Risk factors for death in homeless adults in Boston.

Abstract

HOMELESSNESS IS a major social problem that affects at least half a million Americans.^1-3 Not surprisingly, homeless individuals are at greatly increased risk of death. Studies in Atlanta, Ga, and San Francisco, Calif, found that homeless people often died in their fifth decade, with accidents or homicides causing about half of all deaths.^4,5 The mortality rate among homeless men in Sweden was 4 times higher than expected.⁶ In Philadelphia, Pa, the age-adjusted mortality rate in a cohort of homeless adults was 3.5 times that of the general population; mortality was particularly high among white men and substance abusers.⁷ Homeless men in Boston, Mass, aged 18 to 24 years and 25 to 44 years were 5.9 and 3.0 times more likely to die, respectively, than their counterparts in the general population.⁸