Last year, for the first time, Multnomah County and the Portland Housing Bureau and, especially, Street Roots worked hard to produce something we'd never seen before: an attempt to tally, over the course of 12 months, deaths among those among us living on the street.

That first report showed 47 people died while homeless last year, and it was a slap in the face. Was it an aberration? Would the next year be better? Sadly, no. The second annual report (pdf), officially released this morning, shows deaths have climbed to 56. It's too soon to draw a trend line, but an increase isn't what anyone working on this report wanted to see.

Especially since both reports—drawing only from cases worked by a medical examiner, and not including the deaths of anyone who first made it to a hospital before dying—mask a potentially huge undercount. Every day, according to a stat that's soon to be revised, some 1,700 people are without shelter in our region every day.

"That's pretty alarming in my mind," Israel Bayer, director of Street Roots, told the Mercury.

Many details in the report are equally grim. The average age of the 56 human beings recorded in this year's report was just 46 years old. Almost half—20—died from overdoses. Eighteen of those ODs involved some kind of opiates. Ten more people killed themselves—homelessness is, itself, a painful experience for many and the isolation and lack of access to care can compound that pain for so many people. Both the suicide and OD counts should rightly be seen as related, a question of health care and resources for that care and access.

In addition, one person was burned to death (no report or further details are provided), another drowned, and another froze.

The county's deputy health officer, Dr. Paul Lewis, said in a statement this morning that "most of these deaths are preventable."

And the report comes as Multnomah County and the city of Portland start are revising their joint plan to combat homelessness, agreeing to pool money in a way they haven't been able to before. This report also comes in the midst of a lawsuit and code-enforcement fight over Right 2 Dream Too, which has provided a safe place to bed down for hundreds of people since it planted itself in a vacant lot in Chinatown (invited by the owner) in late 2011.

"It's the idea that homelessness is not just about public safety," Bayer says. "We're talking about a health care issue. We should be able to prevent 56 people from dying homeless. And we know that's an undercount.... If we collect data over a number of years, and draw trends, we'll be able to take the next step, whether that's creating more prevention services or leverage to get more money for housing."

This isn't just happening in Portland. It's happening all over the country.