This text was produced for ProPublica’s Native Reporting Community in partnership with Road Roots. Join Dispatches to get tales like this one as quickly as they’re revealed.
As the town of Portland, Oregon, clawed its method out of the pandemic, it confronted a brand new set of crises: The town’s homeless inhabitants was rising. Tents lined some metropolis blocks. Excessive-powered enterprise associations held press conferences demanding the town take away homeless individuals and touted self-funded surveys saying that with out motion, companies and residents would flee the town.
By late spring 2021, the town dedicated to a brand new technique that then-Mayor Ted Wheeler mentioned would “reprioritize public well being and security amongst homeless Portlanders,” finally allocating $1.3 billion by the tip of 2024.
However though the town spent roughly $200,000 per homeless resident all through that point, deaths of homeless individuals recorded within the county quadrupled, climbing from 113 in 2019 to greater than 450 in 2023, in keeping with the newest information from the Multnomah County Well being Division. The rise in deaths far outpaces the expansion within the homeless inhabitants, which was recorded at 6,300 by a 2023 county census, a quantity most agree is an undercount. The county started together with newly obtainable state loss of life information in its 2022 report, which added about 60 deaths to the yearly tolls.
Homeless residents of Multnomah County now die at the next charge than in any main West Coast county with obtainable homeless mortality information: greater than twice the speed of these in Los Angeles County and the Washington state county containing Seattle and Tacoma. Nearly all of the homeless inhabitants in Multnomah County lives inside Portland metropolis limits.
These deaths got here throughout the identical interval that Portland started a two-pronged response to public stress over homelessness. Metropolis leaders started shifting homeless individuals out of public view by eradicating tents at a charge far surpassing these of its West Coast friends. Since 2021, it carried out 19,000 sweeps, and it dismantled over 20 encampments per day in 2024, in keeping with metropolis information.
On the similar time, the town diminished cash for secure everlasting housing whereas dramatically growing its funding in short-term shelters. The town spent $19.4 million to accommodate previously homeless Portlanders in 2019, in keeping with the town finances. By 2024, the town budgeted $4.3 million, which housed 391 individuals.
These strikes have been echoed in Trump administration coverage, which has prioritized the pressured elimination of homeless individuals from encampments and public areas. For many years prior, the federal authorities’s place emphasised secure housing.
Researchers from 4 universities informed Road Roots and ProPublica that sweep-heavy techniques like Portland’s harm security fairly than enhance it, putting homeless individuals at larger danger of hurt or loss of life. Present and former employees members at six native service suppliers, like Rose Haven Govt Director Katie O’Brien, say the town’s strategy didn’t do what was promised.
O’Brien mentioned extra persons are in disaster after they arrive at Rose Haven, a daytime shelter serving girls and transgender individuals.
“It’s including to the complexities and the challenges that they’re already coping with, mentally, bodily, safety-wise,” mentioned O’Brien.
Katie O’Brien, proper, govt director of Rose Haven, has lunch with visitor Leslie and her canine, Norma. Leslie is a sixth-generation Oregonian.
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Leah Nash for ProPublica
Cody Bowman, a spokesperson for the town, known as the rise in deaths throughout the newest efforts “heartbreaking and deeply regarding.”
He informed the information organizations the town takes “a multifaceted strategy to saving lives and supporting people in disaster.” The steps the town has taken embrace offering new shelter beds, investing in outreach, sweeping encampments in areas with accidents and floods, and dispatching emergency personnel as a part of the town’s life-saving measures, he mentioned. Bowman additionally mentioned the town educated sweep crews to make use of remedy that may save somebody who’s overdosing.
Elevated Danger From Sweeps
Homeless residents in Multnomah County die, on common, greater than 30 years sooner than the common U.S. life expectancy of 78, in keeping with the newest Multnomah County homeless fatality report.
Some 1,200 homeless individuals died in Multnomah County from 2019 via 2023, in keeping with the Multnomah County Well being Division. Of these, 659 died of drug- and alcohol-related causes, 323 died of pure causes, and 142 died of murder or suicide — a charge about 18 occasions increased than among the many common inhabitants in Portland.
Multnomah County Had a Increased Dying Fee of Homeless Residents Than Different West Coast Counties
The Oregon county, which encompasses Portland and surrounding cities, additionally noticed the most important loss of life charge improve between 2019 and 2023.
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Word: Homeless inhabitants estimates are based mostly on point-in-time counts. Information doesn’t embrace pure deaths in hospitals as a result of it was not obtainable in all counties. The San Francisco Division of Public Well being didn’t reply to requests for information.
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Lucas Waldron/ProPublica
Forcibly shifting homeless individuals can improve overdoses, in keeping with a 2023 peer-reviewed examine revealed within the American Medical Affiliation’s journal JAMA. The authors estimated that amongst homeless individuals who inject medication, those that face repeated sweeps are 10% to 22% extra prone to die from an overdose than those that don’t. They had been additionally far much less prone to receive remedy for opioid use dysfunction.
“We all know that the extra persons are swept, the extra they lose entry to their drugs,” mentioned Dr. Josh Barocas, a doctor and co-author of the examine. “They lose entry to their neighborhood. And so they lose entry to hope, and due to this fact they really are at elevated danger of overdose and loss of life.”
Maybe nobody is aware of the dangers to Portland’s homeless inhabitants higher than Dr. William Toepper, a volunteer doctor working to cut back Portland’s rising homeless mortality for the previous seven years. And because the surge in sweeps after 2020, Toepper sees an more and more scattered inhabitants.
“I don’t know why they’re spending this cash on destabilizing individuals and displacing them,” Toepper mentioned of the town of Portland. “I don’t know why anybody thinks that may assist. It’s not like they’re being swept to providers.”
Toepper leads certainly one of 4 crews at Portland Road Medication, a nonprofit he co-founded in 2018, every crew protecting a special a part of the town. Toepper’s staff makes weekly rounds in North Portland in and round Delta Park, the place industrial districts and strip malls converge on one of many metropolis’s largest parks. The staff goes from tent to tent — alongside bike paths, sidewalks, waterways and freeway overpasses — treating wounds, infections and post-operative incisions, and serving to individuals monitor and handle continual well being circumstances. Whereas they’ll’t dispense prescription remedy, they write prescriptions and assist coordinate pharmacy journeys.
First picture: Dr. William Toepper, co-founder of Portland Road Medication, shares provides throughout a road spherical in Portland, Oregon. Second picture: Affected person Duane, who lives in his automobile, receives therapy from Mary Sorteberg, a nurse and volunteer with Portland Road Medication.
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Leah Nash for ProPublica
Toepper mentioned medically weak and disabled persons are particularly susceptible to extreme outcomes from sweeps. That was the case with certainly one of Toepper’s sufferers, Debby Beaver, 57, who died in 2019. Beaver had seizures, hypertension and diabetes. She lived in an encampment on the intersection of Southeast thirty fifth Avenue and Yamhill Road, a residential space one block faraway from a bustling buying district, when metropolis contractors dismantled the encampment and took her drugs, in keeping with a wrongful loss of life swimsuit filed by her household.
John Mayer, former govt director of a homeless providers nonprofit throughout the road from the place Beaver slept, described her as a “very candy, type of aged stateswoman of the place.”
Beaver died every week after the sweep on account of dropping her remedy, in keeping with the lawsuit. In court docket, the non-public, for-profit firm employed to take away homeless individuals dwelling within the space mentioned it by no means swept Beaver’s encampment or took her remedy. The corporate maintains its staff didn’t seize Beaver’s remedy, however it settled the lawsuit for $45,000 in July 2024, with out admitting any wrongdoing.
“It was just a little little bit of a way of, you realize, this was sure to occur to any individual, and right here it’s,” Toepper mentioned of Beaver’s loss of life. “Even with this story and with the publicity it gained, and a reasonably first rate quantity of witnesses to it, so far as I can inform, properly, nothing’s modified.”
In an electronic mail to Road Roots and ProPublica, the town acknowledged sweeps could be traumatic or dangerous however mentioned it really works to reduce the dangers. Bowman mentioned the town labored in session with Oregon Justice Useful resource Heart, a civil rights legislation agency, to reduce hurt.
The agency mentioned it represented homeless plaintiffs in a lawsuit in opposition to the town and agreed to a settlement. Whereas the town posts notices saying its contractors will sweep an space within the subsequent three to 10 days, the settlement required the town to present further discover the day earlier than a sweep and supply extra exact sweep places and descriptions of things it might discard or save.
“Sweeps in and of themselves are traumatic, dangerous experiences for these experiencing them and are merely not needed to unravel homelessness,” mentioned Alice Lundell, the agency’s communications director. The group “doesn’t endorse or help the town’s present sweep insurance policies,” she added.
When requested if sweeps led to extra deaths, the town mentioned the connection wanted extra examine.
“We maintain detailed information and make our camp elimination information publicly obtainable,” Bowman mentioned. “We might welcome analysis utilizing that information as a part of a complete evaluation exploring this query.”
Neglecting Housing
The opposite prong of the town’s strategy to homelessness was a pivot towards shelters and away from long-term housing — one other transfer every of the 4 consultants mentioned may contribute to the growing loss of life charge amongst homeless individuals. Case narratives from the county report on homeless deaths typically cite a scarcity of secure housing as an element.
Matthew Fowle, a College of Pennsylvania researcher who’s studied homeless mortality, mentioned information exhibits cities with sturdy shelter techniques like New York Metropolis and Boston nonetheless have excessive homeless mortality charges, however they’re significantly decrease than Portland’s.
“All options to homeless deaths start and finish with housing — with secure, secure and inexpensive housing,” Fowle mentioned, including that supportive providers generally must accompany that housing. “It’s a completely needed situation to cut back homeless deaths.”
An encampment in Portland. Consultants say secure housing can scale back deaths of homeless individuals.
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Leah Nash for ProPublica
In Portland, the choice to deal with short-term shelter got here after Wheeler needed to implement a public sleeping ban within the metropolis. A federal court docket had dominated cities couldn’t advantageous or arrest homeless individuals for public sleeping if the town couldn’t supply shelter. Though the Supreme Courtroom has since reversed it, on the time, the federal court docket ruling meant Portland wanted hundreds of shelter beds to implement its ban on public sleeping. The town greater than quadrupled its annual sweep and shelter spending — from $16.3 million in 2021 to $72.5 million in 2025 — including as much as practically 1 / 4 of a billion {dollars} throughout the 5 years. It added 826 shelter beds since 2021.
Multnomah County’s native public shelter system now has roughly 3,000 beds and operates close to capability every night time, in keeping with the county. Though the county homeless census exhibits 6,300 homeless individuals on any given day, as many as 15,245 use homeless providers in a month. Some could also be briefly homeless.
The town says emergency shelters are an vital software for connecting homeless individuals with providers like habit therapy, however critics say shelter restrictions push individuals again to the streets. Shelters are sometimes first-come, first-served, and should prohibit or restrict pets, romantic companions and belongings. Strict in-and-out occasions can also preclude homeless Portlanders with jobs.
The town has additionally positioned 651 shed-sized single-person pods with warmth and electrical energy in a number of elements of the town away from the downtown core. The pod cities are managed by contractors, a few of which have confronted criticism for heavy-handed administration, overly strict safety protocols and a complicated referral course of.
Bowman mentioned the town doesn’t view the hassle to deal with homelessness as a alternative between shelter and everlasting housing. In an electronic mail to Road Roots and ProPublica, he referenced the town’s inexpensive housing program as proof of a continued funding in everlasting housing. The town spent greater than $1 billion since 2019 to extend inexpensive housing provide to low- and medium-income individuals through the town’s Inclusionary Housing program.
A lot of that housing is out of attain for homeless individuals. Metropolis information present landlords may cost not less than $1,229 monthly for 95% of the items created beneath this system in 2024, which native and federal requirements deem inexpensive solely to individuals incomes $49,560 or extra.
The dearth of accessible everlasting housing for homeless Portlanders is cited within the county’s annual report on homeless deaths.
Of the 17 narratives revealed within the final 5 studies about people who died, 10 embrace some reference to a scarcity of constant entry to housing, shelter, providers or some mixture of the three. A number of narratives talk about emergency shelter not offering long-term options.
Nancy Lee Charlotte Hill, 35, grew up in foster care with bodily and studying disabilities. Hill labored onerous to get via highschool with good grades whereas working a job, her sister Loraine mentioned. It was round that point Hill started utilizing medication and alcohol. She utilized her penchant for onerous work to sobriety, accessing therapy on a number of events. However with out housing, she had nowhere however the streets when she left therapy and struggled to remain sober, her sister informed the county.
Cities Say They Retailer Property Taken From Homeless Encampments. Folks Not often Get Their Issues Again.
She died on a sidewalk July 5, 2023, in downtown Portland close to the Tom McCall Waterfront Park after taking a mix of fentanyl and methamphetamine.
“Nancy had a robust want to reside her personal path,” her sister mentioned in a story. “However she was solely in her 30s when she died. She had an entire life left to reside.”
John Ellstrom, 54, was one other resident who wanted stability he by no means discovered, mentioned his sister Tamara. Ellstrom first grew to become homeless as a child after working away from abusive foster houses. He spent years with habit and tried to get assist. He managed a 12 months of sobriety and commenced renting a spot and going to highschool for engineering. He and Tamara had been shut, and she or he did every part she may to help him. However he relapsed and was again on the streets. A driver in an SUV struck and killed Ellstrom whereas he walked throughout the Morrison Bridge on Mom’s Day, Could 8, 2022.
“He wanted a spot the place he may’ve stayed and gotten assist,” Tamara informed the county in a story.
A memorial to homeless individuals who have died in Portland hangs on the wall of Portland Road Medication’s workplace.
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Leah Nash for ProPublica
Information sources for graphic: Multnomah County Medical Examiner’s Workplace, Multnomah County Homeless Companies Division, San Diego County Medical Examiner’s Workplace, San Diego Regional Process Drive on Homelessness, Los Angeles County Division of Public Well being, Los Angeles Homeless Companies Authority, Public Well being — Seattle & King County, All Residence — Seattle/King County, Santa Clara County Medical Examiner, Santa Clara County Homeless Census and Survey, U.S. Division of Housing and City Improvement.
