Many of them took their final breaths alone and anonymously, in narrow alleys, empty fields or cold riverbeds.
During the past 11 years in Sacramento County, at least 501 men, women and children have died homeless, according to the first comprehensive analysis of its kind in the region. That equates to a rate of about one death per week.
About 38 percent of those deaths, all of which were documented by the County Coroners Office, occurred outdoors.
Two nonprofit groups, Sacramento Steps Forward and the Sacramento Regional Coalition to End Homelessness, prepared the Homeless Deaths report based on coroner records from June 2002 through June 2013. The records list, among other things, where people died and whether they had a permanent address or were transient.
Authors of the study said they hoped the information would serve as a catalyst for new programs and policies to curb homelessness in the region.
The report, which lists the names and ages of all 501 people who died, also serves to mark the passing of people who were largely invisible to many residents, homeless advocates said.
So many homeless people are on our streets everyday, yet many of us hardly even notice them, said Sister Libby Fernandez of Loaves & Fishes, which offers food and services to the homeless and indigent. Its very lonely out there. When our people die, we try to find family members, but often there is no one. We were their family.
More than 2,000 people are homeless in Sacramento County on any given night, according to point in time surveys conducted in recent years. Those surveys count, on a single night, people living in shelters and transitional living programs, as well as those who sleep outside in places such as parks, under bridges and on sidewalks.
The death count uncovered some surprising trends, said Bob Erlenbusch of the homelessness coalition.
There are so many stereotypes, Erlenbusch said. Dont all homeless people die in the wintertime? Arent they all drug addicts and alcoholics? The answer to both questions is no, according to the report.
The seasonal distribution of deaths was roughly even, with 26 percent occurring in winter, 26 percent in summer and 24 percent in both spring and fall, the report shows. Alcohol or drugs were blamed in 27 percent of the cases documented in the report. Injuries, heart disease, infections and gunshot or stab wounds accounted for much of the rest.
Behind the numbers, there are people such as Evelyn Roper, Martin Roller and Michael Wentworth.
Roper was 66 years old and in poor health when she died in her tent on a January night in 2008 during a harsh winter storm, according to friends and relatives. The coroner ruled that she died of natural causes.
Rollers body was found floating in the American River near a transient camp in 2011. He suffered from depression and addiction, and his former wife believes he may have committed suicide. His official cause of death is listed as undetermined.
Michael Lawrence Wentworth, affectionately known on the streets as Gremlin, was stabbed to death earlier this year as he came to the aid of another homeless person. He was among the 6 percent of homeless deaths that resulted from homicide during the period studied. Another 5 percent committed suicide.
Among the reports other findings:
• About 77 percent of the 501 people listed had spent time in the county jail.
• Ages of the dead ranged from infants to 81 years old. The average age of death among homeless adults was 47 for women and 50 for men.
• About 10 percent of the homeless people who died were military veterans.
• Nearly half the deaths occurred on weekends.
• Homeless deaths were disproportionately located downtown, and tended to follow transportation corridors including the interstate highways and light rail.
John Kraintz, a homeless activist who spent years on the streets before a health crisis propelled him inside, said he believes the number of deaths reflected in the study may be low. The figures, he noted, represent only cases reviewed by the coroner. Homeless people who died in hospitals after lengthy illnesses likely are not represented, he said.
There is a bigger story to be told, he said.
Erlenbusch acknowledged that the report does not cover every homeless persons death over a decade, but he said the authors are confident that the document captures most of them.
The report calls for various policy changes, including increased funding for affordable housing programs, aggressive efforts to enroll homeless people in medical, dental and mental health insurance under the federal Affordable Care Act, increased funding for year-round shelters, transportation subsidies for homeless people and increased funding for alcohol and drug treatment.
Weve got to get serious about creating safe places for homeless people to stay, and places for them to receive care, Erlenbusch said.
A proposed Safe Ground for Sacramento, where homeless people could live with basic facilities and without police interference, is making progress, he said. A group pressing the issue has identified property in Del Paso Heights for the project, he said, and is working with developers to move the effort forward.
Call The Bees Cynthia Hubert, (916) 321-1082. Follow her on Twitter @Cynthia_Hubert.