Using Point-in-Time Homeless Counts to Monitor Mortality Trends Among People Experiencing Homelessness in Los Angeles County, California, 2015-2019
Using Point-in-Time Homeless Counts to Monitor Mortality Trends Among People Experiencing Homelessness in Los Angeles County, California, 2015-2019
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DOI：
10.2105/ajph.2021.306502
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发表时间：
2021-12-01
影响因子：
12.7
通讯作者：
Simon, Paul
中科院分区：
文献类型：
--
作者：
Nicholas, Will;Greenwell, Lisa;Simon, Paul
目的：通过使用年度特定时间点的无家可归者统计数据，报告加利福尼亚州洛杉矶县无家可归者的死亡率、死亡率比值（MRR）以及死亡原因的趋势，并将研究结果与已发表的关于无家可归者死亡率的纵向队列研究进行比较。
方法：我们利用2015 - 2019年与死亡证明数据匹配的法医 - 验尸官数据，统计无家可归者的死亡人数并确定死因。我们通过计算连续1月特定时间点无家可归者统计数据的平均值来估算年中无家可归人口的分母。我们利用对无家可归者的年度人口统计调查来估算年龄和性别调整后的MRR。我们通过文献综述确定了用于比较的研究。
结果：从2015年到2019年，死亡率上升。药物过量是首要死因。白人无家可归者的死亡率高于黑人和拉丁裔无家可归者。与普通人群相比，所有原因的MRR范围从2.8（95%置信区间[CI]为2.7，3.0）到药物过量的35.1（95% CI为31.9，38.4）。比较队列研究中的粗死亡率和全因MRR与本研究相似。
结论：其他寻求更好地了解和降低其无家可归人口死亡率的城市辖区可以采用这些方法。
Objectives. To report trends in mortality rates, mortality rate ratios (MRRs), and causes of death among people experiencing homelessness (PEH) in Los Angeles County, California, by using annual point-in-time homeless counts and to compare findings to published longitudinal cohort studies of homeless mortality.Methods. We enumerated homeless deaths and determined causes by using 2015-2019 medical examiner-coroner data matched to death certificate data. We estimated midyear homeless population denominators by averaging consecutive January point-in-time homeless counts. We used annual demographic surveys of PEH to estimate age- and gender-adjusted MRRs. We identified comparison studies through a literature review.Results. Mortality rates increased from 2015 to 2019. Drug overdose was the leading cause of death. Mortality was higher among White than among Black and Latino PEH. Compared with the general population, MRRs ranged from 2.8 (95% confidence interval [CI] 52.7, 3.0) for all causes to 35.1 (95% CI531.9, 38.4) for drug overdose. Crude mortality rates and all-cause MRRs from comparison cohort studies were similar to those in the current study.Conclusions. These methods can be adapted by other urban jurisdictions seeking to better understand and reduce mortality in their homeless populations.