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Article

Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study

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Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain
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Department of Quality Assessment, Evaluation and Research, Health and Community Foundation, 08010 Barcelona, Spain
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Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain
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Centre d’Acolliment i Serveis Socials “la Sopa”, Ajuntament de Girona, 17004 Girona, Spain
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Centro de Atención Primaria Santa Clara, Institut Català de la Salut, 17004 Girona, Spain
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Unitat d’Aguts, Institut d’Assistència Sanitària, 17190 Salt, Spain
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Centro de Atención Primaria Blanes, Institut Català de la Salut, 17300 Blanes, Spain
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Escola Universitària d’Infermeria i Teràpia Ocupacional, EUIT, Universitat Autònoma de Barcelona, UAB, 08221 Terrassa, Spain
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Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain
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Facultat de Psicologia, Ciències de l’Educació i l’Esport Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain
*
Author to whom correspondence should be addressed.
Academic Editors: Kate Frazer and Thilo Kroll
Int. J. Environ. Res. Public Health 2021, 18(4), 1762; https://doi.org/10.3390/ijerph18041762
Received: 20 December 2020 / Revised: 4 February 2021 / Accepted: 4 February 2021 / Published: 11 February 2021
(This article belongs to the Special Issue Health and Homelessness)
(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox’s proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89–10.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62–5.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12–3.29), and infectious diseases (HR = 1.6; 95% CI = 1.09–2.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality. View Full-Text
Keywords: homelessness; mortality; infectious disease; immigration; mental health; drug use disorder; alcohol use disorder; type 2 diabetes homelessness; mortality; infectious disease; immigration; mental health; drug use disorder; alcohol use disorder; type 2 diabetes
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MDPI and ACS Style

Calvo, F.; Turró-Garriga, O.; Fàbregas, C.; Alfranca, R.; Calvet, A.; Salvans, M.; Giralt, C.; Castillejos, S.; Rived-Ocaña, M.; Calvo, P.; Castillo, P.; Garre-Olmo, J.; Carbonell, X. Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study. Int. J. Environ. Res. Public Health 2021, 18, 1762. https://doi.org/10.3390/ijerph18041762

AMA Style

Calvo F, Turró-Garriga O, Fàbregas C, Alfranca R, Calvet A, Salvans M, Giralt C, Castillejos S, Rived-Ocaña M, Calvo P, Castillo P, Garre-Olmo J, Carbonell X. Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study. International Journal of Environmental Research and Public Health. 2021; 18(4):1762. https://doi.org/10.3390/ijerph18041762

Chicago/Turabian Style

Calvo, Fran, Oriol Turró-Garriga, Carles Fàbregas, Rebeca Alfranca, Anna Calvet, Mercè Salvans, Cristina Giralt, Sandra Castillejos, Mercè Rived-Ocaña, Paula Calvo, Paz Castillo, Josep Garre-Olmo, and Xavier Carbonell. 2021. "Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study" International Journal of Environmental Research and Public Health 18, no. 4: 1762. https://doi.org/10.3390/ijerph18041762

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