February 15, 2023
EMBARGO UNTIL 11:30 Wednesday, February 15, 2023
The Multnomah County Health Department’s annual review of deaths reveals that during calendar year 2021, at least 193 people died while experiencing homelessness. The number is up from 126 a year ago and is the highest since Multnomah County began analyzing deaths for medical examiners in 2011.
At the same time, the approximate percentage of deaths that occur among homeless individuals has remained stable over the past six years, averaging 10% of all deaths investigated by the Medical Examiner.
View and download a copy of the report here.
Each year Multnomah County undertakes this report in partnership with The roots of the road to determine the number, characteristics and causes of homeless deaths in Multnomah County. For more than a decade, detailed analysis in Residence unknown has helped raise awareness of the deadly risks experienced by people living homeless, from exposure to the elements and interpersonal violence, to the impact of untreated mental health and substance use disorders.
Deaths that meet the criteria for coroner’s investigations are often premature by definition, but the data show how much. The median age of death among men who experienced homelessness in 2021 was 48. For women, it was 46. That’s three decades younger than the average life expectancy for someone living in the United States.
In 2021, due to the ongoing threat of COVID-19, even the life-saving act of entering a shelter carried some risk. The transmissibility of the virus cut off formal and informal resources, separated people from their safety nets and isolated them. Just as the pandemic was accelerating the prevalence and severity of substance use and mental health disorders—among both sheltered and homeless people—our community was actively losing the counselors, residential treatment beds, and sobering resources needed to keep up. the need.
Two deaths identified as part of this report resulted from complications of COVID-19; the virus was a cause in a third. No deaths from COVID-19 were identified in 2020.
“It is impossible to capture all the ripple effects of the COVID-19 pandemic on people’s lives, but there is no doubt that 2021 was another extremely difficult year.” said Dr. Jennifer Vines, Multnomah County Health Officer.
COVID-19 also drove more people into homelessness and onto the streets, where they were exposed to increased violence throughout the community. In the timed count conducted in January 2022, more than 500 people identified the pandemic as the cause of their homelessness — a number that equates to more than half of the total increase in homelessness since 2019.
In 2021, more people experiencing homelessness died by homicide than at any time since 2011, more than doubling from eight in 2020 to 18. This reflects an 83% increase in overall homicides documented by the Bureau of Portland Police, who reported 90 murders.
Homeless people also faced unprecedented severe weather. Four people died of overheating during the historic and devastating Heat Dome event from June 25 to June 30, 2021, when temperatures reached 116 degrees Fahrenheit. And hyperthermia contributed to a fifth death, an overdose, during that period.
However, more people who experienced homelessness died from the cold in 2021 than from the heat. There were eight deaths in which hypothermia, or low body temperature, contributed — out of three deaths in 2020. Only one occurred during severe cold events or winter emergencies, but all were during Oregon’s winter months, often in combination with the use of substances.
“It is a life that is based not only on survival, but the survival of this survival: People are looking for ways to endure,” wrote Kaia Sand, executive director of Street Roots, in the report’s introduction.
Highly potent and increasingly available substances, often used in combination, remain a leading cause of death. Methamphetamine, a stimulant that can stress the brain and heart, contributed to 93 deaths — nearly half of all deaths and 82% of all deaths involving substances — the highest total number and the highest percentage of total cases since publication first of “Domicile Unknown”.
But fentanyl, used alone or in combination with other substances, has also emerged as a key factor.
Fentanyl, a synthetic opioid increasingly sold as cheap street pills, was a major or contributing factor in 36 deaths (32%), a dramatic increase from four deaths in 2020 and an average of one to two deaths in year since it was first recorded as a factor in 2017.
“I’ve never seen the drug supply change in such a short time,” said Haven Wheelock, program supervisor of Drug User Health Services at Outside In.
And this figure is likely to continue. The Multnomah County Sheriff’s Office reported the number of Individual fentanyl pills seized rose from 7,423 in 2021 to 141,864 a year later. A September 2022 bust alone received 92,000 pillsas well as 10 kilograms of cocaine cut with fentanyl.
Crystal Sellers died in 2021 at the age of 37 from a combination of methamphetamine and fentanyl. Her sister Melinda Peevy shared their family’s experience with substance use in this year’s report, a tribute to hundreds of relatives who lost a loved one.
“We grew up poor, got into our addictions young and carried it into adulthood,” Peevy said. “I decided to break the cycle and I thought she could too. She was the strongest.
“But she couldn’t beat that.”
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