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

Author

Listed:
  • Fran Calvo

    (Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain
    Department of Quality Assessment, Evaluation and Research, Health and Community Foundation, 08010 Barcelona, Spain)

  • Oriol Turró-Garriga

    (Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain)

  • Carles Fàbregas

    (Centre d’Acolliment i Serveis Socials “la Sopa”, Ajuntament de Girona, 17004 Girona, Spain)

  • Rebeca Alfranca

    (Centro de Atención Primaria Santa Clara, Institut Català de la Salut, 17004 Girona, Spain)

  • Anna Calvet

    (Unitat d’Aguts, Institut d’Assistència Sanitària, 17190 Salt, Spain)

  • Mercè Salvans

    (Centro de Atención Primaria Santa Clara, Institut Català de la Salut, 17004 Girona, Spain)

  • Cristina Giralt

    (Centro de Atención Primaria Blanes, Institut Català de la Salut, 17300 Blanes, Spain)

  • Sandra Castillejos

    (Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain)

  • Mercè Rived-Ocaña

    (Escola Universitària d’Infermeria i Teràpia Ocupacional, EUIT, Universitat Autònoma de Barcelona, UAB, 08221 Terrassa, Spain)

  • Paula Calvo

    (Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain)

  • Paz Castillo

    (Unitat d’Aguts, Institut d’Assistència Sanitària, 17190 Salt, Spain)

  • Josep Garre-Olmo

    (Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain
    Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain)

  • Xavier Carbonell

    (Facultat de Psicologia, Ciències de l’Educació i l’Esport Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain)

Abstract

(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.

Suggested Citation

  • Fran Calvo & Oriol Turró-Garriga & Carles Fàbregas & Rebeca Alfranca & Anna Calvet & Mercè Salvans & Cristina Giralt & Sandra Castillejos & Mercè Rived-Ocaña & Paula Calvo & Paz Castillo & Josep Garre, 2021. "Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study," IJERPH, MDPI, vol. 18(4), pages 1-10, February.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:4:p:1762-:d:497783
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    References listed on IDEAS

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    1. Rostila, M. & Fritzell, J., 2014. "Mortality differentials by immigrant groups in Sweden: The contribution of socioeconomic position," American Journal of Public Health, American Public Health Association, vol. 104(4), pages 686-695.
    2. Fabian Termorshuizen & Addi PL van Bergen & Ronald BJ Smit & Hugo M Smeets & Erik JC van Ameijden, 2014. "Mortality and psychiatric disorders among public mental health care clients in Utrecht: A register-based cohort study," International Journal of Social Psychiatry, , vol. 60(5), pages 426-435, August.
    3. Anne Laporte & Stéphanie Vandentorren & Marc-Antoine Détrez & Caroline Douay & Yann Le Strat & Erwan Le Méner & Pierre Chauvin & The Samenta Research Group, 2018. "Prevalence of Mental Disorders and Addictions among Homeless People in the Greater Paris Area, France," IJERPH, MDPI, vol. 15(2), pages 1-11, January.
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    Cited by:

    1. Fernando Fajardo-Bullón & Jesús Pérez-Mayo & Igor Esnaola, 2021. "The Association of Interpersonal Relationships and Social Services with the Self-Rated Health of Spanish Homelessness," IJERPH, MDPI, vol. 18(17), pages 1-18, September.
    2. Alícia Parés-Bayerri & Fran Calvo & Sílvia Font-Mayolas & Sonia Panadero & José Juan Vázquez, 2023. "Differences in Drug Use among Persons Experiencing Homelessness According to Gender and Nationality," IJERPH, MDPI, vol. 20(5), pages 1-16, February.
    3. Kate Frazer & Thilo Kroll, 2022. "Understanding and Tackling the Complex Challenges of Homelessness and Health," IJERPH, MDPI, vol. 19(6), pages 1-3, March.

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