As the city of Portland, Oregon, clawed its way out of the pandemic, it faced a new set of crises: The city’s homeless population was growing. Tents lined some city blocks. High-powered business associations held press conferences demanding the city remove homeless people and touted self-funded surveys saying that without action, businesses and residents would flee the city.

By late spring 2021, the city committed to a new strategy that then-Mayor Ted Wheeler said would “reprioritize public health and safety among homeless Portlanders,” ultimately allocating $1.3 billion by the end of 2024.

But although the city spent roughly $200,000 per homeless resident throughout that time, deaths of homeless people recorded in the county quadrupled, climbing from 113 in 2019 to more than 450 in 2023, according to the most recent data from the Multnomah County Health Department. The rise in deaths far outpaces the growth in the homeless population, which was recorded at 6,300 by a 2023 county census, a number most agree is an undercount. The county began including newly available state death records in its 2022 report, which added about 60 deaths to the yearly tolls.