Report: At least 193 people died while homeless in Multnomah County in 2021

By Jeff Thompson (OPB)
Feb. 15, 2023 10:54 p.m.

More people died while experiencing homelessness in Multnomah County in 2021 than in any other year since the county started gathering the information, according to the report.

At least 193 people died while experiencing homelessness in 2021, according to Multnomah County’s Domicile Unknown report released on Wednesday.

The report reviewed the number of unhoused people whose deaths were investigated by the Multnomah County Medical Examiner’s Office.


The number of deaths in the 2021 report is the highest it has been since the county started reviewing the data in 2011. Of the deaths listed in 2021, 18 were homicides. That statistic is also higher than it has ever been.

The report found that the average age of those whose deaths were reported — 48 years old for men and 46 for women — was about three decades younger than the nation’s average life expectancy.

Drug use was a significant factor in two-thirds of the deaths, with methamphetamine contributing to 93 of them. Fentanyl contributed to 36 deaths in 2021, up from just four in 2020.


Haven Wheelock, with the homelessness outreach program Outside In, says fentanyl was not a factor in these reports until 2017.

“I don’t think anyone was really prepared for how quickly and sustained the changes in our drug supply have been,” Wheelock said. “I’ve been doing work with this community for nearly two decades and I’ve never ever seen our drug supply change, the way people are using substances change, as quickly as we’ve seen in the last few years.”

In a year that saw extreme weather, including the Northwest “heat dome,” five deaths listed in the report were caused by hyperthermia. But extreme cold led to eight of the deaths.

COVID-19 is listed as the cause of two deaths in the report. But health officials say disruptions from the pandemic had other immeasurable impacts on homelessness, mental health and substance abuse in 2021.

“It’s impossible to capture all of the rippling effects of the COVID-19 pandemic on people’s lives, but there is no question that 2021 was another extraordinarily difficult year,” said Multnomah County Health Officer Dr. Jennifer Vines.

County leaders say the information in the Domicile Unknown report helps inform future harm reduction strategies for people experiencing homelessness.

Related: 2020 deaths: At least 126 people died while homeless in Multnomah County