Nearly one in two deaths among New York City residents experiencing homelessness were linked to drugs or alcohol, according to a stark new city report.
Of the 634 homeless New Yorkers who died during the 2024-25 reporting period, 285 deaths were attributed to drug addiction, overdoses or alcoholism, the city Departments of Health and Social Services/Homeless Services said in their 2026 report.
The review covers documented deaths between July 1, 2024, and June 30, 2025, including people who died in temporary shelters and those who were living on the streets, in subways, in abandoned buildings or staying at an acquaintance’s home.
Hospitals were the most common place of death, accounting for 58% of homeless deaths, while 22% of unsheltered residents died outdoors.
Overall, 52% of those who died were classified as unsheltered, while 48% died in a homeless facility, the report found.
Report authors cautioned that the totals may be an undercount, citing challenges in tracking thousands of migrants served by other agencies that operated temporary encampments during the migrant surge tied to the Mexican border crisis.
“Some of the tens of thousands of new migrants provided shelter by H+H [Health+Hospitals], HPD [Housing Preservation and Development] and New York City Emergency Management (NYCEM) could have died and not be identified as homeless decedents since DOHMH did not receive data from these agencies for matching,” the report said.
The five leading causes of death in FY25 were drug-related causes, at 40% or 251 deaths; heart disease, at 12% or 78; accidents excluding drug overdoses, at 9% or 60; alcohol misuse or dependence, at 5% or 34; and cancer, at 4% or 23.
There were 18 deaths by suicide, 15 deaths attributed to exposure to cold/hypothermia, 15 subway accident deaths, 14 auto accident deaths and 11 homicides, the data showed.
There were also five deaths from toxic substances, four heat-related deaths and three deaths attributed to falls, the report said.
At least 15 people died from hypothermia this past brutally cold winter, autopsies conducted by the city’s chief medical examiner’s office in late February found.
Ten other deaths in the report listed no cause, because it could not be determined if the intent was homicide, suicide or accidental.
The report found a positive trend.
The number of deaths among persons experiencing homelessness dropped by nearly 18%, from 770 in the prior 2024 fiscal year to 634 in FY 2025.
Drug-related deaths remained the leading cause of death among the homeless population, consistent with prior city and national trends.
Drug-related deaths plummeted 28%, from 348 (45% of the total) in FY 2024 to 251 (40%) in FY 2025.
The Office of the Chief Medical Examiner investigated and confirmed the overwhelming majority of deaths in the report.
While city agencies provide temporary emergency shelter and help individuals and families transition into permanent and supportive housing, officials said people experiencing homelessness are a vulnerable population at greater risk of health issues and death.
“Negative social factors such as poverty and racism, compounded by the stressors of housing instability, put persons experiencing homelessness at a greater likelihood of having physical and mental health conditions that are poorly controlled, when compared to the general public, resulting in poor health outcomes for this population,” the report said.
The annual report on the cause of homeless deaths — required under the law — helps city policy makers and care workers identify and address pressing health concerns for the vulnerable population, the authors said.
The just-released report is the 20th issued.
“This information provides critical insight into the health issues of this population and is essential for better understanding their health challenges,” the report said.
Data from prior reports led the city to develop needed services and interventions, such as creating and expanding its Opioid Overdose Prevention Program and anti-overdose drug naloxone administration trainings aimed at reducing the harmful impacts of substance use.
The city’s homeless shelter population swelled to more than 100,000 during the peak of the migrant crisis in 2023.
As of Aug. 6, there were 83,197 persons in the city’s shelter system, the Department of Homeless Services reports.
Still, the Mamdani administration re-upped a $1.86 billion contract that will see commercial hotels across the five boroughs continue to provide emergency space for the homeless over the next three years, a continued reliance on tourist lodging facilities that accelerated during the COVID-19 outbreak and then the migrant crisis.
