Honolulu's acting chief medical examiner says 127 people considered homeless died on Oʻahu in 2019, up from two years ago.
The latest analysis by Dr. Masahiko Kobayashi released Thursday reflects a slight increase from the 120 homeless deaths reported in 2018, but a 46% increase since 2017 when 87 deaths were reported.
The cause for the deaths varied, but Kobayashi said some patterns have developed.
"Many of the reported cases had a drug history, unclear circumstances surrounding the death, or no physician to sign the death certificate," Kobayashi said. "Drugs, especially methamphetamine, continually take their lives."
Kobayashi also noted that the number of individuals who died by homicide increased from 3 in 2018 to 10 in 2019, although his office has not yet completed its analysis on all cases.
The average age at time of death among Oʻahu homeless was 54 years old, far below the national average of 78.
Honolulu Mayor Kirk Caldwell said the latest numbers is a reminder that ignoring the homeless is not humane, and he stressed the importance of efforts to help homeless individuals.
"Connecting our homeless population with services and available housing needs remains a key focus," he said.
Pamela Witty-Oakland, director of city Department of Community Services, said advocates who work with mentally ill homeless reported more psychotic behaviors and individuals resistant to services.
She said those with severe mental illness need social services beyond that contracted by the city. She said services like the Assisted Community Treatment law, that allows judges to order intensive outpatient treatment, are a more appropriate solution for this group of homeless.
The state's Point in Time homelessness count stood at 6,448 in 2019, a decrease of 18.6 percent since 2016. But a recent report from the U.S. Department of Housing and Urban Development ranked Hawaiʻi second in the country in homelessness per capita.
State lawmakers were told by experts at a summit on homelessness earlier this month that to make a big dent in the unsheltered numbers, the state will need to greatly expand programs succeed in getting individuals off the streets.