Suicide Among Persons Experiencing Homelessness.

INTRODUCTION: This study aims to characterize suicide and associated disparities among persons experiencing homelessness (PEH). MATERIALS AND METHODS: We reviewed suicide victims in the National Violent Death Reporting System (NVDRS) from 2003 to 2018 and compared factors surrounding suicides of PEH to factors of housed victims. We also utilized the Point-in-Time (PIT) survey (2010-2018), and census population estimates, to estimate suicide rates among PEH and the wider population. RESULTS: 1.1% of suicide victims were described as experiencing homelessness at the time of their deaths, a value that is disproportional given the overall homeless rates of 0.2% in the past decade. Compared to nonhomeless victims, PEH were more likely to be younger, Black, male, and nonveterans. PEH were significantly more likely to have an identified alcohol/substance use disorder. PEH were half as likely to die via firearm and were more likely to die in natural areas, motels, and the streets. PEH were significantly more likely to have a history of suicidal thoughts, a history of suicide attempts, and a history of disclosure of intent, particularly to health care workers. CONCLUSIONS: PEH are disproportionately overrepresented among all suicide victims, but the circumstances surrounding their deaths create opportunity for targeted interventions.

Left out in the cold: Homicide amongst persons experiencing homelessness.

BACKGROUND: There is no American population-level study comparing the characteristics of homicides involving victims who were vs were not experiencing homelessness at time of death. We aim to identify variables surrounding homeless homicide that are unique, and intervenable. METHODS: In this retrospective cohort study, we reviewed the National Violent Death Reporting System (NVDRS) from 2003 to 2018 and compared the characteristics surrounding homicides of victims who were not-homeless (cohort 1) vs experiencing homelessness (cohort 2) at death. We utilized the available perpetrator data to characterize the average perpetrator for each cohort. We considered housing status to be our primary predictor and recorded NVDRS variables, such as age of victims and likelihood to know perpetrators, to be our primary outcomes. RESULTS: 81,212 Homicide Victims and 60,982 Homicide Perpetrators were included in analysis. Homeless cohort victims were more likely younger, White, male, and to have a known mental health or substance abuse disorder. PEH were also more likely to have co-morbid mental health and substance abuse disorders but were roughly half as likely to be getting treatment for said disorders. Circumstances surrounding incidents, including geographic location, mechanism of injury, and premeditation, varied; homeless cohort victims were more likely to die in random acts of violence, but were less likely to die via firearm. CONCLUSIONS: There is room for targeted interventions against homeless homicides. LEVEL OF EVIDENCE: Epidemiological, Level IV.