At least 92 people who died in Multnomah County in 2018 were homeless at the time of their death.

On Tuesday, the county released its annual "Domicile Unknown" report, which presents data collected from the county medical examiner's office on the number of people who died without a home address (marked "domicile unknown" on their death certificate). According to the report, 2018 saw the highest number of homeless deaths since the county began recording this data in 2011. However, because of population growth in Multnomah County, the proportion of homeless people represented in the county's total annual death count (around 8.6 percent) has remained stable since 2015.

"It’s been a fairly steady drumbeat of preventable deaths among young and midlife people. In a way, it’s the monotonous nature that’s important,” said Tri-County Health Officer Paul Lewis, who oversees the Multnomah County Medical Examiner's office, in a press release. “This allows us to refocus our energy. It shows that many of these deaths are preventable, but prevention is hard to implement if people are unhoused.”

Fifty-three percent of the recorded homeless deaths were linked to alcohol and drug use. Of those deaths, 55 percent were caused by methamphetamines, with 47 percent attributed to opioids and 31 percent related to alcohol consumption.

This makes 2018 the second consecutive year that meth use has surpassed opioids as the top cause of death among homeless people who died from a substance-related cause.

This trend doesn't just impact the homeless community. According to a recent federal study, 45 percent of all drug-related deaths in Oregon in 2018 involved meth. In the past decade, Oregon has witnessed an overall decrease in deaths linked to opioids and a steady increase in meth-related deaths.

The county report found that 32 percent of homeless deaths in 2018 took place in public spaces. Seventeen percent died in a hospital and 14 percent died in a car or camper. Sixty-seven of the 92 deaths were either marked "accidental" or "natural." Ten people were murdered and nine people died from suicide.

When Multnomah County first began tracking this data in 2011, it recorded 47 recorded homeless deaths. The annual tallies calculate that at least 530 homeless people have died in Multnomah County in the past eight years.

In the report, Street Roots Director Kaia Sand attributed many of these deaths to a simple lack of permanent housing.

"This is about how hearts suffer too much until they stop, how bodies are torn up by violence and immune systems are ravaged by exhaustion," Sand said. "Housing is healthcare too: A door with a lock and a key creates a space to be safe, the autonomy to heal and the ability to hold onto sentimental belongings that nourish the spirit."