Nearly 500 people living on the streets and in vehicles in San Diego County died so far this year and were examined by the Medical Examiner's Office.
According to data obtained by CBS 8, the county has averaged approximately 45 deaths per month since January of this year.
It is only a small percentage of the actual number. The San Diego County Medical Examiner says the 499 deaths this year are those where the deceased person's housing status was made known to the office. In addition, the office says it only investigates 14 percent of all deaths countywide, and only those that result from an injury, accident, or trauma.
It does not, according to a spokesperson, include "any persons experiencing homelessness that may have died of natural causes in hospitals or under other circumstances in which a community physician was able to complete a death certificate" or was sealed for a police investigation.
And while the Medical Examiners say the number of deaths of those living on the streets and in their vehicles represents only a fraction of the total number, the number is staggering.
According to the data, a vast majority of deaths occurred, as would be expected due to population size, in the city of San Diego, followed by Oceanside, Chula Vista, El Cajon, and Escondido.
City of San Diego Homeless Deaths: "A Staggering Number"
From January 1 to November 1, of the 499 homeless whose deaths were investigated by the Medical Examiner's Office throughout the county, 311 occurred in San Diego. That is an average of 28 deaths per month or nearly one death a day when averaging out the numbers.
"It's a staggering number," says longtime homeless advocate Michael McConnell. "When I started doing this, it was around 60 deaths a year for the entire region. So, what does it say about the county and about the city, it says failure. Unfortunately, I don't see how it can say anything else."
McConnell says that during his daily trips, traversing the city and speaking to those on the streets and in encampments he gets a sense of desperation that he has never seen before.
"I've never seen the suffering," said McConnell. "A lot of people have just given up. It's just a complete system-wide breakdown. We're seeing so many deaths because our homeless service system has just completely broken down. There are plans but there's no strategy to implement those plans in order to alleviate the incredible amount of deaths and suffering on our streets. It's just desperation out here."
According to the Medical Examiner's Office, the cause of death in 169 of the 311 deaths is still under review. For the remainder, however, substance abuse is one of the leading factors, most notably fentanyl.
According to the Medical Examiner, fentanyl use was the cause or played a contributing factor in 43 deaths so far this year, while methamphetamine played a part in 38 of those deaths - some of which were a combination of drugs.
Other leading causes of death included those with severe health conditions such as cardiovascular disease, cancer, lung disease, and COVID, among others.
As for addressing the increasing number of unhoused people dying on city streets, Mayor Todd Gloria says it is a work in progress and he says the city is working feverishly on a solution.
"Look at what my administration has done over the last two years," said Gloria. "Whether that is growing the offerings that we have for our homeless population, whether that's coordinated street outreach in every city council district, growing our shelter capacity by 40%, and diversifying those offerings."
Gloria said that his administration is partnering with the county, the agency that runs the health and mental health programs for the county.
"We're partnering with the County of San Diego, to make sure that it's the shelter that we provide, along with the behavioral health and substance abuse services that they provide. Working together, we can have a greater impact on those individuals who are at least willing to come out and get shelter, get food, get to get some safety and provide the counseling and the treatment that hopefully will in their addiction. And then we continue to expand the amount of permanent supportive housing in our community, recognizing that addiction for those who are in recovery is a daily battle, and making sure that those who are able to be stably housed have the wraparound services to continue to keep them housed for the long haul."
The city of San Diego is not alone in its quest to find a solution to the homelessness crisis.
Oceanside: 36 deaths so far this year
Throughout the county, the city of Oceanside had the second-highest number of homeless deaths, according to the Medical Examiner's Office.
From January through November 1, the medical examiner investigated 36 deaths of homeless people.
And while fentanyl was one of the leading factors in those deaths in San Diego, only four of the 39 deaths in Oceanside were attributed to fentanyl abuse.
A spokesperson for the city of Oceanside tells CBS 8 that the city and its staff are also working to address the issue.
"Homelessness is a statewide and regional crisis, and Oceanside is no exception," said the spokesperson. "Our hearts go out to the family, friends and loved ones of anyone who has passed away without shelter."
The city says that while fentanyl may not have played such a large part in the deaths, drugs and alcohol did.
"In our experience, however, deaths due to environment exposure are rare in Oceanside, and most are unfortunately attributed to drug overdoses."
Alcohol and methamphetamine use were among the leading causes of death citywide so far this year.
Added the spokesperson, "It’s no surprise that Oceanside, as the third most populated City in the County, has a large number of homeless residents. That said, Oceanside is working on many fronts across nearly every department to house and aid those living on the streets.
- We have two homeless outreach teams that work daily to supply and offer aid. What they find is, that in many cases, it takes many contacts with one individual before they are ready to accept help.
- We offer a hotel voucher program that provides free short-term housing and food.
- We also employ Bridge Housing while we’re assisting someone in finding permanent housing.
- And the Oceanside Navigation Center, Oceanside's first year-round 50+ bed shelter, is under construction, and is anticipated to open in early 2023.
- Along with these efforts, the Oceanside will soon have a 60 unit permanent housing apartment complex for homeless individuals (Greenbrier Village).
- Homelessness prevention endeavors also include emergency funding for rent and family reunification
El Cajon: 19 Deaths So Far This Year
From January to November, 19 people died in El Cajon.
In recent months the East County city has battled with county supervisors over the placement of homeless individuals in city hotels, claiming the county was using El Cajon as a homeless dumping ground.
At the same time, the city has worked to help the unhoused by opening up a safe parking program.
According to the medical examiner, fentanyl was the cause or a contributing factor to five of the 16 deaths citywide, while two others were drug-related.
City officials say they are urging the county to focus on substance abuse in order to prevent additional deaths from occurring.
"El Cajon leaders have been shouting from the rooftops that the homeless crisis in our County is more than a lack of affordable housing," said City Manager Graham Mitchell. "Drug addiction and mental health are integrally connected to homelessness. Rather than ignoring the reality that drug use is a problem among our most vulnerable community members experiencing homelessness, we should be focused on helping individuals with voluntary and involuntary drug treatment. One of the most humane actions we can take as leaders are to help our brothers and sister break the cycle of addiction. However, current sate and county laws and policies prevent us from helping these suffering individuals."
City of Escondido: 16 Deaths Reports This Year
Meanwhile, in Escondido, officials say they too are working to prevent additional deaths from happening.
Since January, the Medical Examiner reported 16 deaths in the city of Escondido.
The numbers, says Deputy City Manager Chris McKinney, are unfortunate.
"To hear 16 people dying while in the condition of homelessness is tragic. It is tragic no matter where it happens, but definitely so for us in Escondido," said McKinney. "Our clinicians are out working to try to prevent these deaths, to offer services and unfortunately so many people are not able to accept the help."
According to Housing & Neighborhood Services Manager, Holy Nelson, the city is putting millions of dollars into a number of new homeless housing programs.
Escondido applied for and received $4.4 million from the federal government for a wide variety of homeless housing programs. The city, says Nelson, is also awaiting for Interfaith Community Services to open its new detox and health center for homeless people.
"We are working to address so many issues including the issue of tri-morbidity in some homeless individuals, where homeless people are battling physical, mental, and substance abuse issues. So many of these people have trouble agreeing to services because they are focused on their immediate needs and not the long-term," said Nelson.
"The Region's Piecemeal Approach":
And while individual cities as well as county supervisors are working to open new shelters and establish more services, homeless advocate McConnell says the county does not have a centralized approach needed to solve the homelessness crisis and prevent further deaths from happening.
"There's nobody who's taken charge of a regional approach to move forward with implementing the strategies and solutions that are needed across our region, to alleviate the suffering and deaths on our streets," said McConnell.
"There's not the overarching leadership, there's not a, a control center that's working on this day in and day out, and moving forward the strategies. Instead, it's all piecemeal, and it's all bits and pieces. So there's good stuff that's going on. But it's all bits and pieces moving forward very slowly. We'll never get ahead of this at the snail's pace that the cities and the county are moving."
Added McConnell, "Almost everybody knows somebody out here who's died out here. It's really that common...it's just a complete breakdown. That's really why we're seeing so many deaths is our homeless service system has just completely broken down.
*CBS 8 reached out to the county of San Diego, the city of Chula Vista, as well as county supervisors for comment, all of which declined to comment.