Director’s Desk | These deaths are the horrible outcome of inequitable access to housing and other healthcare necessities
The Little Match Girl had no good options.
She contended with poverty and freezing cold, Hans Christian Andersen writes in his 19th-century tale. Her one means of survival was selling matches, but ultimately, she chose the bigger reprieve from suffering: hallucinations. She’d strike a match and see a fantasy: a fancy brass stove; a goose that, stuffed with apples and plums for a feast, came to life and hopped off the table; a tree lit with thousands of candles that became stars in the sky.
But it wasn’t until she saw her grandmother's face that she tipped over the edge.
She longed so strongly for her long-dead grandmother that she kept striking matches, her grandmother’s face glowing in the fire until she had struck all her matches. Her grandmother took her in her arms, and they began to fly until “there was neither cold, nor hunger, nor care,” writes the Danish fablist.
But while she hallucinated her grand escape from suffering, her own body froze in the cold. No longer with any matches to sell, she also had nothing to keep her warm as she leaned against a wall. Andersen grimly describes how she was found dead in the morning.
I see the Little Match Girl everywhere as people slip into hallucinations that mask their daily suffering. Without access to foundational needs like housing, some escape into their own burning hallucinations. Others take substances to stay awake, ever more vigilant to grim survival, watchful against violence, against the rats that roam the night sidewalks. Some stay awake to piece together an income harder to come by in daylight, collecting bags of clanking cans to redeem at bottle exchanges.
Like the Little Match Girl, people are far more likely to die young on the streets, whether from the weather too harsh for human survival, the drive for hallucinations that overcomes a person’s capacity to breathe, or the drive for wakefulness that defies the pumping heart. Others die exposed to violence or from a body worn sick from suffering.
Margot Kushel, director of the University of California San Francisco Benioff Homelessness and Housing Initiative, writes people on the streets often need geriatric medicine by middle age. A woman near my age described her terminal diagnosis with a rosy tone. She had seen a lot in her many years of homelessness, she assured me. We leaned on humor to discuss the painful news, joking that she had lived eight of her nine lives while the obvious sorrow hummed beneath our chatter.
After the Oregon legislature passed Senate Bill 850, funeral directors were required to record housing status in vital statistics reports. The Oregon Health Authority recently released a dashboard counting at least 207 people who died while homeless in the first half of 2022.
There are people dying the way of the Little Match Girl all across our state.
Now we know that within Baker, Malheur, Morrow, Umatilla, Union and Wallowa counties, five people died while homeless during the first half of this year.
Within Crook, Deschutes, Grant, Harney, Jefferson, Klamath, Lake and Wheeler counties, 17 people died while homeless during the first half of this year.
Within Gilliam, Hood River, Sherman and Wasco counties, three people died while homeless during the first half of this year.
Within Jackson and Josephine counties, 15 people died while homeless during the first half of this year.
Within Coos, Curry, Douglas and Lane counties, 40 people died while homeless during the first half of this year.
Within Benton, Lincoln, Linn, Marion, Polk and Yamhill counties 37 people died while homeless during the first half of this year.
Within Clackamas, Clatsop, Columbia, Multnomah, Tillamook and Washington counties, 90 people died while homeless during the first half of this year.
I wrote this litany to acknowledge that every region of our state suffers these losses, with disproportionate numbers of Native American, Alaskan Native and Black Oregonians dying.
Missing other ways of eulogizing the dead, this litany serves as a stand-in to create a marker of loss. I’ve learned at Street Roots the importance of memorials, that facing the despair of life on the streets, people at least need to see that their lives will be remembered. Rick Davis, a long-time Street Roots vendor, built a memorial board in our office to honor deceased vendors, and we are in the midst of preparing our next memorial for four vendors who’ve died this year.
We will also memorialize them in an upcoming issue.
The Oregon Health Authority data complements the annual report Street Roots publishes with Multnomah County, “Domicile Unknown,” which began a decade ago when Israel Bayer, former executive director of Street Roots, approached Multnomah County Commissioner (now the chair) Deborah Kafoury, urging this tracking.
The report relies on medical examiner findings, which investigate deaths caused by suspicious or unknown circumstances such as homicides, suicides, accidents or injuries, unlawful use of controlled substances, or the use of a chemical or toxic substance, contagious diseases that threaten public health, and deaths of people who are incarcerated in jail, prison or police custody.
Spurred by the state legislation, the Oregon Health Authority data casts a wider net: all vital records must record whether someone’s address — or “domicile” — is unknown.
Multnomah County has additional researchers study death narratives to determine whether the people were, indeed, homeless when they died. The data is also analyzed to understand more about each cause of death. Kate Yeiser, communications coordinator for Multnomah County, reaches out to families to write about the lives of people in the report, if possible. By including extra analysis and context, the report yields a fuller understanding of some of the causes and circumstances of deaths.
Because of the additional outcome and research, there is a greater delay on the Domicile Unknown report than the new Oregon Health Authority dashboard. The next report will focus on 2021, before the state began tracking data.
It won’t be until the 2022 Domicile Unknown report (released in 2023) that the state data will inform the county data, and hospital deaths that didn’t pass through the medical examiner will be included too.
The need for these reports is the horrible outcome of inequitable access to housing and other healthcare necessities. Too many of the dead died too soon, and their own stories likely could be told by the likes of Hans Christian Andersen. I read these numbers, and I think of the Little Match Girl who, after she struck all her matches at once in a desperate act, died with a fist of burnt matches that did her no good at all.
Street Roots is an award-winning weekly investigative publication covering economic, environmental and social inequity. The newspaper is sold in Portland, Oregon, by people experiencing homelessness and/or extreme poverty as means of earning an income with dignity. Street Roots newspaper operates independently of Street Roots advocacy and is a part of the Street Roots organization. Learn more about Street Roots. Support your community newspaper by making a one-time or recurring gift today.
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