Fifth of all UK homeless deaths in London
154 homeless people died in the capital in 2021
London had the highest number of homeless deaths in the UK in 2021, with 154.
The rate of 22.5 per million general population is the highest since figures began in 2013.
It also accounts for 21% of all homeless deaths across the UK.
North-west England followed the capital with 114 homeless deaths (15%).
Some 741 deaths of homeless people were registered in 2021 in England and Wales, up 8% on the previous year, estimates from the Office for National Statistics show.
The increase means the number of deaths has returned to pre-pandemic levels after a drop in 2020.
It is "too early" to say whether the rise signals the return of an upward trend in deaths that was under way before Covid-19, however.
"we need more preventative measures to stop people getting on the streets in the first place"
London mayor Sadiq Khan fears it's going to get worse this winter:
"We've managed to take off our streets more than 13,500 rough sleepers over the last 6 years and 90% stay off the streets because our In For Good policies, working with brilliant charities and councils.
"The problem is though, as soon as we take somebody off the streets somebody else takes their place. There's a pipeline of people coming on the streets because of government policies. We need to address at root the problems. Welfare benefits cuts is a big problem. The lack of affordable housing is a big problem. The cost of living crisis is a big problem.
"So we'll carry on working with charities to support those who get on our streets and sleep rough, but what we need though is to have more preventative measures to stop people getting on the streets in the first place."
The estimates published by the Office for National Statistics (ONS) show that 26 homeless deaths registered last year involved coronavirus - twice the number in 2020.
Nearly two in five deaths (35%) were related to drug poisoning, which was consistent with previous years.
The dip in 2020, to 688, is likely to reflect the impact of the Everyone In scheme, which saw thousands of homeless people given emergency accommodation at the start of the pandemic to protect their safety.
This made it difficult to identify some of the deaths of homeless people housed under the scheme.
While the 741 deaths in 2021 represents a return to pre-pandemic levels, it is "significantly higher" than estimates for the period 2013 to 2017, the ONS added.
"Utterly awful and unacceptable"
Polly Neate, chief executive of homeless charity Shelter, said the figures were "utterly awful and unacceptable", adding: "Our frontline services are seeing more people who've run out of options, are facing homelessness, and the very real possibility of sleeping rough.
"This is going to be one of the toughest winters yet as so many people battle rising rents while housing benefit stays frozen.
"The Government promised to end rough sleeping, but things are getting worse not better. They must immediately unfreeze and increase housing benefit to protect people from the ravages of homelessness this winter, and to keep people off the streets for good it has to invest in building good quality, supported social homes."
Her comments were echoed by the charity Crisis, which said its services are preparing for "an incredibly challenging winter, with thousands facing the brutality of homelessness as the rising cost of living pushes them to breaking point".
Chief executive Matt Downie said: "These dire economic times must not lead to more people falling through the cracks and dying needlessly on our streets.
"We can stop this before it's too late. We desperately need more social homes and for the UK Government to invest in housing benefit so it covers the true cost of rents. Only decisive action will ensure everyone has a safe place to call home and prevent more loss of life in the future."
Due to delays in registrations, around half of the deaths registered in 2021 took place in previous years, the ONS said.
The figures mainly cover people who were sleeping rough or using emergency accommodation such as homeless shelters at or around the time of death.
The total number of deaths includes people who were identified from death records held by the ONS, together with an estimate of the most likely number of additional registrations not identified as homeless people.
Males accounted for 87% of deaths registered in 2021 compared with 13% for females, a ratio similar to previous years.
An estimated 259 deaths were related to drug poisoning, accounting for 35% of the total.
Alcohol-specific causes and suicide accounted for 10% (71 deaths) and 13% (99) respectively.
Together these three causes accounted for an estimated 58% of homeless deaths registered last year, a proportion consistent with previous years.