At least 88 homeless people died last year in Multnomah County, according to a report issued Friday.

That number, up from 56 in 2014, marks a five-year high.

Multnomah County Health Officer Dr. Paul Lewis said that nearly all the deaths appeared avoidable or premature.

"Everyone needs basic shelter and security," Lewis said. "These lives ended decades too soon, and for all the wrong reasons."

The new report says 71 who died in 2015 were men, and 17 were women. Their ages ranged from 17 to 78.

More than half of the deaths were accidental, the report says, and a quarter were from natural causes. Homicide accounted for five deaths, up from one homicide in 2014.

Alcohol or drugs contributed to 44 of the deaths, with heroin or prescription opiates contributing to 22.

Multnomah County Chair Deborah Kafoury said the report demonstrates the need for more affordable housing and greater access to mental health and substance abuse treatment.

"My thoughts are with the 88 families who will never be the same because of what happened on our streets," Kafoury said in a statement. "Short-term, shelters will protect some. But long term, only permanent housing and adequate health and mental health care will save lives."

Since the county first began tracking deaths in 2011, at least 279 people have died, according to the report. The numbers show that 32 people died in 2013, 56 died in 2012 and 47 died in 2011.

Over half of homeless decedents were found outside, followed by indoor public spaces, according to the county report.

In a statement, Israel Bayer, executive director of Street Roots, called the numbers "beyond tragic."

"There's no reason," he said, "that in a community that is thriving economically that hundreds of people should be dying on our streets isolated and alone and without a safe place to call home."

-- Emily E. Smith

esmith@oregonian.com

503-294-4032; @emilyesmith