How many homeless die in Albuquerque each year? It’s complicated.

Although it’s hard to get an exact count, advocates say more people experiencing homelessness are dying each year.

Neil Greene, a fellow at the University of New Mexico’s Center on Alcohol, Substance Use, and Addictions and a scholar of homelessness, researched the issue for City Desk ABQ — using Office of the Medical Investigator records and other sources — and determined that in Bernalillo County in 2021, there were 94 deaths; in 2022 it was 95. For New Mexico, the totals were 162 in 2021 and 180 in 2022. He didn’t readily have data for 2023.

These numbers are higher than a recent five-year average of 65 deaths each year in the county and 128 in the state.

“The number has undeniably been increasing,” Greene said. “Some of the rise is because the prevalence of homelessness is higher [and] part of the increase is due to improved documentation.”

Accurate death data for the population of those experiencing homelessness is difficult to pinpoint in cities and states across the country. There’s no official national estimate.

Homeless advocates and health care officials say the data is important to better understand relationships between housing, poverty, and health — topics that are top of mind due to a rise in homelessness and an epidemic of opioid overdoses. They say such data is also crucial to more effectively direct public and private funds toward solutions, and to prevent future deaths.

Homeless Persons’ Memorial Day

When a person experiencing homelessness dies it’s more than just a statistic. Each year on Dec. 21 — the longest night of the year —  family members, friends and those working in homelessness services, like Albuquerque Health Care for the Homeless (AHCH) and the New Mexico Coalition to End Homelessness (NMCEH), host Homeless Persons’ Memorial Day events, a national day to recognize those who have died throughout the year. AHCH also maintains a memorial wall with the names of those who have died on tiles that family and friends have created.

“It’s kind of a hard thing to go to,” Greene said of the Memorial Day events. “But it also feels really important.”

His doctoral work was focused on analyzing the death records of those experiencing homelessness through a community approach.

Greene said he’s attended the memorial events for several years with his young son — which includes a group walk to a local church for a vigil where the names of those who have died that year are read aloud.

“What always happens at the end is they ask for other names that were missed,” he said. “And every year that I’ve been, there are 10 to15 other names that are added from the community of advocates and peers and people who work in homelessness services who know other people that weren’t included in the death data.”

Greene said the memorial list probably represents the most accurate data available. 

‘We need each other’

Ashley Meehan has solutions to help improve homelessness mortality data and is highly credentialed on the subject. She’s researched homelessness and public health for the Centers for Disease Control and Prevention (CDC) and is coordinator of the National Health Care for the Homeless Council’s (NHCHC) homeless mortality working group. Meehan recently presented at the 2024 National Alliance to End Homelessness conference on the need for housing and homelessness status on death certificates. 

“This work is tough and we need each other,” she said. “It’s difficult because our federal leaders aren’t helping give local jurisdictions any sort of structure on how to do this — there’s no consistency in how we are approaching this work.” 

Meehan said ideally the CDC, which manages the National Vital Statistics System, would issue recommendations and guidance because there’s insufficient data sharing between public health departments, homelessness service providers, health care centers, and medical examiner and coroner’s offices. Each entity sources data differently and has varied resources and staffing, she said, and many use different definitions of homelessness and inconsistent periods of observation. 

Further, some jurisdictions rely exclusively on medical examiner data, which is a subset of deaths from accidents, overdoses, injuries, violence or trauma. 

“That’s not really the full picture of all deaths, so it’s going to skew towards those causes,” Meehan said. “It’s very likely that others are dying in a health care facility from a chronic condition (like diabetes, and heart, kidney and liver diseases). It’s really limited in how we can make any sort of bigger conclusion.” 

Meehan would like to see city and county leaders fund homelessness mortality review committees; a coordinating body with a dedicated person working full time. Such an effort could then help to motivate state leaders, she said. 

“If enough states start collecting this information, then that might put pressure on the CDC,” Meehan said.

‘Nobody’s winning here’

One of Meehan’s solutions reflects a suggestion similar to Daymon Ely’s — more interaction with homeless experts and those formerly or currently experiencing homelessness. Ely is advising Albuquerque Mayor Tim Keller on policy proposals to help reduce the city’s population of people experiencing homelessness. Meehan said events like Homeless Persons’ Memorial Day are critical to raise awareness.

“I think amplifying those events, inviting the media, and promoting it on social media is a huge opportunity,” Meehan said. “None of us is going to remain untouched by death – it’s always painful when somebody we love or care about dies, and yet we as a country are willing to let people experiencing homelessness die and let their loved ones suffer in silence and alone. In my mind, nobody’s winning here.”