The Health Impacts of the January 2025 Los Angeles Wildfires among Unhoused Communities

Abstract The impact of the devastating January 2025 Los Angeles (LA) County wildfire and extreme wind event (“firestorm”) on the health trajectory of people experiencing homelessness (PEH) is unknown. The study objective was to determine the health and social impacts of the firestorm on PEH in LA County. We analyzed data from the Periodic Assessment of Trajectories of Housing, Homelessness, and Health Study (PATHS), an ongoing longitudinal monthly panel survey of roughly 500 PEH in LA County. We administered survey questions on firestorm exposure 2 weeks after the firestorm began. We conducted analyses to assess relationships between sociodemographic factors and firestorm exposure and performed difference-in-differences analyses using mixed-effects logistic regression models to determine associations between firestorm exposure variables and self-reported health, controlling for sociodemographic variables. Of the 534 active PATHS participants, 403 were included in the primary analytic sample. 55.6% of survey participants reported disruption from the firestorm. Non-Hispanic Black/African American respondents had higher odds of reporting disruption compared to non-Hispanic White respondents (aOR = 2.24, 95% CI: 1.16–4.40), as did those who were primarily unsheltered (aOR = 4.43, 95% CI: 2.70–7.40) or displaced (aOR = 2.75, 95% CI: 1.68–4.56) in the past month. Difference-in-differences analyses found no consistent evidence of associations between firestorm-related disruption and subsequent outcomes, with confidence intervals for all estimates spanning the null. Our findings suggest that unsheltered PEH were especially vulnerable to the firestorm but that the firestorm did not significantly affect longitudinal measurements of self-reported health, which were already poor at baseline.