Fran Calvo1,2, Oriol Turró-Garriga3, Carles Fàbregas4, Rebeca Alfranca5, Anna Calvet6, Mercè Salvans5, Cristina Giralt7, Sandra Castillejos1, Mercè Rived-Ocaña8, Paula Calvo9, Paz Castillo6, Josep Garre-Olmo3,9, Xavier Carbonell10. 1. Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain. 2. Department of Quality Assessment, Evaluation and Research, Health and Community Foundation, 08010 Barcelona, Spain. 3. Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain. 4. Centre d'Acolliment i Serveis Socials "la Sopa", Ajuntament de Girona, 17004 Girona, Spain. 5. Centro de Atención Primaria Santa Clara, Institut Català de la Salut, 17004 Girona, Spain. 6. Unitat d'Aguts, Institut d'Assistència Sanitària, 17190 Salt, Spain. 7. Centro de Atención Primaria Blanes, Institut Català de la Salut, 17300 Blanes, Spain. 8. Escola Universitària d'Infermeria i Teràpia Ocupacional, EUIT, Universitat Autònoma de Barcelona, UAB, 08221 Terrassa, Spain. 9. Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain. 10. Facultat de Psicologia, Ciències de l'Educació i l'Esport Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain.
Abstract
(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox's proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89-10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62-5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12-3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09-2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality.
(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox's proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 peopledied during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89-10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62-5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12-3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09-2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality.
Entities:
Keywords:
alcohol use disorder; drug use disorder; homelessness; immigration; infectious disease; mental health; mortality; type 2 diabetes
Authors: Fabian Termorshuizen; Addi P L van Bergen; Ronald B J Smit; Hugo M Smeets; Erik J C van Ameijden Journal: Int J Soc Psychiatry Date: 2013-06-28