Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 year follow-up study.
Mortality among residents of shelters, rooming houses, and hotels in Canada: 11 year follow-up study.
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DOI：
10.1136/bmj.b4036
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发表时间：
2009-10-26
期刊：
影响因子：
--
通讯作者：
Dunn JR
中科院分区：
文献类型：
--
作者：
Hwang SW;Wilkins R;Tjepkema M;O'Campo PJ;Dunn JR
目的研究全国范围内无家可归者和居住在收容所、公寓和旅馆的边缘人群的死亡率。设计随访研究。加拿大1991-2001年。参与者15100名1991年人口普查中被点算的无家可归者和边缘居住者。主要结果测量年龄特异性和年龄标准化死亡率，25岁时的剩余预期寿命，以及25岁至75岁的生存概率。数据与最贫穷和最富有的收入五分之一的数据以及整个队列的数据进行了比较。结果在无家可归和边缘居住的人中，3280人死亡。这些人的死亡率大大高于收入最低的五分之一人口的死亡率，其中最高的死亡率比率出现在较年轻的年龄。在无家可归或住房简陋的人中，男性活到75岁的可能性为32%（95%置信区间为30%至34%），女性为60%（56%至63%）。25岁时的剩余预期寿命分别为42岁（42至43岁）和52岁（50至53岁）。与整个队列相比，男性和女性的死亡率比值分别为11.5（8.8至15.0）和9.2（5.5至15.2）对于药物相关死亡，6.4（5.3至7.7）和8.2（5.0至13.4），4.8（3.9至5.9）和3.8（2.7至5.4）的精神障碍，2.3（1.8至3.1）和5.6（3.2至9.6）的自杀。对于男性和女性来说，死亡率差异最大的是吸烟相关疾病、缺血性心脏病和呼吸道疾病。结论：居住在收容所、公寓和旅馆中的死亡率比仅基于低收入的预期要高得多。要降低这一人群过高的过早死亡率，就需要采取干预措施，解决与吸烟、酗酒、吸毒、精神障碍和自杀等原因有关的死亡问题。
Objective To examine mortality in a representative nationwide sample of homeless and marginally housed people living in shelters, rooming houses, and hotels. Design Follow-up study. Setting Canada 1991-2001. Participants 15 100 homeless and marginally housed people enumerated in 1991 census. Main outcome measures Age specific and age standardised mortality rates, remaining life expectancies at age 25, and probabilities of survival from age 25 to 75. Data were compared with data from the poorest and richest income fifths as well as with data for the entire cohort Results Of the homeless and marginally housed people, 3280 died. Mortality rates among these people were substantially higher than rates in the poorest income fifth, with the highest rate ratios seen at younger ages. Among those who were homeless or marginally housed, the probability of survival to age 75 was 32% (95% confidence interval 30% to 34%) in men and 60% (56% to 63%) in women. Remaining life expectancy at age 25 was 42 years (42 to 43) and 52 years (50 to 53), respectively. Compared with the entire cohort, mortality rate ratios for men and women, respectively, were 11.5 (8.8 to 15.0) and 9.2 (5.5 to 15.2) for drug related deaths, 6.4 (5.3 to 7.7) and 8.2 (5.0 to 13.4) for alcohol related deaths, 4.8 (3.9 to 5.9) and 3.8 (2.7 to 5.4) for mental disorders, and 2.3 (1.8 to 3.1) and 5.6 (3.2 to 9.6) for suicide. For both sexes, the largest differences in mortality rates were for smoking related diseases, ischaemic heart disease, and respiratory diseases. Conclusions Living in shelters, rooming houses, and hotels is associated with much higher mortality than expected on the basis of low income alone. Reducing the excessively high rates of premature mortality in this population would require interventions to address deaths related to smoking, alcohol, and drugs, and mental disorders and suicide, among other causes.
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影响因子：
1.9
作者：
Kasprow, WJ;Rosenheck, R
通讯作者：
Rosenheck, R
DOI：
10.1007/bf03405081
发表时间：
2003-11-01
影响因子：
4.3
作者：
Hwang, SW;Martin, RE;Hulchanski, JD
通讯作者：
Hulchanski, JD
影响因子：
120.7
作者：
Hwang, SW
通讯作者：
Hwang, SW
DOI：
10.1097/00126334-200502010-00010
发表时间：
2005-02-01
影响因子：
3.6
作者：
Riley, ED;Bangsberg, DR;Moss, AR
通讯作者：
Moss, AR
影响因子：
1.8
作者：
Beijer, U.;Andreasson, A.;Fugelstad, A.
通讯作者：
Fugelstad, A.