Examiner. Medical examiner records document deaths of people experiencing homelessness. In 2018, a total of 998 deaths were represented. We analyzed event description, synopsis, and cause of death. Social exclusion was identified as a major theme, highlighted through three subthemes: exposure to harsh environments, denial of social rights, and social isolation. Contextualizing deaths among people experiencing homelessness deepens our understanding of mortality in this population. People experiencing homelessness are unable to access an adequate standard of living or equity before the law. Interventions to address social exclusion, including providing housing and eliminating criminalization of homelessness, can help to reduce preventable deaths among people experiencing homelessness.