The grim links between poor health and homelessness are brought into the spotlight once again, in a study from Glasgow.
Researchers writing in The Lancet tracked the links between an early death and people experiencing homelessness, drug addiction, prison and psychosis. Gathering data from more than half a million Glasgow residents over a five-year span, they found that premature death was much more likely among people experiencing both homelessness and several of the other indicators than those who experienced only one. And experiencing any of the indicators was also more likely to lead to premature death than among people who experience none.
The most significant finding was that most of the causes of premature death were either preventable or treatable. In other words, many of the deaths could be avoided with timely and appropriate interventions.
Of the population studied, 2.4% made a homelessness application, 1.4% received opiate substitute therapy, 2% either went to prison or had a court report in the absence of prison, and under 1% were recorded as experiencing psychosis.
The study found that people who experienced homelessness alone (not any of the other indicators) accounted for almost 2% of the Glasgow population yet had a 2·4 times greater risk of premature death than those who didn’t. The combination of homelessness, opioid dependence and involvement in the justice system was particularly high risk for early mortality.
The authors say the findings could help identify groups particularly at risk. They also call for more attention on preventing and treating non-communicable illnesses among these groups. Current policy tends to focus on communicable diseases.
The authors suggest that current public health and health care provision is “failing to benefit many of those with the experiences of interest, creating unjust inequalities in risk of death”.
They add: “These findings suggest the need for wide-ranging policy and service efforts across the population to prevent these experiences and mitigate associated poor health outcomes.”
Premature mortality in people affected by co-occurring homelessness, justice involvement, opioid dependence, and psychosis: a retrospective cohort study using linked administrative data
Emily J Tweed, Alastair H Leyland, David Morrison, S Vittal Katikireddi
