Editor’s Note: Although we do not often run stories specifically about Las Vegas and southern Nevada, we are sharing this article from the Nevada Current because it closely relates to reporting from This Is Reno on deaths of those living homeless. Past This Is Reno reporting on the issue is linked throughout the story.
Though the number of unhoused who died since 2020 has spiked 79%, there is still much unknown
By Michael Lyle
The morning had just hit 96 degrees when Elizabeth Cannon sat down in a vacant lot nestled in between a church and the edge of a mostly shadeless neighborhood near Sahara and Eastern avenues.
The National Weather Service reported the high for the day in Las Vegas reached 102 degrees, three degrees shy of an excessive heat warning when cooling stations open for unhoused individuals, like Cannon, to seek temporary respite.
The church was closed that Monday, and the closest emergency homeless shelter from her location was roughly four miles away near downtown Las Vegas, more than an hour’s walk.
As she arrived at the empty lot, a man living in the house across the street noticed Cannon, walked outside and gave her water as she sat in silence.
An hour later, when the heat climbed to 99 degrees and Cannon laid down on the pavement, the man called 911.
“I didn’t call the police earlier because she was still sitting and I thought well maybe she’d be better,” the unidentified man told the 911 operator during the call. “Now she is having that quick breathing like you hear when someone is about to die.”
During the 9-minute phone call, which started with the Las Vegas Metropolitan Police Department and was transferred to Las Vegas Fire & Rescue halfway through, the man remained on the phone waiting for help to arrive.
He doesn’t know Cannon, 41, nor has he seen her in the neighborhood before. Still, the operator asked him a series of questions to assess the situation: Is she pregnant? Is she diabetic? Does she have a history of stroke or brain tumor?
“I don’t know. I don’t know. I don’t know her,” he responded.
There were long pauses on the call as the man waited for emergency services. Twice, the operator asked him to count Cannon’s breaths, which are deemed slightly elevated.
After a nearly minute-long silence, he told the operator Cannon’s breathing was getting slower and he thought she was dying.
“Hey, someone’s on their way,” the man told Cannon, who was still unresponsive.
The operator asked him to keep monitoring Cannon’s breathing. The call went silent for another 30 seconds.
“I think she just stopped breathing,” the man said, interrupting the pause.
“You don’t see her breathing at all?” the operator asked.
“No. She’s not breathing at all,” he said. “Oh man!”
“We’re coming as fast as we can,” the operator said, trying to reassure him.
The man is instructed to place his hand on top of her breast bone to do chest compressions as the operator counted two beats per second: “One, two, three, four. One, two, three, four.”
Cannon was breathing a few moments later as the ambulance pulled up and first responders took over. The call ended abruptly.
According to the Las Vegas Fire & Rescue incident report, the ambulance was at the scene for seven minutes before departing for Sunrise Hospital, where it arrived roughly 10 minutes later.
Shortly after arriving at Sunrise – at 1:14 p.m. on July 31, 2023 – Cannon was pronounced dead.
The Clark County Coroner’s Office attributed Cannon’s cause of death to hyperthermia, when the body temperature becomes abnormally high and overheats.
By the time she arrived at the hospital, her body temperature had reached 108.9 degrees.
Across the country in New York City, Cannon’s brother Michael Hernandez wouldn’t find out for weeks that his sister died. Cannon, who he lost contact with toward the end of 2019, had struggled with mental health issues and addiction throughout her life, he said.
“I would pray and hope she was OK and that she would find her way back to the (rehabilitation) program, and find her way back to her family,” Hernandez said.
While Hernandez was able to gather basics about how his sister was living on the streets when she died in the extreme summer heat, there are still many questions he will never get answered.
“Many things have run through my mind like what would happen if someone happened upon her sooner,” he asked. “If there had been appropriate places for addicts to go or any kind of services that could have been provided or help assist her in this situation could she have been saved?”
Cannon was one of 333 individuals who died in 2023 who were considered homeless or transient, according to the Clark County Office of the Medical Examiner.
Nevada Current examined homeless death data provided by the coroner’s office and found there has been a nearly 80% increase in the number of unhoused people who have died in Southern Nevada since 2020, when the office reported 186 deaths.
The manner by which homeless mortality data is collected all but assures the numbers are an undercount.
Yazmin Beltran, a spokeswoman with Clark County, said the report only included “deaths the coroner’s office investigated in which we could not identify a place of residence for the decedent.”
The county’s numbers don’t include cases where next of kin was unable to be identified or homeless individuals hospitalized and under medical care before their death.
The Current reached out to the Southern Nevada Health District and University Medical Center, but neither collected data on homeless deaths that occur in medical situations.
Cities nationwide seldom collect or analyze homeless mortality data, said Matthew Fowle, a researcher with the University of Pennsylvania who studies homeless mortality rates. The lack of data prevents cities from understanding the complexities of unhoused deaths, he said.
“We have no idea how many people experiencing homelessness die in the United States each year,” he said. “If we don’t know the full scope of the problem, it’s really difficult to start thinking about solutions to it.”
‘A human rights crisis’
There was a nearly 30% increase between 2022, when 257 unhoused people died, and last year.
“There is no way to look at this except as a human rights crisis,” said Alyssa Johnson, the regional outreach coordinator for HELP of Southern Nevada. “We are one of the most prosperous countries. We should not have our people out suffering on the street.”
The increase of deaths has coincided with the growing number of people experiencing homelessness, which has increased in the wake of the Covid-10 pandemic that saw rental rates spike as housing stock dwindled.
According to the 2023 homeless point-in-time count, an annual census that attempts to estimate the number of unhoused folks on any given night, the number of people experiencing homelessness grew 16% from the previous year.
When a person dies in Southern Nevada, the coroner’s office investigates the cause of the death. That includes looking “into who the person is and who the family is,” according to Coroner Melanie Rouse.
“As part of that, it does provide us with information regarding their current housing status,” she said. “An individual may have fingerprints on file. Sometimes it is a more lengthy process if we’re not able to make a quicker identification.”
It is through that process they have identified 333 people last year who had no last known address and were considered homeless or transient at the time of their death. The data doesn’t include circumstances where next of kin wasn’t identified. Over a six-month period from the end September 2023 to March 2024, the county identified more than 100 people who they believed died while experiencing homelessness but no next of kin was found.
The vast majority of known homeless deaths were categorized as accidental.
Drug overdose and heat are the most common causes of death last year for the unhoused.
In total, the number of environmental-related deaths, which includes heat and cold, rose from 39 in 2022 to 69 in 2023, a 77% increase.
Of those 69 environmental deaths, 62 were heat-related, either classified as hyperthermia, when a core body temperature is known, or environmental heat stress, when the temperature isn’t known.
July proved to be the deadliest month last year by a significantly large margin with 110 total deaths, a third of the yearly total.
Cannon wasn’t only one of three unhoused people who died July 31, 2023, she was among the 52 heat-related deaths that month among people experiencing homelessness.
By comparison, July 2022 had 14 heat-related deaths among the unhoused population.
“If we know it’s going to get over 105 degrees, we’re out in the street in full force in cooperation with Clark County, which has opened up a multitude of cooling stations,” said Lou Lacey, the director of the homeless response team at HELP of Southern Nevada. “We are literally getting people to cooling stations, delivering frozen and cool water and passing out summer survival kits, which include tarps and fans and cooling rags.”
Even if temperatures don’t reach the level to trigger an excessive heat warning, the heat can still be deadly.
When comparing the temperatures in July and the county’s homeless death data, 12 of the 52 unhoused people whose deaths were heat-related, including Cannon, died when temperatures were 105 degrees or below.
‘Fentanyl is just running rampant’
Though the coroner’s data provided to the Current only identifies one cause of death attributed to both drug toxicity and environmental health stress in 2023, Lacey said drugs are likely playing a role in many of the heat-related deaths.
“Think about how substance abuse affects people and then some of the environmental factors,” he said. “You may say a client did not die of an overdose. But maybe they were incapacitated and passed out, which we’ve seen.”
The coroner lists Cannon’s official cause of death as hyperthermia. Her toxicology report identifies acute toxic effects of methamphetamine as a “contributing condition.”
The number of drug-related deaths among those unhoused in Southern Nevada jumped from 109 in 2022 to 151 last year, a 38% increase.
“Fentanyl is just running rampant in the community,” said Lacey. “We have individuals we are encountering who are just so deep into their addiction that we are offering immediate housing and immediate treatment. They are refusing these services. When we talk to them about what factors keep them out in the street and not using services, a lot of them say ‘I’m using.’”
While some individuals might decline services, Johnson said there are systemic barriers that prevent them from going into shelter.
Shelters, she said, don’t take couples and often split them up, causing individuals to remain unhoused. Some spaces have sobriety requirements.
“They don’t take pets,” she said. “They also have strict background requirements. We have a lot of people who can’t go to the Navigation Center because of those three things.”
The lack of access to health care also puts a toll on unhoused folks dying, Johnson said. Many living on the streets lack identification or transportation, which become barriers to medical care.
The data showed a 22% decrease in health-related deaths, when 52 people died last year from a variety of health complications such as sepsis, complications of diabetes, cardiovascular disease and pneumonia.
The coroner’s report identified 67 health-related causes of deaths the year before. Cardiovascular disease remains the largest health-related killer in both years.
There were four Covid-19 deaths in 2022, while zero were reported last year.
As a response to Covid, the City of Las Vegas opened a medical respite program at the Recuperative Care Center in 2021.
The city has contracted with the federally qualified health care center, Hope Christian Health Center, to operate the facility within the Corridor of Hope, the area downtown where homeless services are located.
The center has grown to include a place for unhoused individuals to stay in the short term while receiving other types of medical care such as chemotherapy and cancer treatment, post-operative care, wound care or hospice and end-of-life care.
Jocelyn Bluitt-Fisher, the community resources manager with the City of Las Vegas, said it is “a safe place for homeless individuals to finish their healing,” after being discharged from the hospital.
“Housing is health care and we are still pushing to make sure there is enough adequate housing to meet the needs of our population,” she said. “As a community, we are starting to realize that we can’t wait until the housing is built to start providing health care for this very vulnerable population. While we are waiting for housing we are losing people every day, every year.”
A high number of patients, she added, come in for uncontrolled high blood pressure and wound care.
She said these are “wounds that with a little bit of care at the beginning could have healed nicely but because someone spent time on the street without changing bandages or antibiotics have really taken a turn for the worse.”
The center has had around 900 patients since it opened its doors, Bluitt-Fisher said.
“What we have found is that the need for this type of service is great,” she said. “Greater than we as one agency can accommodate. We are almost always full and sometimes we have to turn patients away.”
The community also lacks long-term facilities to house homeless individuals who are recovering from chronic diseases or need a higher level of care, she said.
“What we are starting to see more of is individuals who are paralyzed, who are recovering from stroke or dementia,” she said. “These are illnesses that impact their ability to care for themselves. It’s not something we can handle at the Recuperative Care Center because we are not long-term care.”
Number of deaths increasing statewide
Similar to Clark County, Washoe County has also seen an increase in the number of unhoused people who died.
Washoe County identified 99 homeless deaths in 2022. The number of unhoused folks who died last year jumped to 135.
The county provided the Current with total deaths per calendar year since 2016, when data identified 19 people died. This year marks the first in nearly a decade where totals are triple digits.
In an email, Washoe County said its medical examiner’s office includes people who were hospitalized before their time of death in its numbers, differing from Clark County.
The Current also sought homeless mortality data from Nye County and Carson City, which according to the Rural Nevada Continuum of Care report have the highest number of individuals experiencing homelessness in rural areas.
Nye counted 132 unsheltered individuals during its 2023 point-in-time count. Yet, the county doesn’t collect data around homeless deaths and wasn’t able to provide any data.
Carson City, which has the second highest rural homeless rate with 62 sheltered and 68 unsheltered, had three deaths last year. While one listed environmental cold exposure as the cause of death, all three autopsy reports listed health-related causes.
It recorded a single death in 2022, which was attributed to cardiovascular disease.
Putting the pieces together
For nearly three years before Cannon’s death, her brother Michael Hernandez would periodically reach out to her by calling her, leaving comments on her Facebook wall or sending her direct messages.
“Hey Elizabeth, how are you doing?” he messaged her on Facebook in April 2020.
“Happy Birthday sister. Call me” he wrote on her Facebook wall in February 2021 along with three heart emojis.
“Hey Elizabeth, my birthday is 19 days on Sunday … Would you be available for a quick 30 minute ZOOM call to catch up and celebrate?” He messaged in May 2022.
“Happy Mother Day!!” he messaged again in May 2022.
There were no replies to posts nor answers to direct messages.
He hoped they would still eventually reconnect, especially since it wasn’t the first time in their life they had lost contact.
The siblings, who share the same mother, moved out to Las Vegas from New Jersey in 1990 when Hernandez was 14 and Cannon was 7.
When Hernandez was around 16, his mother moved to Germany with a then 11-year-old Cannon. Hernandez decided to move in with his father back in New York instead of relocating abroad.
Hernandez still doesn’t know all the details about Cannon’s time abroad; only that was when she first started struggling with addiction and ran away from home after a falling out with her mother.
A few years later, Cannon, then 16, and her mother reconciled and moved back to Las Vegas. She still struggled with addiction and was sent to juvenile detention, Hernandez said. He remembers visiting her once and feeling hopeful she was getting her life back on track.
Cannon, he said, aged out of the juvenile system and the siblings lost contact.
“She was lost to me for a number of years and I didn’t know where she was,” Hernandez said.
Then one day in 2006, Cannon reached out to Hernandez. The two stayed in contact regularly over the next decade as Cannon received addiction and mental health treatment.
She fell in love. She had three children.
Cannon rarely spoke about the years they were out of touch, but when she did Hernandez said she “had a lot of regret and sadness about that chapter in her life.” The years went by and they would talk over the phone every few weeks and even were able to have a reunion in 2015.
“There was a period of time she had several sponsors, going to (Alcoholics Anonymous) meetings regularly and calling me regularly to talk about life and addiction,” he said. “Then she started to drift away from the program. She stopped going to AA and talking to her sponsor.”
Cannon, he said, told him she wanted to leave her partner as their relationship soured and her boyfriend was controlling. She talked about starting relationships with other men and using marijuana.
Though concerned about some of Cannon’s decisions, Hernandez was torn about how to broach the topic.
Finally, he spoke up to tell her he thought her life “was not going in the right direction.“ He said he was trying to “find that balance of not pushing her away but helping her to retain her recovery.”
“Her response was, ‘See, I didn’t think you’d understand. I just wanted to be honest with you and this is how you responded,” he said, recalling a phone call in 2019. That ended up being their last conversation.
She moved out of her boyfriend’s house sometime after that conversation, Hernandez later found out.
As the Covid-19 pandemic raged in 2020, Hernandez didn’t know where his sister was. He reached out to distant family members to see if they had heard from her. He left periodic messages. He occasionally scoured jail and court records to see if he could obtain any information. He would google her name to see if a newspaper article came up.
“Nothing ever came up,” he said. “I didn’t know what else to do.”
As months of absence stretched into years, Hernandez received no word on the whereabouts of his sister.
Everything changed last summer when he received a phone call from Clark County Social Services. Cannon’s ex-boyfriend had died and the children were taken by social services.
“Nobody was able to find her,” Hernandez said.
Through friends and family of Cannon’s ex-boyfriend, Hernandez learned that she had been living on the streets for several years and was rumored to have also died.
“I reached out to the coroner’s office to see if they had any information about my sister,” he said.
Hernandez wasn’t the next of kin and wasn’t able to get any answers. However, he was able to put the office in touch with his mom.
In September, a little more than a month after Cannon’s death, the family was able to confirm she had died. Cannon was cremated Sept. 11.
‘There is no national guidance’
Hernandez may never get a complete picture about Cannon’s life on the street.
However, there is something to learn by analyzing the deaths of those who die while experiencing homelessness, Fowle, the researcher, said.
In addition to seeing causes of death and what leads to increases or decreases, he said cities can notice trends including whether the number of deaths coincide with the rise in seniors experiencing homelessness.
In recent years, cities across Nevada, in conjunction with localities across the country, have ramped up enforcement of encampment removals and passed more laws that criminalize homelessness.
Fowle said some research has suggested that could lead to an increase in homelessness deaths.
“We know from talking to people who are experiencing homelessness how encampment sweeps and the criminalization of people experiencing homelessness through infractions and citations and general harassment by police affects somebody’s health,” Fowle said. “Not just the stress and trauma of moving constantly but losing medication they rely on, finding a new place to sleep every day, not being around a social support system that may help prevent an overdose.”
Some counties in recent years, such as Oregon’s Multnomah County, which includes Portland, have ramped up efforts to collect homeless mortality data. Their annual report includes causes of death, race and age demographics, a breakdown of deaths by ZIP code and insights on common trends.
Fowle said California added a new checkbox on death certificates to indicate if someone was experiencing homelessness at the time of death.
But there are no standard or consistent practices.
“Because there is no national guidance or really even best practices around homeless mortality data collection, every jurisdiction seems to do it slightly differently,” Fowle said. “Some might include people who are hospitalized or currently incarcerated and will live and be homeless. Some might include people in transitional housing while others might include those who are literally on the street or in shelter.”
Creating a standard practice would make it easier for other counties to start collecting data.
With those numbers, cities would be able “to get a scope of the problem and know if our solutions are working.”
The Southern Nevada Health District doesn’t compile reports about homeless deaths specifically, but has incorporated homeless data into other reports, such as its heat-related death report.
Hernandez is still trying to piece together everything that led up to his sister’s death.
He may never know the answers. All he knows is that he misses his sister and the memory of her infectious laugh.
“I miss her,” Hernandez said. “I treasure the memories of her as a child and the time we spent together. I miss that we don’t have a future together and I won’t be able to share the rest of my life and her life.”
