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Marie was about 50 years old and a homeless mother when she died in September.
She was living near the Tully Community Branch Library and Coyote Creek, a location common to the unhoused in San Jose, said the Rev. Scott Wagers of CHAM Deliverance Ministry, a front-line ministry providing homeless people with food and other needs.
Wagers said Marie complained of internal pain and she later died of internal bleeding.
Marie is just one of the more than 1,100 homeless people over two decades who have succumbed to illness and accidents, suicide and violence in Santa Clara County, according to data provided by the county’s medical examiner.
And, as is true of most deaths of homeless people, she died in one the poorest areas of the county, according to data compiled and analyzed by the Bay City News Foundation, highlighting the need for services and the patterns of poverty.
Nearly 100 of those homeless people died in one of the county’s poorest ZIP codes, 95112, located in downtown San Jose and where the median household income is $63,500.
“That’s my territory,” Wagers said, adding that San Jose’s homeless population is living — and dying — along the creek beds, hiding because they don’t want to be swept.
“They’re cut off from health care out there,” Wagers said. “It’s apocalyptic.”
By far, more homeless people died in the 95112 ZIP code than any other in the county, except for two where major hospitals are located. Downtown San Jose deaths accounted for about 58% of all deaths in the county over two decades, not including deaths in hospitals and rehabilitation centers.
Nearly 400 homeless people died in hospitals while nearly 800 died on the streets.
Mark Jones was shot and killed Dec. 5, 2018, at East Virginia and South Third streets in downtown San Jose. He was 49 years old. His death was considered a homicide.
Jones was a father of four, though one child had died, and an uncle, according to posts to the National Gun Violence Memorial (gunmemorial.org).
Homeless people tend to live in poorer areas, as shown in this interactive map. The map identifies the number of homeless people by ZIP code who died in the county over the last 19 years juxtaposed against household median income.
Phillip Dryden, 60, died May 28, 2017, in front of 305 N. 11th St. in downtown San Jose from complications caused by a community-acquired lower respiratory infection.
The unhoused are dying throughout the county with most dying in poorer areas and at a much younger age than the housed — underscoring the difficulty of helping this population. The number of deaths of homeless people rose 350% over the last two decades while the homeless population shrank by 5% between 2004 and 2018, according to a Bay City News Foundation analysis published in June.
While homelessness isn’t a cause of death, it is a contributing factor that can worsen underlying health issues, which can be fatal, according to health providers who treat this population.
Homeless people like Marie typically die decades earlier than those who are housed. People with housing in Santa Clara County live on average 83 years, according to 2014 data, the latest available. The average age of death for a homeless person in the county was 52.
More homeless people die in low-income areas because that’s where most are living at the time of death, said Liz Thurstone, a charge nurse at Regional Medical Center of San Jose.
“That’s where a lot of resources are, too,” she said.
Food, transportation, free clinics, food banks and shops like Goodwill are just some of the resources homeless people can take advantage of in those areas of larger cities.
“There’s lots of board-and-cares and shelters,” she added.
Santa Clara Valley Medical Center, which is operated by the county, delivers services to homeless people and directs those services to low income areas, county spokeswoman Joy Alexiou said.
Excluding the many who died in hospitals and rehabilitation centers, 85% of deaths of homeless people between 2000 and 2018 occurred in ZIP codes with median household incomes below the county’s, according to data from the medical examiner. The county’s median of almost $126,000 was the highest in the state in 2018, according to the U.S. Census Bureau.
“Poverty is a big factor in health issues,” Thurstone said. “It’s always been one of those common determinants.”
And while the median household income of the poorest ZIP code in the county is $55,000, not poor by some standards, the cost of living in Santa Clara County is much higher, too. The county makes up part of Silicon Valley, home to tech companies like Apple and Facebook, where the median home price in August 2020 was $1.26 million, according to Zillow.
About 120 deaths occurred at Santa Clara Valley Medical Center or nearby rehabilitation centers, in an area where the median income is $88,000.
In addition to deaths at Regional Medical Center of San Jose, 45 homeless people died on the streets of 95116, in East San Jose, which is home to Regional hospital.
“We have a very underserved population there, where you’re going to find a lot of homeless people,” Thurstone said.
Access to health care for unhoused people is more limited than for others, according to many researchers.
A 2015 study in the American Journal of Public Health said, “Many of them are uninsured or do not have a usual source of care, which often leads them to rely on emergency departments (EDs) as a source of routine medical care.
“Furthermore, when unmanaged symptoms trigger urgent events or injuries occur, homeless individuals may seek care in EDs, and they may be hospitalized,” the authors said.
About 130 homeless people or more died on the street in East San Jose. An additional 100 died at Regional.
Thurstone said homeless people who come into Regional Medical Center are treated well. They are given clothes, a meal before being discharged and a consultation with a social worker.
A pharmacy is across the street. Hospital staff will go pick up prescriptions for homeless people who come into the hospital.
Some homeless people make the rounds of the hospitals, she said.
The number of homeless deaths per 100,000 people in Santa Clara County was about two times higher than in the nation in 2019 and roughly one and a half times higher than in the state in 2017, according to the latest available data.
* This story was reported with support from the California Fellowship through the USC Annenberg Center for Health Journalism.
Note to Editors: This is the second in a three-part series about homeless people dying in Santa Clara County.