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Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England.
Aldridge, Robert W; Menezes, Dee; Lewer, Dan; Cornes, Michelle; Evans, Hannah; Blackburn, Ruth M; Byng, Richard; Clark, Michael; Denaxas, Spiros; Fuller, James; Hewett, Nigel; Kilmister, Alan; Luchenski, Serena; Manthorpe, Jill; McKee, Martin; Neale, Joanne; Story, Alistair; Tinelli, Michela; Whiteford, Martin; Wurie, Fatima; Hayward, Andrew.
Afiliación
  • Aldridge RW; Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK.
  • Menezes D; Collaborative Centre for Inclusion Health, Institute of Epidemiology & Health Care, University College London, London, NW1 2DA, UK.
  • Lewer D; Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK.
  • Cornes M; Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK.
  • Evans H; Collaborative Centre for Inclusion Health, Institute of Epidemiology & Health Care, University College London, London, NW1 2DA, UK.
  • Blackburn RM; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE1 1UL, UK.
  • Byng R; Health and Social Care Workforce Research Unit, King's College London, London, SE1 1UL, UK.
  • Clark M; Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK.
  • Denaxas S; Public Health Data Science, Institute of Health Informatics, University College London, London, NW1 2DA, UK.
  • Fuller J; Community and Primary Care Research Group, University of Plymouth, Plymouth, Devon, PL6 8BX, UK.
  • Hewett N; Personal Social Services Research Unit, London School of Economics, London, WC2A 2AE, UK.
  • Kilmister A; Institute of Health Informatics, University College London, London, NW1 2DA, UK.
  • Luchenski S; NIHR Health and Social Care Workforce Research Unit, King's College London, London, SE1 1UL, UK.
  • Manthorpe J; Pathway Charity, Pathway Charity, London, NW1 2PG, UK.
  • McKee M; Health and Social Care Workforce Research Unit, King's College London, London, SE1 1UL, UK.
  • Neale J; Collaborative Centre for Inclusion Health, Institute of Epidemiology & Health Care, University College London, London, NW1 2DA, UK.
  • Story A; Health and Social Care Workforce Research Unit, King's College London, London, SE1 1UL, UK.
  • Tinelli M; Department of Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, WC1E 7HT, UK.
  • Whiteford M; National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE1 1UL, UK.
  • Wurie F; Collaborative Centre for Inclusion Health, Institute of Epidemiology & Health Care, University College London, London, NW1 2DA, UK.
  • Hayward A; Tropical and Infectious Diseases, University College London Hospitals NHS Trust, London, NW1 2PG, UK.
Wellcome Open Res ; 4: 49, 2019.
Article en En | MEDLINE | ID: mdl-30984881
ABSTRACT

Background:

Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes. 

Methods:

We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group).

Results:

We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).  The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130/600), cancer (19.0%; 114/600) and digestive disease (19.0%; 114/600).  The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181/600) compared to 23.0% in the IMD5 group (578/2,512).

Conclusion:

Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prevalence_studies Aspecto: Determinantes_sociais_saude Idioma: En Revista: Wellcome Open Res Año: 2019 Tipo del documento: Article País de afiliación: Reino Unido
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Tipo de estudio: Etiology_studies / Observational_studies / Prevalence_studies Aspecto: Determinantes_sociais_saude Idioma: En Revista: Wellcome Open Res Año: 2019 Tipo del documento: Article País de afiliación: Reino Unido