Mortality among men using homeless shelters in Toronto, Ontario
Mortality among men using homeless shelters in Toronto, Ontario
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DOI：
10.1001/jama.283.16.2152
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发表时间：
2000-04-26
影响因子：
120.7
通讯作者：
Hwang, SW
中科院分区：
文献类型：
--
作者：
Hwang, SW
美国城市中的无家可归者死亡率很高。然而，很少有比较数据存在的死亡率之间无家可归的人在其他发达countries.Objectives比较死亡率之间的男性使用无家可归者收容所和一般人口在多伦多，安大略，并确定死亡率是否有显着差异之间的男性使用无家可归者收容所在加拿大和美国cities.Design队列研究从1995年到1997年进行，研究对象为1995年在多伦多使用过无家可归者收容所的18岁或以上的男性（n=8933）。使用多伦多无家可归者收容所的男性的特定死亡率与多伦多一般人群中男性的特定死亡率以及使用纽约无家可归者收容所的男性的特定死亡率纽约州约克;马萨诸塞州波士顿;结果在多伦多，使用无家可归者收容所的男性比该市普通人群中的男性更容易死亡。18 - 24岁男性的死亡率比为8.3（95%置信区间[CI]，4.4-15.6），25 - 44岁男性为3.7（95% CI，3.0-4.6），45 - 64岁男性为2.3（95% CI，1.8-3.0）。然而，在大多数情况下，在多伦多使用无家可归者收容所的男性的死亡风险明显低于美国城市的男性。对于使用无家可归者收容所的25至44岁男性，多伦多与波士顿相比的死亡率比率为0.52（95%CI，0.41-0.65），多伦多与纽约市相比的死亡率比率为0.61（95%CI，0.44-0.85）。对于35至54岁的男性使用无家可归者收容所，死亡率比为0.42（95%CI，0.27-0.66）为多伦多相比，Philadelphia.Conclusions死亡率之间的男性谁使用无家可归者收容所在多伦多，而高于一般人口的多伦多，是远远低于男性使用无家可归者收容所在美国3个主要城市中观察到的死亡率。需要进一步研究，以确定这种差异的原因。
Context Homeless persons in US cities have high mortality rates. However, few comparison data exist for death rates among homeless persons in other developed countries.Objectives To compare mortality rates among men using homeless shelters and the general population in Toronto, Ontario, and to determine whether mortality rates differ significantly among men using homeless shelters in Canadian and US cities.Design Cohort study conducted from 1995 through 1997, with a mean follow-up of 2.6 years.Participants Men aged 18 years or older who used homeless shelters in Toronto in 1995 (n=8933).Main Outcome Measure Mortality rate ratios comparing age-specific mortality rates among men using homeless shelters in Toronto with those of men in the general population of Toronto and of men using homeless shelters in New York, NY; Boston, Mass; and Philadelphia, Pa.Results Men using homeless shelters in Toronto were more likely to die than men in the city's general population. Mortality rate ratios were 8.3 (95% confidence interval [CI], 4.4-15.6) for men aged 18 to 24 years, 3.7 (95% CI, 3.0-4.6) for men aged 25 to 44 years, and 2.3 (95% CI, 1.8-3.0) for men aged 45 to 64 years. In most cases, however, the risk of death was significantly lower for men using homeless shelters in Toronto than for those in US cities. For men aged 25 to 44 years using homeless shelters, mortality rate ratios were 0.52 (95% CI, 0.41-0.65) for Toronto compared with Boston and 0.61 (95% CI, 0.44-0.85) for Toronto compared with New York City. For men aged 35 to 54 years using homeless shelters, the mortality rate ratio was 0.42 (95% CI, 0.27-0.66) for Toronto compared with Philadelphia.Conclusions Mortality rates among men who use homeless shelters in Toronto, while higher than in the general population of Toronto, are much lower than mortality rates observed among men using homeless shelters in 3 major US cities. Further study is needed to identify the reasons for this disparity.