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Epidemiology
Research
Five-year standardised mortality ratios in a cohort of homeless people in Dublin
  1. Jo-Hanna Ivers1,
  2. Lina Zgaga1,
  3. Bernie O’Donoghue-Hynes2,
  4. Aisling Heary1,
  5. Brian Gallwey2,
  6. Joe Barry1
  1. 1 Department of Public Health and Primary Care, Institute of Population Health, School of Medicine, Trinity College Dublin, Dublin, Ireland
  2. 2 Research, Dublin Regional Homeless Executive, Dublin, Ireland
  1. Correspondence to Dr Jo-Hanna Ivers; jivers{at}tcd.ie

Abstract

Objective To calculate standardised mortality ratios (SMRs) for a cohort of homeless people in the Dublin region over a 5-year period and to examine leading causes of death.

Setting Homeless services reporting deaths from homeless persons in their care across the Dublin Homeless Region.

Methods Death data among people who experience homelessness was acquired from the Dublin Region Homeless Executive (2011–2015) and validated from both death certificates and records from the Dublin Coroner’s Office.

Participants Two hundred and nine deaths were recorded; of these 201 were verified (n=156 males, 77.6%). Deaths that could not be verified by certificate or coroners record were excluded from the study.

Results SMRs were 3–10 times higher in homeless men and 6–10 times higher in homeless women compared with the general population. Drug and alcohol-related deaths were the leading cause of death, accounting for 38.4% of deaths in homeless individuals. These were followed by circulatory (20%) and respiratory causes (13%).

Conclusion Mortality rates among homeless persons are exceptionally high. Services and programmes, particularly housing and those targeting overdose and alcoholism, are urgently needed to prevent premature mortality in this vulnerable population.

  • homeless
  • standardised mortality ratios

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-023010

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    Footnotes

    • Patient consent for publication Not required.

    • Contributors JI and JB developed and directed the study. JB and JI conceived and designed the survey questions. JI coordinated data collection and JI, BOH and AH carried out data cleaning and cross-validation. JHHI and LZ performed the statistical analyses. JI drafted the manuscript. JI, JB, LZ, BOH and AH contributed to the final draft of the paper.

    • Funding This work was supported by the Dublin Region Homeless Executive and the Health Service Executive [Grant No N/A].

    • Competing interests None declared.

    • Ethics approval The study received ethical approval by Ethics Committee at the Faculty of Health Sciences, Trinity College Dublin.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data available.

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