On December 31, 2014, longtime homeless Castro figure "Anastasia" was found dead on Market Street. A rare event it was not, but people knew Anastasia — the scarves, the coffee cups — so perhaps it was different, that time.
Most San Franciscans with a thing or two to tell you about homelessness have a few numbers at their disposal. The city's homeless population: roughly 7,000 according to last year's Homeless Point-In-Time Count & Survey. The size of that population that were once housed in San Francisco: 71 percent. The amount the city spends annually on the seemingly intractable issue: $241 million, spread out among 400 contracts with 76 private organizations, the effects of which are not tracked by any single group.
But there are more numbers. For example: Anastasia was one of 41 people who died in San Francisco between December 2014 and 2015 without permanent housing according to numbers from the Medical Examiner's Office and the Public Health Department obtained by the Examiner. Over 11 years, from July 2005 to December 2015, 415 homeless San Franciscans died while living on our streets.
“Homelessness can be fatal,” homeless czar Sam Dodge told the Ex. “I’ve always struggled with everyone remembering the humanity in homelessness.”
The leading cause of such deaths last year was drugs, which resulted in 16 fatalities. There were eight natural deaths, though at the unnaturally early ages of 49 to 56. Four died in homicides. One died in suicide. Two were hit by cars, one was drowned, and in six cases, a cause of death was not specified. 31 were male, 10 were female, and their average age was 56. 22 were white while 11 were black, five were White Hispanic, one was Pacific Islander, and two were not identified by race.
As the medical director of the Homeless Outreach Team, Dr. Barry Zevin added his thoughts to the Examiner's coverage. "I review these homeless deaths and then I work with living people," he said. "Everyday it’s on my mind, 'Is this person going to be the next one I read about in one of these reports?'"
Compared to the '90's, homeless deaths are down significantly. Zevin points to a decline in heroin-related deaths thanks, in part, to overdose reversal medicine. Another factor he cites is supportive housing. “We have taken the sickest people and provided them with supportive housing,” said Zevin said. “This is quite calculated. We sit and have these discussions when we decide who is going to get the housing slot.”
Myths abound in discussions of homelessness in San Francisco, and hard facts are often hard to come by. The Chronicle took a bit of myth-busting upon itself just recently, debunking several pernicious ideas about homelessness, from the magnet theory that posits a preponderance of people come to San Francisco for its homeless services to the idea that homeless San Franciscans don't want housing.
As one man who spoke to the Ex put it, "Of course I want housing. Of course you feel better when you have housing."
Of course, you might actually be better too. The best way to keep people from dying on the streets of San Francisco, Zevin points out, is to house them.