Anchorage hit a record for homeless people dying on the streets. Then something unexpected happened: The deaths almost completely stopped. Why?

Mar. 24—Last year, Anchorage hit a grim milestone: A record 52 homeless people died on the streets of Anchorage — more than double the previous year's toll.

The deaths unfolded at a relentless pace: Eight people died in April. Seven in July. By November, the scourge of deaths of homeless people on Anchorage streets were making national headlines. Two men died in wheelchairs, within a day of each other.

Then, something unexpected happened: The deaths slowed and then almost completely stopped.

In the first three and a half months of 2024, the Anchorage Police Department has reported only one outdoor death — that of a 40-year-old man found dead at Folker Park in East Anchorage in January.

By this time in 2023, eight people had died.

What accounts for an apparent sudden decrease in outdoor deaths? Is it a sign that Anchorage is doing something right? Is it a fluke? Is it a signal of something broken in the reporting process?

Homeless service providers, activists and unhoused people themselves all have different thoughts about that. But they agree that the question is worth asking.

If outdoor deaths have dramatically declined, said Molly Cornish, head of communications for Catholic Social Services, "the question is why?"

An imperfect measure

Outdoor deaths — defined by Anchorage police as the death of a person outdoors and with no fixed address — have always been an imperfect and incomplete measure of mortality among unhoused people in Anchorage. They do not capture deaths that happen in hospitals, vehicle collisions, homicides or other settings.

And they may not even capture incidents where an unhoused person is found by paramedics unconscious outdoors and then dies on the way to the hospital, or at the hospital, according to Anchorage Fire Department deputy chief Alex Boyd.

Still, they have become an important barometer of the city's homeless response. Elected officials have said reducing such deaths is a priority, and activists and faith communities have focused on the human toll of deaths: First United Methodist Church, a downtown congregation, is planning a "No More Deaths" vigil for "unhoused neighbors who died on the streets" on March 30.

A death on the streets is a tragedy, but also the last stop of what is often a long road of suffering, said David Rittenberg, a longtime shelter and resource center manager with Catholic Social Services.

"Every person that passed away, is a member of our communities," he said. "Those are our neighbors. Those are some of the most vulnerable people in our community."

Some have wondered if something about the way police recognize and tally outdoor deaths quietly changed in recent months.

Not so, says the Anchorage Police Department: An outdoor death is still defined as "a person who does not have a fixed address and passes away outside," said spokesperson Renee Oistad in an email.

The department says nothing about the way it defines or reports outdoor deaths has changed in recent months. Outdoor overdose deaths or suspected overdose deaths are still counted, the department said. And no procedures related to which entity or where a person is considered to be officially deceased have changed either, the department said.

So then, what to make of the apparent decrease? Is it a sign efforts are working?

Alexis Johnson, the municipality's homeless coordinator, attributes the decrease to the fact that Anchorage has more shelter beds open this winter than ever before — between the Alex Hotel, Aviator Hotel and Central Waste Services emergency mass shelter, she says the city has 574 shelter beds. Private shelters account for more beds, and hundreds of people have been moved into long-term housing.

That means more people are spending the depths of winter indoors, she said. And when people are inside "you really have an opportunity to intervene," she said. "Whereas if they're just living in encampments, there's really not a 24-hour presence."

Intervening can mean halting overdoses, Johnson said — significant because overdose was the leading cause of Anchorage outdoor deaths, followed by cardiac arrest and hypothermia, according to an October 2023 analysis from the Alaska Medical Examiner's Office.

And this winter, people have been revived from opioid overdoses hundreds of times at the city-operated shelter sites alone. Since Oct. 15, 143 doses of Narcan have been administered at the Aviator Hotel, 114 doses at the former Solid Waste Services administration building shelter and 4 doses at the Alex Hotel, according to data supplied by the city.

The reason for the drop isn't clear, said Boyd, the fire department deputy chief. He suggested one factor could be the cold weather.

"I don't know why the numbers have had such a precipitous drop," he said. "It may be a data collection process. It may be the fact that ... it got so cold that a lot of people living in the field found shelter."

When a deep cold snap consumed Anchorage in January, care providers "started moving mountains" to get more people inside, Boyd said. "Maybe that was effective and those folks have been able to stay. ... But I can't prove it one way or the other."

"I don't believe it"

People who are living on the streets or in camps say they doubt deaths that would be considered "outdoor deaths" have actually slowed as much as the official tally suggests.

"It's not true," said Maddy Greenewald, who said she's living in a Mountain View area camp. "Just being out here, I know the facts of what's going on."

Greenewald said she personally knows several people who've died recently under circumstances she thought would be considered "outdoor deaths."

Simon Mireles also has questions about the drop in outdoor deaths. Mireles lives at the sprawling Cuddy Park camp in Midtown, which on Tuesday was thawing with the first stirrings of warmer spring weather. The wet snow soaked everything, he said, including the area around his makeshift shelter, which boasts a permanent-looking two-by-four frame.

Mireles knew exactly how many people died outdoor deaths in 2023: "Fifty two," he said.

But he was surprised to hear that only one person had died outside this year. He said he thought there was a man who died near the Midtown Wal-Mart. He gestured to a spot in the snow where he said a different man "fell down" — he wasn't sure if the man was having a seizure, or if he had died or not.

But he was most concerned with some of the pressing difficulties of his current living situation. A trailer had burned and left a pile of charred debris he said he felt responsible for cleaning up, despite overflowing dumpsters.

Shelters were not an option for him, he said. He cited noise, drugs and aggressive people as the reason — even though he said he sometimes hears gunshots at the Cuddy Park camp.

Onaje McLash, an outreach worker with the Anchorage Health Department, walked through the melting trails of the camp. She's worried that the low may only be a lull — the months of deep winter have historically been a time when people hunker down quietly, taking advantage of any indoor shelter they can.

The months of deep winter have historically recorded the lowest numbers of outdoor deaths, according to an analysis of data collected by the Daily News that goes back to 2017. Spring and summer months have recorded the highest number of deaths.

That may be counter-intuitive to people who assume the coldest temperatures are the most deadly for people living outdoors in Anchorage's frigid winter climate, said Alexis Johnson, the city's homeless coordinator.

But because the cold is extreme, winter is when "people hunker down," Johnson said.

Shoulder seasons can be even more dangerous, said Rittenberg, with Catholic Social Services: Right now it's warm during the day, but with feet of melting snow still on the ground, people get soaked and chilled outside. Then it gets cold again at night — conditions that increase the risk of hypothermia and frostbite.

Johnson said she's worried about what the summer brings. Again, the temporary mass shelter and hotel shelters the city is paying for are slated to close on June 1, again bringing a flood of people out of shelter and onto the streets, she said. This summer, people shouldn't expect to see Third and Ingra, which became a large camp last summer, used, she said. Cuddy Park is permitted to host a music festival in June, so people will be moved from the area for that. Where will they go? She isn't sure. Mclash says she's accumulating tents to hand out.

"One of the reasons we advocate for year-round shelter is because come June 1, and the shelters let out, we're going to have close to 900 people on the street," Johnson said. "They're going to be in their own tents, without a lot of interaction."