The Multnomah County Health Department’s annual review of homeless deaths finds that during calendar year 2019, 113 people died in Multnomah County without an address or a home of their own. The number of deaths counted in 2019 is the highest since the County began producing the report, called Domicile Unknown.
Each year, Multnomah County undertakes this report in partnership with Street Roots to determine the number, characteristics and causes of homeless deaths in our community. We believe the vast majority of these deaths were preventable. Domicile Unknown is intended to help the public, elected officials and social services providers identify resources and policies that can save lives.
“It can be hard to confront, in such a stark way, how our community allows so many people to lose their lives on our streets year after year,” Chair Deborah Kafoury said. “This report is a reminder that safe shelter or housing isn’t just walls, a roof and a door. It’s safety, comfort and warmth. It’s the stability that means someone can tend to their health and personal needs. It’s survival. It’s a right.”
Since 2011, when the Multnomah County Health Department and Medical Examiner’s Office began tracking deaths among people experiencing homelessness, at least 643 people have been counted. In 2018, 92 people died, preceded by 79 in 2017, 80 in 2016, 88 in 2015, 56 in 2014, 32 in 2013, 56 in 2012 and 47 in 2011. The proportion of medical examiner deaths occurring among homeless individuals has remained mostly steady, at an average of 8.9 percent of all the deaths investigated by the Medical Examiner.
“We release this report 10 months into a pandemic that has stricken people across the world, but the deaths counted here preceded the pandemic,” said Street Roots Executive Director Kaia Sand. “Many of us can look beyond COVID-19 and imagine the life we will return to. But homelessness is its own relentless public health epidemic. It is my hope that the tenderness and rawness of 2020 will translate into ongoing commitment to meeting the enduring challenge of homelessness.”
Drugs or alcohol caused, or contributed to, about half of the deaths in 2019. Methamphetamines were a leading cause and contributor of deaths associated with drugs or alcohol, followed by opioids. The combination of methamphetamine and opioids occurred in a quarter of cases where drugs or alcohol caused or contributed to death.
Nearly half of those who died, 53 people, were found in outdoor public spaces that included sidewalks, parks and encampments. An additional 10 people were discovered in outdoor spaces that were privately owned, such as parking lots. Hypothermia caused or contributed to the deaths of four people.
Among those who died in 2019, one-third died of natural causes, some caused by complications from drug and alcohol use, while others died from chronic disease including heart disease or stroke, uncontrolled diabetes, or untreated pneumonia.
Ten people died in traumatic accidents, including deaths from inhaling smoke from a fire or being struck by a car, truck or train.
“This report is a litany of grief. It reminds us that a too-frequent outcome of homelessness is early death,” Sand said. “Too many people do die in anonymity, many enumerated in this report, but let us memorialize them in the work we do for the living.”