Multnomah County, Street Roots Release 2022 Domicile Unknown Report

For the first time, the total includes both the accidental or suspicious deaths investigated by the Multnomah County Medical Examiner — 249 — as well as the deaths of 66 people who died at the hospital or under medical care and whose deaths were tallied from death certificates recorded by funeral homes. Hospital and medical care deaths numbers were included after Senate Bill 850 established mandatory reporting of housing status at death.

Because the County has long tracked deaths investigated by the Medical Examiner — the first jurisdiction in the state to do so — it can chart changes in that subset year over year. The 249 deaths in 2022 investigated by the Medical Examiner is up from 193 deaths in 2021. Medical Examiner deaths among people experiencing homelessness have jumped 29% on average every year between 2018 and 2022 — although that average is affected by larger increases recorded during and since the COVID-19 pandemic.

Deaths among the entire population of Multnomah County also rose in 2022. But the risk of an unhoused person dying a preventable death is starkly obvious. People experiencing homelessness were 45 times more likely to die from a transportation-related injury, 37 times more likely to die from a drug overdose, 32 times more likely to die from homicide, 18 times more likely to die from suicide and six times more likely to die from any cause compared to the general population.

Each year Multnomah County undertakes the Domicile Unknown report in partnership with Street Roots to determine the number, characteristics and causes of deaths among people experiencing homelessness in Multnomah County. Domicile Unknown is intended to help the public, elected officials and social service providers identify resources and policies that can save lives.

Since the Multnomah County Health Department and Medical Examiner began tracking deaths among people who were homeless in 2011, at least 1,274 people have died while unhoused.

The findings in this report direct policy decisions and guide efforts by the County Chair, County departments and the Joint Office of Homeless Services. In recent years, and all the way through the past several weeks, County officials have worked to expand shelters — including day shelters and services — respond more effectively to severe weather, coordinate plans across the homeless response system and behavioral healthcare to better address fentanyl and polysubstance use, and collaborate more closely with jurisdictions including the City of Portland, east County cities and neighboring counties.

“The raw and human costs of this crisis are moving in the wrong direction,” said Chair Jessica Vega Pederson. “The loss of these lives is beyond humbling, and today we sit with the full weight of these losses as a County and a community. Drug overdoses, traffic fatalities, and homicides were major contributors, and our homelessness response system must become more coordinated and effective to address these issues and reverse these trends. People’s lives depend on it.”