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Mortality by Age, Gender, and Race and Ethnicity in People Experiencing Homelessness in Boston, Massachusetts.
Fine, Danielle R; Dickins, Kirsten A; Adams, Logan D; Horick, Nora K; Critchley, Natalia; Hart, Katherine; Gaeta, Jessie M; Lewis, Elizabeth; Looby, Sara E; Baggett, Travis P.
Afiliação
  • Fine DR; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston.
  • Dickins KA; Harvard Medical School, Boston, Massachusetts.
  • Adams LD; Community, Systems and Mental Health Nursing Department, Rush University Medical Center, Chicago, Illinois.
  • Horick NK; Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, Boston.
  • Critchley N; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston.
  • Hart K; Harvard Medical School, Boston, Massachusetts.
  • Gaeta JM; Biostatistics Center, Massachusetts General Hospital, Boston.
  • Lewis E; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston.
  • Looby SE; Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Boston.
  • Baggett TP; The Institute for Research, Quality, and Policy in Homeless Health Care, Boston Health Care for the Homeless Program, Boston, Massachusetts.
JAMA Netw Open ; 6(8): e2331004, 2023 08 01.
Article em En | MEDLINE | ID: mdl-37651141
ABSTRACT
Importance People experiencing homelessness (PEH) face disproportionately high mortality rates compared with the general population, but few studies have examined mortality in this population by age, gender, and race and ethnicity.

Objective:

To evaluate all-cause and cause-specific mortality in a large cohort of PEH by age, gender, and race and ethnicity. Design, Setting, and

Participants:

An observational cohort study was conducted from January 1, 2003, to December 31, 2018. All analyses were performed between March 16, 2021, and May 12, 2022. A cohort of adults (age ≥18 years) seen at the Boston Health Care for the Homeless Program (BHCHP), a large federally funded Health Care for the Homeless organization in Boston, Massachusetts, from January 1, 2003, to December 31, 2017, was linked to Massachusetts death occurrence files spanning January 1, 2003, to December 31, 2018. Main Outcomes and

Measures:

Age-, gender-, and race and ethnicity-stratified all-cause and cause-specific mortality rates were examined and compared with rates in the urban Northeast US population using mortality rate ratios (RRs).

Results:

Among the 60 092 adults included in the cohort with a median follow-up of 8.6 (IQR, 5.1-12.5) years, 7130 deaths occurred. The mean (SD) age at death was 53.7 (13.1) years; 77.5% of decedents were men, 21.0% Black, 10.0% Hispanic/Latinx, and 61.5% White. The all-cause mortality rate was 1639.7 deaths per 100 000 person-years among men and 830 deaths per 100 000 person-years among women. The all-cause mortality rate was highest among White men aged 65 to 79 years (4245.4 deaths per 100 000 person-years). Drug overdose was a leading cause of death across age, gender, and race and ethnicity groups, while suicide uniquely affected young PEH and HIV infection and homicide uniquely affected Black and Hispanic/Latinx PEH. Conclusions and Relevance In this large cohort study of PEH, all-cause and cause-specific mortality varied by age, gender, and race and ethnicity. Tailored interventions focusing on those at elevated risk for certain causes of death are essential for reducing mortality disparities across homeless-experienced groups.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 2_ODS3 / 4_TD Problema de saúde: 2_enfermedades_transmissibles / 4_aids Assunto principal: Pessoas Mal Alojadas / Infecções por HIV Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: JAMA Netw Open Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Contexto em Saúde: 2_ODS3 / 4_TD Problema de saúde: 2_enfermedades_transmissibles / 4_aids Assunto principal: Pessoas Mal Alojadas / Infecções por HIV Tipo de estudo: Etiology_studies / Incidence_studies / Observational_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Limite: Adult / Female / Humans / Male País/Região como assunto: America do norte Idioma: En Revista: JAMA Netw Open Ano de publicação: 2023 Tipo de documento: Article
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