May 28, 2014
Vol: 21 No: 22


Mere mortals

By Rosette Royale / Interim Editor

For people without homes, death is an accident waiting to happen

A man who appeared to be homeless was struck by a vehicle in March in Pioneer Square. The man survived. Accidents such as traumas, falls, fire and acute intoxication are the leading manner of death in King County. The average life expectancy for a homeless person is 48. Since 2003, more than 800 homeless people have died outside in King County. But county officials and homeless rights advocates say there are more homeless deaths that go unreported.

Photo by Ted Mase / Contributing Photographer

Homeless people tend to die an early death, and accidents are the leading manner death for people who die outside. John says his size keeps him safe on the streets. “I’m a big guy,” he says.

Photo by Ted Mase / Contributing Photographer

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No one knows which truck carried the dead man into the recycling center.

The large recycling truck was part of a fleet that collects metals, glass and plastic bottles from residences and businesses throughout Puget Sound and transports them to Cascade Recycling Center, in Woodinville. There, the materials are deposited into piles that grow to be more than a story high.

One late winter afternoon in early March, an employee operating a bucket loader moved materials from a pile to a conveyor belt for sorting.

As the loader scooped up the refuse, the employee noticed a shape he said resembled a mannequin, according to King County Sheriff’s investigators.

Management later confirmed it was a not a mannequin, but a human body: the body of William Burns.

Burns’s body was clothed, with pants and underwear, jacket and shirt, a medical examiner’s report states. Socks covered both feet, but he wore only one boot. Investigators couldn’t find a wallet.

Det. Mike Mellis, who led the investigation for the sheriff’s office, said Burns appeared to be homeless.

“When we got there, the way he looked: [His clothes] don’t tell the whole story, but they do give some clues,” Mellis said.

The medical examiner’s report states that signs of trauma, consisting of contusions and abrasions, were evident.

Since no identification was found, a death investigator with the medical examiner’s office searched for next of kin. A relative confirmed that Burns had been homeless. Staff at the medical examiner’s office determined that Burns died of blunt force injuries and asphyxia from being crushed in a recycling container. Both the medical examiner’s office and sheriff’s office have ruled the manner of death an accident.

But months after his death, investigators still don’t know where Burns was when he died.

Several weeks prior to Burns’ death, a Capitol Hill business owner had found him sleeping in a recycling bin, Mellis said. The sheriff’s office also learned from Seattle police reports that Burns had a history as a street inebriate, he added.

Mellis said he surmised that Burns probably slept in a recycling bin the night before his body was discovered. But which recycling bin? On which street? And which truck cleared the bin?

“He might have passed through one, two, three trucks before getting to the recycling center,” Mellis said. “We have no idea.”

What law enforcement and public officials do know is this: Homeless people across King County tend to experience similar fates. For homeless people who die outside, the leading manner of death — 41 percent — is accidents, which can include trauma, fire, fall or acute intoxication. 

Between 2003 and 2013 the King County Medical Examiner’s Office counted the deaths of 813 homeless people, according to county health officials.

The average life expectancy for the general population born in 2011 is 80 years, while the current average life expectancy for homeless people is 48.

Though grim, the numbers don’t tell the whole story. 

“It’s really wobbly data,” said Heather Barr, public health nurse with King County’s Health Care for the Homeless Network (HCHN).

That’s because hospitals don’t track the numbers of homeless people who die of natural causes in hospital beds; some family members, when contacted by investigators, may not know the deceased relative was homeless; people who die while couch surfing or staying with others may not be viewed as homeless.

Richard Harruff, King County Chief Medical Examiner, said tracking all homeless deaths is also difficult because his office takes jurisdiction of unnatural deaths or natural deaths that occur in uncontrolled environments.

“Oh, there are definitely more,” he said.

The stress of the streets

At one time, a more comprehensive reckoning was available. In November 2004, HCHN issued the King County 2003 Homeless Death Review, a one-year survey of homeless deaths that fell under the medical examiner’s jurisdiction. The 24-page study was funded by a $20,000 appropriation from the King County Council earmarked to examine the mortality of local homeless people.

The medical examiner’s office identified the deaths of 77 homeless people that year. The average age of death was 47.

Accidents were the most common manner of death for people who died outside. The most frequent cause of death listed in the review was acute intoxication.

(A separate glossary defines “cause of death” as the injury or disease that results in someone’s death. “Manner of death” classifies the events preceding a death. For example, a cause of death can be a “perforating handgun wound,” but the manner of death can be accident, homicide or suicide.)

More than half of all deaths took place outside in 2003, though some occurred in transitional or emergency shelter. The vast majority of deaths —  82 percent — occurred in Seattle.

Yet even with pages of graphs and charts, the review states that public health officials still had a lot to learn.

“The results of this review generate as many questions as they answer,” the authors wrote.

In 2005, HCHN issued a report on deaths of homeless people that occurred in 2004, smaller in scope than the previous year’s review. That year, the medical examiner’s office took jurisdiction of 82 homeless deaths, a slight uptick from the year before.

The people studied in the report had been listed as “likely homeless” in the medical examiner’s database, which designates those with no fixed address, living in emergency shelters, in motels for less than 30 days or people who had been discharged from institutions, such as a mental health hospital or jail, and had nowhere to go.

“The causes of death in 2004,” the authors write, “continue to reflect the many harsh realities and risks faced by those who live on the streets and in shelters — chronic health conditions, traumas, and the troubling role of alcohol and drugs.”

Other annual reports with similar statistics followed in 2006, 2007 and 2009.

Then the reports ceased.

Barr, with HCHN, said a lack of resources was the reason.

“We had cutbacks in staff, and the person doing it is no longer here,” said Barr.

The medical examiner’s office continued collecting data on homeless deaths and while the annual number of homeless deaths has fluctuated for the past decade, the average age of death has always hovered in the upper 40s. Accidents played a part in many outside deaths.

Harruff, the county’s chief medical examiner, said social conditions contribute to how deaths are categorized.

If someone dies of acute alcohol poisoning, he said, it’s called an accident. “But if you die after years of chronic alcoholism of cirrhosis [of the liver], it’s called a natural death,” he said.

The medical examiner’s office, which collects data on homeless deaths, rarely tracks information on natural deaths.

Hospitals do. Susan Gregg, Harborview spokesperson, said she’s not sure how information was tracked a decade ago, but today the medical center staff wouldn’t necessarily know a patient’s housing status.

“We don’t classify people as homeless or not homeless,” Gregg said.

Even determining what is “natural” is tricky. Homeless people, Barr said, tend to age faster than the general population, in large part due to inadequate health care. For people on the streets with diseases like diabetes or hypertension, sticking to a pill regimen or getting regular health care is next to impossible.

All of that is compounded by stress, Barr said.

“It’s a stressful thing to have to sleep with one eye open,” Barr said.

To Barr, the data shows the heavy price of life on the streets: “It’s the homelessness itself that’s the Bermuda Triangle. Poverty, racism and inequity: Those are the three arms of the triangle.”

Next of kin

Harruff said that for each death that falls under the medical examiner’s jusridiction, next of kin must be contacted. In the case of Burns, found in the recycling center, Harruff said it took 30 attempts to locate one of his relatives.

But Julie Hintz, Burns’ ex-sister-in-law, said she found out about his death on the news.

“When they said his name, I thought, ‘Would that be Bill?’”

She said she knew Burns had been struggling with alcoholism and that, years ago, someone had seen him boarding a bus on Aurora Avenue North. But she didn’t know he had been homeless.

Aware of his difficulties, Hintz said wasn’t surprised to hear that he had died. Still, the specifics saddened her.

“At least we could provide a place where someone could get out of the elements and not have to climb into a recycling bin of all places,” Hintz said.

Death creates a beginning

The push to gather statistics began after a brutal death. In August 1999, three young men in their late teens were charged with the murder of a homeless man named David Ballenger. The Seattle Times reported that the teens accosted Ballenger at Green Lake Park, and then followed him to an encampment beneath an I-5 overpass at Northeast Ravenna Boulevard. There, two of them kicked and stabbed Ballenger to death while the third watched. (The three teens were convicted, respectively, of first-degree murder, second-degree murder and manslaughter.)

At the time of his death, Ballenger was 46.

The Times reported that, according to prosecutors, one of the teens explained to a friend why he had blood on him: “Let’s just say there is one less bum on the face of the Earth.” The newspaper quoted the second half of that statement in the article’s headline.

In addition to being outraged by the statement, homeless rights advocates felt that using it in a headline perpetuated the view that homeless people are worthless.

“That really hit us hard emotionally,” said Anitra Freeman, a member of the homeless advocacy group WHEEL. 

In response, homeless women and their advocates decided to hold vigils for homeless people who died outside, Freeman said. They called themselves Women in Black, a name chosen in solidarity with the global peace and justice group began in the 1980s by Israeli women.

In 2000, local members of Women in Black began honoring the deaths of homeless people.

On that Memorial Day weekend, the body of Debbie Cashio was discovered near Eighth and Jackson, in an encampment known as the Jungle. Her death was ruled a homicide, and a suspect was convicted in 2005 of her murder. At the time of her death, Cashio was 40.

Women in Black held its first vigil in June 2000. Soon after, the group held another vigil for a homeless man named Herlie Ray Coker Jr., who died of a drug overdose at 43.

There were more deaths in 2001 and more in 2002. To obtain information about who had died, WHEEL members contacted the medical examiner’s office.

A 1999 study of homeless deaths in San Francisco — released exactly one week after the three teens participated in the Seattle murder of David Ballenger — showed WHEEL members that a local report was possible, said Freeman, who also serves on the board of Real Change. Eventually, members asked Harruff, the county’s chief medical examiner, if his office would publish local summaries of homeless deaths.

Harruff said his office had to develop a system to designate a person who died as having been potentially homeless.

“It had never been done before. So it was a first,” he said.

Around the time WHEEL initially contacted Harruff, members also reached out to county officials to research homeless deaths.

Since 2000, Women in Black have held vigils for 522 people (some early vigils were for deaths outside of King County). Freeman said the number differs significantly from the medical examiner’s total because Women in Black doesn’t hold vigils for people who’ve died inside. If they did, “we’d be [standing] out there 24/7,” Freeman said.

Remembering people with silent vigils, as opposed to loud confrontations, is a powerful way to highlight the deaths of some of the county’s homeless people.

“People can argue with your anger,” Freeman said. “They can’t argue with your grief.”

Silent recognition

On March 26, as a light rain fell, Women in Black held a vigil to honor two people. One was a newborn baby whose body was discovered on February 12 near a roadside in North Bend.

Because the child was discovered near the Kimball Creek Bridge, authorities named her Baby Kimball. (As of press time, the mother had not been found, and police have made no arrests in the case.)

The second person was William Burns, the man whose body was discovered in the recycling center.

More than a dozen people stood in silence. A Women in Black member handed a flyer to man walking down Fifth but he shook his head “no.” A woman talking on a cellphone stared straight ahead as she continued her conversation.

Around 12:15 p.m., a woman walked out of the Seattle Municipal Courthouse. When she passed the person handing out flyers, she took one and glanced at it.

“Everyone needs a safe haven, or shelter, to survive,” it said.

The woman, Jeanena Smith, said the flyer made her consider the difficulties and dangers homeless people face.

“Honestly, it hadn’t ever dawned on me that people could be dying because it’s freezing outside,” she said. Smith paused. “Which is kind of a privileged thing to say.”

Along with the Women in Black vigils, the county also holds its own ceremonies. In September, the county will have an indigent burial ceremony at Mt. Olivet Cemetery in Renton, to honor the deaths of 170 people, some of them homeless. Burns’ cremains will not be among them. Harruff said his ashes will be held for at least another year, to see if they are claimed by next of kin.

Vigils and ceremonies to remember homeless people are important — but also bittersweet, Harruff said: “They’re only recognized when they’re dead.”



We should view homelessness was a life-threatening condition and demand that our governments get serious in addressing the problem. Housing is a human necessity and a human right.

Leslie Jordan | submitted on 05/29/2014, 4:39pm

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