Ryan Cowger, 32, was a 4.0 student who moved to Portland to start a new life after falling into opiate addiction. On Jan. 13, 2015, he was found dead in a shower at a transitional shelter after overdosing on heroin.
These are just two among the 88 deaths of homeless people detailed in an annual report released by Multnomah County Health Department.
READ – Domicile Unknown, for 2015
The findings, which come from a review of deaths by the Multnomah County medical examiner, reveal a sharp increase from the report’s findings from 2014, when 56 homeless had died.
The numbers are solid, though probably an underestimate, according to one of the report’s contributors, Dr. Paul Lewis, the Multnomah County health officer. The numbers don’t include those who were homeless but died under hospitalization.
“In other years we had done inquiries into hospitals to try and identify other people who were homeless who died under hospitalizations … and we found very few,” Lewis said at a news conference Friday.
The report also emphasizes that most of the deaths were preventable if the victims would have had better access to mental and physical health care or substance abuse services, and that many were decades premature.
“I mean when you look at the average age of the deaths — 40 years old for women, 50 years old for men. Those are numbers you read of death rates in the 19th century. It’s a tale of how … traumatic the experience of homelessness is,” said Street Roots Director Israel Bayer at the conference. Street Roots is a Portland weekly publication that addresses homelessness and poverty. It also produces an annual comprehensive resource guide listing services for people experiencing homelessness. Bayer was key in getting the annual Domicile Unknown report on homeless deaths started. The first report was released in 2011.
In 2015’s Domicile Unknown report, more than half of the 88 deaths were accidental with a quarter from natural causes. Five died from homicide.
Drugs and mental health
Drugs and alcohol were major contributing factors to homeless deaths in Multnomah County, with 44 of the 88 deaths caused by those vices. Twenty-two of those 44 died at the hands of heroin or prescription opiates.
“This road map shows us that we are still in the middle of an opioid epidemic,” said Multnomah County Chair Deborah Kafoury. “We have to keep working to prevent overdose deaths with smarter prescribing practices so people don’t become addicted in the first place.”
Cowger, profiled in the report, died after he became addicted to heroin after being prescribed 90 oxycodone pills to ease the pain of passing kidney stones.
Adams, on the other hand, suffered from mental health issues and didn’t get treatment for a perforated ulcer, which is treatable and fixable. The report calls for the city and county to build upon mental, health and first-aid programs to reduce stigma and encourage families to seek care.
Affordable housing a solution?
The reasons an individual becomes homeless stem from myriad factors — drugs, mental health issues, physical health issues, other traumatic life events.
While the report calls for attention to drug and mental health services to put a halt to increasing numbers of homeless deaths in Multnomah County, Kafoury and Bayer placed one issue, in particular, at the crux of the city’s homeless problem: lack of affordable housing.
“Too many people can’t find a place to live. Until we have enough housing, people are going to be living on the street. As long as people are living on the street, they’re more than likely going to be dying on the street,” Kafoury said Friday.
Bayer echoed the sentiment: “It’s not normal that we as a community have not prioritized affordable housing as a public infrastructure.”
Indeed, other states have seen success in reducing the number of homeless people after building more units and initiating housing programs.
The state of Utah reportedly reduced their homeless numbers by 75 percent after giving homeless access to permanent housing. Other cities, such as San Francisco, are taking similar steps to end homelessness.
According to an April San Francisco Examiner article, the city saw drops in homeless deaths — they reported 41 homeless deaths last year, compared to Portland’s 88 — after building new units and prioritizing the sickest homeless individuals for a housing slot. This is in addtion to reduction of heroin-related deaths by use of the overdose reversal medicine, naloxone.
Kafoury says money is coming. During its last session, the Legislature put $40 million into a statewide fund to build affordable housing. Another $20 million was allocated to build affordable housing for people experiencing mental illness, she said.
“Those are unprecedented numbers,” Kafoury said.
Furthermore, Measure 26-179 on the November ballot in Portland would raise $258 million for affordable housing in the city.
Portland Housing Bureau director Kurt Creager says the deaths are a “tragedy of great proportions,” and pointed to the Joyce Hotel purchase earlier this summer.
There are 64 rooms in the hotel building, which the city intends to repurpose for low-cost housing, and Creager says the city also has 2,100 more affordable units “in our pipeline” not including Joyce Hotel.
“The state of emergency has helped move that sense of urgency, and this report really outlines the need for more action,” he told the Tribune.
The housing bureau has allocated money to eight new projects, he says, including projects in Northeast and Southeast Portland and in the Oregon Convention Center area.
Additionally, Creager says the bureau has put forth a package of tenant protections for the upcoming legislative session.
“There does need to be a just-cause eviction standard right now. The standard now is a no-cause eviction, so people are being evicted for no reason whatsoever and the rate of displacement and frequency has gotten to be a crisis in the city,” Creager says.
When asked what other tenant protections are being proposed, Creager said he didn’t want to disclose until “the council has a chance to get into the nitty gritty.”