Mortality among homeless people in France, 2008-10
Mortality among homeless people in France, 2008-10
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DOI：
10.1093/eurpub/ckw083
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发表时间：
2016-12-01
影响因子：
4.4
通讯作者：
Rey, Gregoire
中科院分区：
文献类型：
--
作者：
Vuillermoz, Cecile;Aouba, Albertine;Rey, Gregoire
背景
不同国家的研究表明，无家可归者的死亡率较高。这项针对法国人群的研究目的是调查无家可归者的死亡率，并与普通人群相比，研究他们的死亡原因。
方法
一个协会登记的1145例无家可归者死亡的代表性样本，通过常见描述性变量与全国医学死因数据库进行匹配。采用对数二项回归比较无家可归者与普通人群的死亡率。使用多重填补法处理缺失的死因。
结果
在1145例登记的无家可归者死亡中，693例与死因数据库匹配。无家可归者死亡时较为年轻（平均年龄：49岁）。总体而言，冬季无家可归者死亡更为频繁。在所有死亡案例中，因低温（相对危险度=6.4）、酒精相关死亡（相对危险度=1.7）、精神障碍、消化系统和循环系统疾病以及未确定原因（相对危险度从1.5到3.7）死亡时是无家可归者的概率更高。
结论
2008 - 2010年，无家可归者平均在49岁死亡，而普通人群为77岁。无家可归者的健康问题不应仅在冬季或从酒精或寒冷相关状况的角度考虑。这项研究还强调需要更精确的数据来估计法国无家可归者的死亡风险。
Background Studies in various countries have shown that homeless people have high mortality levels. The aims of this study concerning the French population were to investigate mortality among the homeless and to study their causes of death in comparison to those of the general population. Methods A representative sample of 1145 homeless deaths registered by an association was matched to the national database of medical causes of death using common descriptive variables. Log-binomial regression was used to compare mortality among the homeless to that of the general population. Multiple imputation was used to manage missing causes of deaths. Results Out of the 1145 registered homeless deaths, 693 were matched to the causes of death database. Homeless deaths were young (average age: 49). Overall, homeless deaths were slightly more frequent during winter. Among all deaths, the probability of being homeless was higher when dying from hypothermia (RR = 6.4), alcohol-related deaths (RR = 1.7), mental disorders, diseases of the digestive and circulatory systems, and undetermined causes (RR from 1.5 to 3.7). Conclusion The homeless died at 49 years old on average compared with 77 in the general population in 2008-10. The health of homeless people should be considered not only in winter periods or in terms of alcohol- or cold-related conditions. This study also highlights the need for more precise data to estimate the mortality risks of the homeless in France.