At least 315 people died while experiencing homelessness in Multnomah County in 2022, according to a report released by the county Wednesday. The number reflects a 63% increase in the number of deaths of unhoused people recorded in 2021. It’s six times larger than the number of deaths counted in 2010, the year the county first began reviewing the data.
The 2022 report reflects data collected by the Multnomah County Medical Examiner’s Office and from local hospitals.
FILE: Tents line both sides of Southwest 13th Avenue in Portland, April 4, 2022.
Kristyna Wentz-Graff / OPB
“There are multiple intersecting causes leading to homelessness, including lack of affordable housing, racial injustice, lack of social support systems, substance use and abuse, mental health challenges, and a lack of access to health care, both physical and behavioral,” it reads. “This report represents the intersection of these drivers.”
This is the first year the report has included data from hospital records in addition to medical examiner’s data, contributing to a potential surge in the total count. About 66 of the total 315 deaths were reported by local hospitals in 2022. Without including hospital data, the deaths recorded by the medical examiner’s office increase 23% between 2021 and 2022.
Nearly half of all recorded deaths were deemed accidental, with the vast majority being categorized as drug overdoses. In total, 123 people experiencing homelessness in 2022 died from an overdose, often from using a combination of illicit drugs. Methamphetamine was the most common drug identified in people’s systems, followed by opioids and synthetic opioids, like fentanyl. The number of overdose deaths among unhoused residents increased 8% from 2021.
While Multnomah County saw a spike in overdose rates last year among all residents — both housed and unhoused — those experiencing homelessness were nearly 37 times more likely to die from a drug overdose compared to the overall population.
People experiencing homelessness were also killed in traffic crashes at a rate 45 times higher than the overall population in 2022. And they were 31 times more likely to die from homicide. A quarter of all people who died by homicide in 2022 were unhoused. Seventeen people died by suicide.
“Living so much of one’s life without secure housing is deadly, vulnerable to both guns and cars, a toxic drug supply… and despair,” wrote Kaia Sand, executive director of nonprofit Street Roots, in the report’s preface. Street Roots leadership played a key role in getting the county to begin tracking and reporting unhoused deaths 13 years ago.
In all, the mortality risk for people experiencing homelessness compared to the general county population was nearly 6 times higher in 2022.
The report categorizes death by cause. Overall deaths rose in nearly each category from 2021. However, 2022 saw a decline in deaths caused by extreme weather. While 2021 recorded 13 deaths from either hyperthermia or hypothermia, 2022 only counted three.
The increase in recorded deaths follows a rise in the county’s unhoused population. In 2022, the county estimated that, on a given night, at least 5,228 people were experiencing homelessness. The county did not collect homeless population data in the two years prior, due to limitations caused by the COVID-19 pandemic. In 2019, the county estimated that just over 4,000 residents were experiencing homelessness.
The average age of people who died while experiencing homelessness was 49, which is nearly 30 years below the average life expectancy nationwide in 2022. The report points to a recent study published in the Journal of the American Medical Association finding that poverty increases a person’s risk of death in the United States by 42%
Sand said these data points should inform better policymaking and care for unhoused people in Multnomah County.
“This report provides data, but that data is also a collective keening,” Sand wrote. “We fight to solve for the future, but grieve the fact that people who suffer in our county die three decades before the rest of us do.”