Dying on the Streets

On Abby Von Kaenel’s death certificate, it says the 18-year-old was a resident of Battle Ground when she died on Jan. 26, 2015. But sometimes, she was a resident of nowhere in particular. The streets, hidden encampments and parks were also where she lived.

A homeless man found her dead on a bench in Esther Short Park, said her adoptive mother, Mary Von Kaenel. Although she was resuscitated, she never regained consciousness and later died at the hospital, where her death was ruled the result of a seizure.

Mary Von Kaenel surmises that Abby, who struggled with mental illness, learning disabilities and brain cancer, would still be alive today if she had been home or at least around people who could’ve taken her to the hospital right away.

“People wanted to help her and tried hard to help her,” Mary Von Kaenel said. But Abby was strongly attracted to the streets and often ran away to Portland.

It’s hard to discern how many homeless people die on the streets, as Abby did. The most recent available data says that in 2014, 3,277 residents of Clark County died. Among those, four did not have a known address listed in their death certificates and could have presumably been homeless. But officials are quick to acknowledge that is likely an undercount.

Katherine Garrett, housing-first director at homeless service provider Share, estimates seven to 10 people die on the streets in Clark County each year. Some years there are more deaths and some years there aren’t any, said Garrett, who occasionally helps the medical examiner’s office get connected with homeless people’s families.

Candlelight memorial

During a candlelight memorial for homeless people in late December, Adam Kravitz, who heads Outsiders Inn, talked about Dennis Fink, a local homeless man who died in September as a result of methamphetamine use, according to the medical examiner’s office.

“Dennis was an incredibly happy-go-lucky guy, considering he had a lot of health issues,” said Kravitz, adding that Fink dealt with physical and mental illness. “Even when he was housed, he had trouble with his medications.”

At 47, Fink lived a typical lifespan for homeless people.

On average, homeless people live to be between 42 and 52, according to “Premature Mortality in Homeless Populations,” written by Dr. James J. O’Connell, who founded Boston Health Care for the Homeless.

In contrast, the average life expectancy is 78 in the U.S. In Clark County, women on average live to be about 82, while men live to be about 78, according to the Institute for Health Metrics and Evaluation.

The Centers for Disease Control and Prevention says that the homeless have a mortality rate four to nine times higher than those who are not homeless. They are more likely to die from suicide or accidentally as a result of an unintentional injury, such as a methamphetamine overdose. Accelerated aging can lead them to die naturally, but early.

“When you break your body down and live in those conditions for a long period of time it takes a toll,” Garrett said.

Homeless people are more likely to have problems with both chronic and acute illnesses that can lead to early death, said Dr. Alan Melnick, Clark County’s health officer and public health director. Examples of chronic illness that would be exacerbated by being unhoused are diabetes, high blood pressure and malnutrition. Acute illnesses could include falling in the street, catching an infectious disease, or even getting assaulted or shot.

“In Clark County, we’ve had homeless people with tuberculosis,” Melnick said.

Andy Silver, executive director of the Council for the Homeless, worked with a homeless man who had basal cell carcinoma on his chin caused by long-term sun exposure. Although it can be disfiguring if it’s not removed, for most patients it is not life-threatening.

“It was untreated for 15, 20 years, and he eventually died of complications from it because he never got the proper medical attention,” Silver said. “It was eating away at his face. … Your risk of developing cancer and other diseases increases, but your ability to effectively deal with them decreases. It’s a vicious cycle.”

He compares homelessness to smoking in terms of how bad it is for health outcomes.

“There are all kinds of reasons for that, from the long-term stress of homelessness to the straight elements of living outside in the sun, the cold and the wet,” Silver said.

The homeless have higher hospitalization rates and make more emergency room visits, Melnick said. Basically, the poorer and more housing insecure somebody is, the worse their health.

“We could improve the health of Clark County by ensuring adequate housing for everybody,” Melnick said. “We lose productivity when people are homeless, as well.”

Lincoln Place

Housing-first complexes such as the soon-to-open Lincoln Place in downtown Vancouver are aimed at preventing the most at-risk people from dying on the streets. Housing-first or “wet housing” prioritizes permanent housing before addressing people’s issues, such as addiction and mental illness. The $6 million complex was funded largely by low-income housing tax credits, and the Vancouver Housing Authority.

To determine who would be invited to live at Lincoln Place, VHA and Share used the Vulnerability Assessment Tool to determine how likely a person is to die on the streets. It measures several “domains of vulnerability,” including survival skills, mortality and medical risks, mental health, substance use and social behaviors.

In theory, what results is the neediest of the needy getting prioritized for housing that will help them get healthier. Some of the people who come to Lincoln Place may be in such bad shape from their chronic homelessness that they die at Lincoln Place, said Amy Reynolds, deputy director of Share.

“At least they will die with dignity and be inside,” she said.

Service providers, such as nursing students from the University of Portland, will help identify residents’ health problems and prompt people to get needed care.

Residents may start moving into the 30-unit complex as early as this weekend, Garrett said, though it depends on where people are at in the application process.

Stories of Clark County’s homeless who died

It’s unclear exactly how many homeless people have died in the last couple of years in Clark County. Here are a handful of their stories:

• On Jan. 2, a boater found the body of Jessica Newton, 40, washed up on the western shoreline of Bachelor Island near Ridgefield. Detectives with the sheriff’s major crimes unit identified Newton as a transient from Portland. She died of homicidal violence, according to the Clark County Medical Examiner’s Office. No one has been arrested.

• On Dec. 16, David Emerson, 54, died at a Vancouver hospital from gastrointestinal bleed as a result of alcohol abuse, according to the medical examiner’s office.

• On Sept. 30, employees at Chuck’s Produce in Salmon Creek found a man’s body near the parking lot at about 7:30 a.m. Sheriff’s detectives found the body of 20-year-old James Chick, who was homeless at the time, Sgt. Fred Neiman said. His death was ruled a suicide. 

• On Sept. 12, Dennis Fink, 47, died accidentally from methamphetamine use, according to the medical examiner’s office. He died at a hospital.

• On July 1, loggers found the body of Robert Lee Huggins, 56, in an open field about 100 feet south of Northeast 179th Street near 15th Avenue. Investigators said they believe Huggins was killed elsewhere and his body subsequently dumped in the field. Huggins, of Portland, was homeless at the time of his death and mainly living out of his car, investigators said. No one has been arrested in his death.

• On July 19, 2014, Vancouver police found 19-year-old Daytona Hudgins dead at a homeless camp behind a business on Fort Vancouver Way. A hysterical group of her friends told officers that she had overdosed on drugs, but an autopsy showed that Hudgins was strangled, according to Clark County Superior Court documents. Convicted sex offender Gregory Wright, 35, is awaiting trial on a charge of second-degree murder.