Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study

Fran Calvo, Oriol Turró-Garriga, Carles Fàbregas, Rebeca Alfranca, Anna Calvet, Mercè Salvans, Cristina Giralt, Sandra Castillejos, Mercè Rived-Ocaña, Paula Calvo, Paz Castillo, Josep Garre-Olmo and Xavier Carbonell
Additional contact information
Fran Calvo: Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain
Oriol Turró-Garriga: Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain
Carles Fàbregas: Centre d’Acolliment i Serveis Socials “la Sopa”, Ajuntament de Girona, 17004 Girona, Spain
Rebeca Alfranca: Centro de Atención Primaria Santa Clara, Institut Català de la Salut, 17004 Girona, Spain
Anna Calvet: Unitat d’Aguts, Institut d’Assistència Sanitària, 17190 Salt, Spain
Mercè Salvans: Centro de Atención Primaria Santa Clara, Institut Català de la Salut, 17004 Girona, Spain
Cristina Giralt: Centro de Atención Primaria Blanes, Institut Català de la Salut, 17300 Blanes, Spain
Sandra Castillejos: Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain
Mercè Rived-Ocaña: Escola Universitària d’Infermeria i Teràpia Ocupacional, EUIT, Universitat Autònoma de Barcelona, UAB, 08221 Terrassa, Spain
Paula Calvo: Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain
Paz Castillo: Unitat d’Aguts, Institut d’Assistència Sanitària, 17190 Salt, Spain
Josep Garre-Olmo: Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain
Xavier Carbonell: Facultat de Psicologia, Ciències de l’Educació i l’Esport Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain

IJERPH, 2021, vol. 18, issue 4, 1-10

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.

Keywords: homelessness; mortality; infectious disease; immigration; mental health; drug use disorder; alcohol use disorder; type 2 diabetes (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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