MORTALITY IN A COHORT OF HOMELESS ADULTS IN PHILADELPHIA
MORTALITY IN A COHORT OF HOMELESS ADULTS IN PHILADELPHIA
复制标题
费城一组无家可归成年人的死亡率
DOI：
10.1056/nejm199408043310506
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发表时间：
1994-08-04
影响因子：
158.5
通讯作者：
FIFE, D
中科院分区：
文献类型：
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作者：
HIBBS, JR;BENNER, L;FIFE, D
背景。无家可归者因多种原因死亡的风险很高，但明确定义的无家可归者的年龄调整死亡率尚未确定。方法。我们确定了 1985 年 1 月 1 日至 1988 年 12 月 31 日期间由费城两个无家可归者机构之一或两者提供服务的 6308 名 15 至 74 岁无家可归者。使用包含费城所有死亡情况和同一时期所有费城居民列表的数据库，我们将这些无家可归者的死亡率与费城一般人口的死亡率进行了比较。结果。无家可归者的年龄调整死亡率是费城普通人口的 3.5 倍（95% 置信区间，2.8 至 4.5）。无家可归者在 75 岁之前损失的潜在寿命年数按年龄调整是普通人群的 3.6 倍（每 1000 人年观察损失 345 年与 97 年）。 96 名无家可归者死亡中，有 51 名（53%）发生在夏季。无家可归者的死亡率高于非白人、白人、女性和男性的一般人群。在无家可归者群体中，白人和药物滥用者的死亡率高于其他亚群体，但即使是不知道是否为药物滥用者的无家可归者，其死亡风险也比一般人群高出三倍。无家可归者死亡人数中 73% 是由受伤、心脏病、肝病、中毒和不明原因造成的。结论。费城无家可归的成年人的年龄调整死亡率几乎是费城总人口的四倍。白人和药物滥用者面临的风险尤其高。将无家可归者群体与死亡记录进行匹配是监测一段时间内死亡率、评估干预措施和识别死亡风险增加的亚组的有用方法。
Background. Homeless people are at high risk for death from many causes, but age-adjusted death rates for well-defined homeless populations have not been determined.Methods. We identified 6308 homeless persons 15 to 74 years of age who were served by one or both of two agencies for the homeless in Philadelphia between January 1, 1985, and December 31, 1988. Using a data base that contained all deaths in Philadelphia and listings of all Philadelphia residents during the same period, we compared the mortality rate for this homeless population with the rate in the general population of Philadelphia.Results. The age-adjusted mortality rate among the homeless was 3.5 times that of Philadelphia's general population (95 percent confidence interval, 2.8 to 4.5). The age-adjusted number of years of potential life lost before the age of 75 years was 3.6 times higher for the homeless people than for the general population (345 vs. 97 years lost per 1000 person-years of observation). Fifty-one of the 96 deaths of homeless persons (53 percent) occurred during the summer months. Mortality rates were higher among the homeless than in the general population for nonwhites, whites, women, and men. Within the homeless cohort, white men and substance abusers had higher mortality rates than other subgroups, but even homeless people not known to be substance abusers had a threefold higher risk of death than members of the general population. Injuries, heart disease, liver disease, poisoning, and ill-defined conditions accounted for 73 percent of all the deaths among the homeless.Conclusions. Homeless adults in Philadelphia have an age-adjusted mortality rate nearly four times that of Philadelphia's general population. White men and substance abusers are at particularly high risk. Matching cohorts of homeless people to death records is a useful way to monitor mortality rates over time, evaluate interventions, and identify subgroups with an increased risk of death.