Pierce County continues to wrestle with counting deaths among unhoused people
AI-generated summary reviewed by our newsroom.
- Pierce County recorded 58 unhoused deaths in Q1 2025, a three-year high.
- Medical Examiner’s Office attributes data spike to improved case tracking.
- Health officials seek expanded access to county homeless-service data.
During the first quarter of 2025, the Pierce County Medical Examiner’s Office recorded the highest number of deaths among those living unhoused in the past several years.
Public health officials say the spike is likely due to changes in the way local agencies work to improve a previous blind spot in the data.
According to a Medical Examiner’s Office report, 58 people died while experiencing homelessness during the first quarter of 2025 — easily the highest number recorded in the county over the past three years.
The next highest number confirmed by the Medical Examiner’s Office was in the fourth quarter of 2024, which saw 39 deaths of those living unhoused in Pierce County.
During the Pierce County Council’s Safety Committee meeting on June 23, several officials with the Medical Examiner’s Office and the Tacoma-Pierce County Health Department presented new data and strategies on homeless death data.
“You see the giant spike here for quarter one of 2025, I don’t think that is probably real,” Luke Vogelsberg, the director of operations for the Medical Examiner’s Office, told the committee. “I think that stems from an improvement we made to our case-management system to better track these.”
Previously, the deaths were categorized a number of ways in the Medical Examiner’s Office’s case management system, none of which included “presumed to be homeless” at the time of death. According to Vogelsburg, the office started to include that designation in its system at the beginning of 2025.
“I suspect that the jump is most likely related to the improvement in our data collection,” he told the committee.
In February, an analysis by The News Tribune found that data about those who had died while experiencing homelessness in Pierce County was not made readily available by public health agencies.
Vogelsburg gave a “heavy disclaimer” to the committee regarding the data the office has begun collecting.
According to data from 2021 and 2022, about 17% of deaths in the county were investigated by the Medical Examiner’s Office as it only takes jurisdiction over deaths considered to be unnatural. Over the same time frame, about 22% of deaths were reported to the office only to be declined by the agency.
About 61% of deaths in 2021 and 2022 went unreported to the Medical Examiner’s Office.
“We don’t know about all the deaths in the county,” Vogelsburg told the committee. “There very likely are people that were unhoused at the time of their death that died a natural death in the hospital that was not reported to us and we don’t know about it.”
He also said it is difficult for the Medical Examiner’s Office to determine someone’s housing status at the time of their death as they do forensic investigations on decedents and are not necessarily equipped to examine the social circumstances someone experienced while they were alive.
“There are obviously clues, like if they were found deceased at a tent encampment,” Vogelsburg said.
He said making those determinations can be subjective, often relying on testimony from witnesses.
Vogelsburg said there are two times in the death-certification process in which a person’s housing status can be recorded. First by the death certifier, who could record if a person had an address at the time of their death, then by the person arranging the funeral for the person, who might have insight on their housing status at the time of their death.
“This data is not perfect,” he told the committee. “It’s very difficult.”
How can the county improve the process?
On occasion, the Medical Examiner’s Office can use the Homeless Management Information System (HMIS) to confirm whether someone had been experiencing homelessness.
HMIS is a locally-administered data system used throughout the county to record and analyze homeless information. Typically, individuals that receive homelessness and housing services through the county’s contracted providers are put into HMIS.
Vogelsburg said while the Medical Examiner’s Office does not have direct access to the system, it can contact Pierce County’s Human Services Department, which helps administer HMIS, to cross-reference names and confirm if an individual had been receiving homelessness services near the time of their death.
Ingrid Friberg, an epidemiologist with the health department, told the committee the Washington State Department of Health (DOH) is working to add data fields regarding homelessness for death certificates.
“DOH is working on that, and we are literally waiting for the data-sharing agreements to be finalized,” she said.
When those data-sharing agreements are finalized, Friberg said, DOH will be able to provide homeless death data from 2023 to current.
Cam Solomon, an epidemiologist with the health department described that outlook as “optimistic” with the current state budget and staffing cuts.
“They put a hold on [data-sharing agreements] right now, hopefully they will start that up again.” he told the committee. “The dream is that they will give us a comprehensive report of all the people that were experiencing homelessness at the time of death.”
Solomon said he is currently working on a data-sharing agreement with Human Services to allow them to share HMIS data with the health department and cross reference the data with death certifications.
“I know this is a pressing issue and it is something we really wanted to improve the reporting on,” he told the committee.
