Table 2.
ALL-CAUSE MORTALITY & CAUSE-SPECIFIC AGE-STANDARDIZED MORTALITY RATIOS FOR UNSHELTERED COHORT, 2000–2009 BY RISK-LEVEL COMPARED WITH MASSACHUSETTS, 2000–2009 AND TO SHELTERED COHORT, 2003–2008A
| High-Riskb | Lower-Risk | |||||
|---|---|---|---|---|---|---|
| Underlying Cause of Deathc,d | N(%) MAg | SMR (95% CI) high-risk vs. sheltered | SMRe (95% CI)f high-risk vs. cohort | N(%) MA | SMR (95% CI) lower-risk vs. sheltered | SMR (95% CI) lower-risk vs. cohort |
| All-Cause | ||||||
| Total population | 52 (100) | 15.5 (11.7, 20.2) | 4.0 (3.0, 5.2) | 82 (100) | 7.9 (6.3, 9.8) | 2.2 (1.8, 2.8) |
| Men | 45 (86.5) | 15.0 (11.1, 19.9) | 4.2 (3.1, 5.6) | 71 (86.6) | 7.4 (5.8, 9.2) | 2.4 (1.9, 3.0) |
| Women | 7 (13.5) | 9.5 (4.2, 18.8) | 3.0 (1.2, 5.7) | 11 (1 3 .4) | 5.4 (2.9, 9.5) | 1.6 (.9, 2.8)i |
| Natural Causes | ||||||
| Chronic Liver Disease | 11 (21.2) | 86.0 (45.0, 150.0) | 11.7 (6.2, 20.4)d | |||
| Cancer | 9 (17.3) | 8.1 (4.0, 15.0) | 4.5 (2.2, 8.2) | 12 (14.6) | 3.7 (2.0, 6.3) | 2.2 (1.2, 3.7) |
| Heart Disease | 7 (13.5) | 10.4 (4.5, 20.5) | 3.5 (1.5, 7.0) | 11 (13.4) | 5.2 (2.7, 9.0) | 2.0 (1.0, 3.4)i |
| Chronic Substance Use | 5 (9.6) | 104.2 (38.1, 231.0) | 4.9 (1.8, 10.9) | 11 (13.4) | 83.5 (43.8, 144.8) | 4.0 (2.0, 6.8) |
| HIV/AIDS | 5 (9.6) | 122.3 (44.8, 271.1) | 6.5 (2.4, 14.4) | 5 (6.1) | 43.1 (15.8, 95.5) | 2.3 (.8, 5.1)i |
| External Causes | ||||||
| Injuries, non-poisoningh | 6 (11.5) | 44.0 (17.8, 91.6) | 8.4 (3.4, 17.5) | 13 (15.9) | 30.0 (16.7, 50.0) | 6.7 (3.7, 11.1) |
| Drug overdose (poisoning)d | 7 (8.5) | 16.2 (7.1, 32.1) | 1.1 (.5, 2.1)i | |||
| Substance Use Causes | ||||||
| Substance Use | 17 (32.7) | 75.2 (45.2, 117.9) | 4.1 (2.5, 6.5) | 22 (26.8) | 32.9 (21.1, 48.9) | 1.9 (1.2, 2.8) |
| Alcohol | 16 (30.8) | 212.5 (125.8, 337.7) | 14 (17.1) | 71.1 (40.5, 116.4) | ||
| Opioid | d | 8 (9.8) | 18.4 (8.5, 34.9) | |||
Notes:
Sheltered Cohort from Baggett, TP et al. Mortality Among Homeless Adults in Boston: Shifts in Causes of Death Over a 15-Year Period. JAMA 2013 Feb; 173(3):189–95
High-risk individuals slept unsheltered ≥6 consecutive months and met ≥1 criteria: tri-morbidity; ≥1 hospital admission or BHCHP respite admission during previous year due to major medical issue(s); ≥3 ED visits during previous 3 months; ≥60 years old; HIV or AIDS; cirrhosis, end stage liver disease, or renal failure; and/or history of frostbite, hypothermia, or immersion foot
No unknown Causes of Death
Causes of death <5 were suppressed; these were: diseases of digestive system, Influenza and Pneumonia, Chronic Lower Respiratory Disease, Infection (Sepsis, Viral Hepatitis), Anoxic Brain Injury, Cerebrovascular Disease, Renal Failure, Central Nervous System Disease, Mental Disorder, Ill-Defined Conditions, Suicide, Homicide
SMR is Standardized Mortality Ratio and were calculated for deaths ≥5
CI is Confidence Interval
MA is Massachusetts
Injuries, non-poisoning category contains Transportation Accidents codes V01-V99, Other External Causes of Accidental Injuries codes W00-X59 except for X40-X49 which represent accidental poisonings by noxious substances, and Events of Undetermined Intent codes Y20-Y34 except for codes Y10-Y19 which represent poisonings of undetermined intent. Methodology in collapsing ICD-10 categories based on similar methodology in Health of Boston 2014–2015 Report from the Boston Public Health Commission: http://www.bphc.org/healthdata/health-of-boston-report/Documents/HOB-2014–2015/FullReport_HOB_2014–2015.pdf
SMR not significant at p-value <.05 level; all SMRs without symbol were significant at p-value <.05