Think Out Loud

In Multnomah County, homeless deaths are on the rise

By Elizabeth Castillo (OPB)
June 17, 2025 1 p.m. Updated: June 17, 2025 10:45 p.m.

Broadcast: Tuesday, June 17

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In Multnomah County, the number of deaths of homeless residents grew from 113 in 2019 to more than 450 in 2023. Research has found that encampment sweeps can threaten the health of people experiencing homelessness. Portland has carried out 19,000 sweeps since 2021, according to city records.

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Reporting from Street Roots and ProPublica examines why residents of Multnomah County die at a higher rate than in any major West Coast county, according to available homeless mortality data.

K. Rambo is the editor-in-chief of Street Roots and produced the story for ProPublica’s Local Reporting Network. Rambo joins us with details.

Note: The following transcript was transcribed digitally and validated for accuracy, readability and formatting by an OPB volunteer.

Geoff Norcross: This is Think Out Loud on OPB. I’m Geoff Norcross, in for Dave Miller. Four years ago, the city of Portland committed to a new strategy for the homeless population. It had two parts: one, more aggressively move homeless people out of public places through sweeps; two, increase the investment in temporary shelters while reducing money for stable permanent housing. New reporting by Street Roots and ProPublica suggests that was a deadly choice. The number of homeless deaths have quadrupled. And now homeless residents in Multnomah County die at a higher rate than any major West Coast county.

K. Rambo is a Street Roots reporter who wrote the story that was published last week, and they join us now. Welcome to Think Out Loud.

K. Rambo: Hey, thanks for having me.

Norcross: This initiative was announced in the spring of 2021. It was designed to address a real problem. Just for context, can you talk about the state of homelessness in Portland coming out of the pandemic?

Rambo: Yeah, homelessness definitely increased during the pandemic. We saw the cost of housing increase a lot, so there were considerably more folks on the streets. Sweeps became less aggressive, temporarily, early in the pandemic. So visible homelessness, in particular, had increased quite a bit and the city was facing a lot of pressure to respond to it.

Norcross: And they did. What, at the time, was the rationale behind prioritizing sweeps and temporary shelters over permanent housing?

Rambo: That’s a question I’ve really struggled to get answered. A lot of it does have to do with responding to that pressure, trying to kind of jumpstart a recovery economically in the downtown area in particular. And I think there is some idea here that if you can compel people into shelters, then you can connect them with services. And then they will ideally be connected to housing.

Norcross: That turned out to not be the case. We’ll get to that in a minute, but was it a cost cutting move at all?

Rambo: I wouldn’t say so. The city has spent quite a bit of money on this tactic. And it’s important to note that this is something that has certainly evolved over the last several years. It wasn’t like [Mayor] Wheeler just said, alright, this is the new plan and we’re going with this. It did start, I would say, in 2021 and then has been iterated on by local leaders over the last several years.

Norcross: That brings us to the present day. What is the latest data you have for homeless deaths in Multnomah County?

Rambo: The most recent year available, with verified data, would be 2023. There were 456 homeless deaths captured in the county’s annual report.

Norcross:That’s a fourfold increase from 2021?

Rambo: It is a fourfold increase from 2019. It’s also important to note that the last couple years, 2022 and 2023, include some state records that weren’t previously available. But even if you’re just comparing the same data source that was in prior reports, it’s more than tripled in that time period.

Norcross: You say that is the highest death rate for any major West Coast county or a county that has a big city in it – that includes San Diego County, LA County, King County which has Seattle. Why do you think that is?

Rambo: That’s really the question I set out to hopefully find some answers to. The researchers who I interviewed were pretty shocked by Portland’s mortality rate, but also the number of sweeps that the city had conducted, in addition to decreasing its investment in permanently housing homeless people by about 75%. The research is pretty clear that housing, particularly when there are services available to the people in that housing, is the most cost effective and long-term solution that you can provide for homelessness.

So the city really turned away from that established best practice and shifted toward this very sweep-heavy approach. And that was something that researchers really zeroed in on.

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Norcross: There is an X-factor here and that is San Francisco. You didn’t have data for them?

Rambo: That’s correct. San Francisco did not respond to multiple requests for data. Best I can tell, they’re no longer releasing public reports with homeless deaths. So that is a caveat, a major city that did not provide data.

Norcross: But Portland and Multnomah County [are] definitely up there. Here, though, is the correlation causation question: can anyone definitively say that the city’s new approach caused those deaths?

Rambo: No, not on an individual level. I’ll say too, “highest mortality rate” is almost underselling it. It is double every other county that provided data, other than San Diego. And San Diego is the only jurisdiction that conducts, remotely, as many sweeps as the city of Portland does. I’m sorry, what was your original question?

Norcross: The original question is, can you definitively say that the city’s new approach that prioritizes sweeps and temporary housing or temporary shelters actually caused the deaths that you reported on?

Rambo: No, I mean not on an individual level. Part of that is [related to] the data. All we really have are the numbers.The county has the death reports which they refused to release for the individual deaths. But the way a researcher explained it to me that helped me understand it was, like when we’re talking about heart disease and the connection with eating a lot of red meat, you can’t point at a particular meal and say that’s what caused somebody to have a heart attack. But the more that risk factor is introduced to somebody, the higher the risk becomes.

And that’s the same thing with sweeps because it does disconnect people from medical care, it disconnects them from addiction treatment, it disconnects them from any other resources that they may be near. And oftentimes people lose just about everything they own. Then there’s this additional step where now, the people that person relied on for safety – maybe that’s reversing overdoses, maybe that’s protecting them from people who may be dangerous – they’re now removed from the community that was providing them safety previously.

Norcross: You talked to experts who weren’t all that surprised to know that deaths shot up after the city changed its approach. In fact, you spoke with a volunteer physician who said, “I don’t know why anybody thought the sweeps would help. It’s not like the homeless are swept into services.”

Rambo: This is something, again, that I’ve had trouble getting an answer from the city. Where is the evidence to suggest that this approach does improve health and safety? If I’m constructing an argument for them, I might say that if you don’t clean out the camps, then there could be waste, there could be other forms of health and safety risks that spring up. Unanimously, the experts and service providers I spoke to said that there are many ways for a city to ensure that things like communicable diseases are not being spread. They can do that without displacing people, without taking their belongings, and without forcing them to pack up and move on pretty short notice.

Norcross: You wrote about a homeless woman named Debby Beaver. She was 57 when she died in 2019. What happened to her?

Rambo: According to the wrongful death lawsuit that her family filed, as well as some people I interviewed who were close to the situation, Rapid Response Bio-Clean, a for-profit private contractor that the city hires to conduct encampment sweeps, allegedly took her medication during a sweep and she died a week later. She had a number of health conditions and, according to the lawsuit, was recovering from a pretty serious surgery at the time. That is the story.

Norcross: And the story underlines a key point, which is that sweeps are uniquely disruptive to people who are experiencing homelessness, especially if they have medical issues or they need medication. Can you talk more about that?

Rambo: Something that experts really highlighted is that these sweeps are something not good for people’s health, period. When you factor in people who are already medically vulnerable, sweeps really have a major impact and a very disproportionate impact on people with disabilities. Folks with disabilities are also likely to have the hardest time trying to pack up their camp, find a new spot, find somewhere that’s safe and accessible to them. So it does really have some disproportionate impacts on people who are already at a higher risk of dying on the streets.

Norcross: We’re talking about Multnomah County data, but this is a Portland problem, because most of the county’s homeless residents live in Portland, correct?

Rambo: Yeah, about 80%.

Norcross: So you reached out to the city of Portland with these findings. What kind of response did you get?

Rambo: There was some understandable concern. I think “heartbreaking” was a term that was used. The city acknowledged that it has not studied the health impacts of sweeps. They said they would support that research and maintain data that would allow that to take place. But there was no indication that this reporting or the data [among] the eight different experts we interviewed … no indication that this story was going to, at least immediately, cause some reflection on this strategy and maybe a little further examination of some of the unintended consequences it could have.

Norcross: Yeah, but at the same time, Portland has a new mayor who made ending homelessness the center of his campaign. Any indication that Mayor Keith Wilson might do things differently?

Rambo: The city is sweeping more than it ever has. In May, the city swept about 26 encampments per day. So, I mean, so far there’s not really any indication that Mayor Wilson is looking at this differently. In fact, he’s spoken about his desire to actually lessen the amount of notice that folks are getting on the streets, which is already a fraught sort of thing for people.

The notices they get give a three to 10 day window. The city’s supposed to come back the day before they sweep in that three to 10 day window and give additional notice. But we’ve heard from a lot of folks that that doesn’t usually take place. So if anything, so far, Mayor Wilson has been more aggressive with sweeps and has sought to remove some of the scant protections that exist for folks on the streets.

Norcross: K. Rambo, thank you for your reporting on this and thanks for coming on the show. I appreciate it.

Rambo: Yeah, thank you so much.

Norcross: K. Rambo is the editor-in-chief of Street Roots.

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