Multnomah County Sees First Drop in Homeless Deaths in a Decade but Fentanyl Overdoses Still Surge
Of the 372 homeless people who died in Multnomah County last year, 183 overdosed from fentanyl, more than double the 91 deaths linked to the synthetic opioid in 2022.
Source: Multnomah County Health Department Domicile Unknown 2024 release and report summary
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This is a clear sign of fentanyl’s continued deadly impact on communities, despite programs launched to turn the tide, states the Multnomah County Health Department in its 2024 annual review.
Deaths Among the Homeless Population Decreased by 18%
The death rate among homeless people was 84 fewer than the 456 deaths in 2023, and is the first decrease since 2013, and the largest reduction at 18% since 2011, when Multnomah County first began analyzing deaths among the homeless population.
Multnomah County Chair, Jessica Vega Pederson, described fentanyl deaths as tragic, but is hopeful that the downward trend in the death rate is indicative that the behavioral health services are making an impact on opioid addiction.
Her optimism is echoed by Multnomah County health officer, Dr Richard Bruno, who says overdose deaths in 2023 numbered 779, but dropped to 634 in 2024, offering a glimmer of hope for a continued decrease in the future.
The Domicile Unknown Report
The Multnomah County Health Department has published the Domicile Unknown report since 2012 to determine the characteristics and causes of deaths among homeless individuals in the county. The inclusion of hospital and medical care deaths began after Senate Bill 850 took effect at the beginning of 2022.
| Place of death | Share of deaths | Count noted in report |
|---|---|---|
| Outdoor | 40% | 149 |
| Hospital (inpatient) | 27% | 99 |
| Parked car, RV or boat | 9% | Not listed |
| Hospital (outpatient or ED) | 7% | Not listed |
| Hotel, corrections, shelter | 6% | Not listed |
| Home or apartment | 5% | Not listed |
| Light rail or bus, including platforms | 3% | Not listed |
| River | 2% | Not listed |
| Other | 2% | Not listed |
This has enabled authorities to pinpoint additional data, such as gender and age groups.
In 2024, of the 372 homeless people who died, 301 or 81% were male. The 71 females who died represent 19% of the county’s homeless population.
Source: Multnomah County Health Department Domicile Unknown 2024 release
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The average age of those who lost their lives while homeless last year is 48, which is 30 years younger than the average lifespan of Multnomah residents.
Racial Inequities Continue
A further breakdown of the report reveals continued racial inequities among African American and Indian American communities in Multnomah County. African Americans accounted for 12% of deaths among the homeless, compared to 8% of the general population, while Indian Americans accounted for 5% of the death rate and comprise 3% of the general county population.
But no amount of optimism can escape the fact that death by drug overdose continues as the dominant factor. Of the 245 deaths from accidental or unintentional injuries in 2024, 87% were from opioid abuse, equating to 214 deaths by drug overdose, of which fentanyl was present in 86% of the cases.
View a copy of the 2024 report here.