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Death rates among homeless six times higher than national average

Young rough sleepers die up to 22 years earlier than general population

Caroline White

Tuesday, 14 June 2011

Death rates among homeless men and women are six times higher than those of the general population, shows research published online first inThe Lancet.

Furthermore, the life expectancy of those in the 15-24 year age bracket is between 17 (women) and 22 years (men) shorter than that of the general population.

The findings are based on an analysis of 32 711 homeless people aged 16 years and over (23 040 men and 9671 women) who were registered in the Danish Homeless Register.

This showed that 62% of men and 58% had registered psychiatric disorders, while 49% of men and 37% of women were drug and/or alcohol misusers.

During the study period, 3839 men (17%) and 951 women (10%) died. Risk of death was slightly higher in women (6.7 times) than in men (5.6 times) and external causes, including suicide and violence, accounted for 28% of 4161 deaths for which information on the cause was available.

Substance misusers had the highest risk of death. Among men the increased risk was 40%, and among women it was 70%.

“There was a larger disparity in life expectancy between the homeless shelter population and the general population than previous studies have found. Cause-specific standardised mortality ratios for both sexes showed high excess mortality by suicide and unintentional injuries,” say the authors from the Mental Health Centre Copenhagen, Denmark.

“This study underlines that this marginalised population needs more attention on the health agenda,” they conclude.

In a linked Comment, Professor John Geddes and Dr Seena Fazel, from the Department of Psychiatry, University of Oxford, write: “[This study] suggests that integrated psychiatric and substance abuse treatment is necessary to address these inequalities, and further treatment trials on the best strategies to treat dual-diagnosis homeless patients and homeless youth need to be conducted.

Such enhanced treatment is likely to confer additional benefits, including reduction in violent crime, specific causes of mortality including suicide, and victimisation.”

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