At least 113 people experiencing homelessness in Multnomah County died last year — the most since county officials started tracking in 2012.

That year, the county and the homeless advocacy group Street Roots released the first “Domicile Unknown” report, an accounting of all the people who died living within the county without a home address. Since then, homeless deaths have more than doubled, from 47 in 2011 to the 113 counted in 2019.

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The report, released Monday, did not delve into the factors that fueled a steady rise in deaths over the decade. But in a press conference announcing the results, Multnomah County Health Officer Paul Lewis and county Chair Deborah Kafoury said the jump might be attributed, in part, to steadily rising rents and the accompanying increase in homelessness.

“If there’s more folks who are homeless and houseless, we’re going to have more deaths in that group,” Lewis said. “It’s not like there’s a new special plague.”

However, Lewis said he was concerned about the striking uptick in methamphetamine use, a stimulant he said was readily available in the county for the price of a latte. Last year, meth was a primary or contributing cause in 43 of the deaths. In 2018, that number was 27.

According to the report, alcohol or drugs — most commonly methamphetamine or opioids — caused or contributed to about half of the deaths of unhoused people. A third died of natural causes, often complications from drug and alcohol abuse or chronic diseases. Six were homicides and 15 were suicides — up from nine suicides the year before. Ten died in “traumatic accidents,” such as a fire or a car crash. And most of those deaths could have been prevented, said Kafoury.

“113 of our neighbors dying years before their time and in situations that were largely preventable — today is about them,” Kafoury said. “Their stories have been compiled, so they can be read — and it is not for us to look away.”

The report weaves in anecdotes from the lives of victims of three of these accidents: Tisha Moss, a 26-year-old woman hit by a train near 181st Avenue; Terry Riha, hit by a car crossing Northeast Halsey Street; and Michelle Wheeler, who died in a hit-and-run on an off-ramp for Interstate 84. The deaths of all three involved either substance abuse or chronic mental illness. All three were living on the streets at the time of their death.

“These pages are a resounding alarm against the lure of normalizing and accepting homelessness as an inevitable, intractable reality,” Kafoury wrote in an introduction to the report. “We must keep acting with the conviction that Tisha, Terry and Michelle would each be alive today if our systems were positioned to consistently help those who are hardest to reach and most in need.”

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Since 2011, at least 643 people have died while homeless in Multnomah County, according to the report.

The yearly review relies on data from the Oregon State Medical Examiner’s office, which flags individuals who were likely homeless at the time of their death. The authors did not include deaths where they couldn’t confirm a deceased person’s housing status or nor are people included when their fatality did not go through the medical examiner’s office. Lewis said this means the final of 113 deaths is “an absolute minimum estimate.”

Of the deaths counted, nearly half were discovered in outdoor public spaces, such as a park or homeless camp. Eighteen died in the hospital, and two were found in a river.

Three-quarters were male, a population that died at an average age of 46. The women counted died at an average age of 45. The average life expectancy in the U.S. is 78.

“You don’t need a statistician to tell you that’s a short life span,” Lewis said. “An average age of 40 is extraordinarily low.”

The authors were able to establish the race of 98 people who died. Of those, 82% were white, 8% Black, 5% American Indian/Alaska Native, and 4% Hispanic. That is broadly in line with recent demographics for the county’s population, with over representation of Black and American Indian/Alaska Native populations, said Lewis.

Fifty-five percent of the deaths occurred in the colder months between October and March. For four of the deaths, hypothermia was a cause or contributing factor.

Kaia Sand, the executive director of Street Roots, said last week one of the group’s vendors who had both of her legs partially amputated due to frostbite was able to move into housing.

“It was very frightening to think of her enduring another winter,” said Sand.

Addressing reporters from a memorial that another Street Roots vendor had put in the newspaper’s office to remember some of the people who had died, Sand said the report made clear to the public what so many at Street Roots know firsthand.

“This report is foundational for our advocacy efforts because it really is clear what’s at stake,” she said. “The difference between housing and homelessness is the difference between life and death.”

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