Mortality and causes of death among homeless women and men in Stockholm

Beijer, Ulla; Andréasson, Sven; Ågren, Gunnar; Fugelstad, Anna

doi:10.1177/1403494810393554

Cited by 84 publications

(76 citation statements)

References 15 publications

(22 reference statements)

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“…These findings support a growing body of literature suggesting that problematic substance use is one of the most persistent barriers to exiting homelessness, and a contributor to social exclusion (Johnson & Chamberlain, 2008;Kertesz et al, 2009;Kuhn & Culhane, 1998). Moreover, substance misuse has been strongly linked to premature mortality among the homeless, including homeless persons with mental disorders (Beijer, Andre´asson, Agren, & Fugelstad, 2011) and homeless youth (Dibben, Atherton, Doherty, & Baldacchino, 2011). The very worrisome implication of these findings is that substance misuse places homeless individuals at risk of exclusion from services and significantly reduces life expectancy.…”

Section: Discussionsupporting

confidence: 56%

Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia

Patterson

Somers

Moniruzzaman

2012

Mental Health and Substance Use

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Recent research and policy making concerning homelessness has focused on the particular challenges associated with ending chronic homelessness. It is generally assumed that individuals who have been homeless for longer durations have a greater impact on the public system of care and are in need of the most assistance. The aim of this study was to examine key sample characteristics by duration of homelessness (total lifetime duration and longest single episode) using bivariate and multivariable regression analysis. Participants (n ¼ 425) were adults recruited in Vancouver, BC on the basis of absolute homelessness or precarious housing and a current mental disorder. Interviewer-administered questionnaires elicited details concerning demographics, mental illness, substance use, service use, and duration of homelessness. In multivariable models, ''persistent'' homelessness (lifetime duration of three or more years) was independently predicted by male gender, older age, younger age when first homeless, incomplete high school, past month alcohol use, and daily illicit drug use. ''Prolonged'' homelessness, a single episode of one year or more, was independently predicted by older age, younger age when first homeless, current substance dependence, daily illicit drug use, and not seeing a psychiatrist in the past month. Substance use is strongly associated with prolonged and persistent homelessness among people with mental disorders, as is the early experience of first becoming homeless. Our findings replicate and extend those of previous studies, and are discussed in terms of their implications for service delivery and the broader construct of social inclusion.

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Section: Discussionsupporting

confidence: 56%

Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia

Patterson

Somers

Moniruzzaman

2012

Mental Health and Substance Use

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“…Studies have documented that between 29 and 75 % of homeless populations use alcohol and/or illicit drugs. 1,2 Homeless individuals who use substances are more likely to drop out of treatment programs, 3 have higher rates of post-treatment relapse, 4 premature mortality, 5 chronic physical illness, and longer durations of homelessness. 6 Recently, Housing First has been shown to be effective among homeless individuals with active substance use disorders.…”

Section: Introductionmentioning

confidence: 99%

Daily Substance Use and Mental Health Symptoms among a Cohort of Homeless Adults in Vancouver, British Columbia

et al. 2012

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Substance use can be a barrier to stable housing for homeless persons with mental disorders. We examined DSM-IV symptoms among homeless adults (N0497), comparing those who reported daily substance use (DSU) with non-daily substance users. Multivariable linear regression modeling was used to test the independent association between DSU and symptoms using the Colorado Symptom Index total score. DSU was independently associated with higher symptoms (beta03.67, 95 % CI 1.55-5.77) adjusting for homelessness history, age, gender, ethnicity, education, marital status, and mental disorder sub-type (adjusted R 2 00.24). We observed a higher prevalence of DSU in our sample than has been previously reported in a Housing First intervention. DSU was also independently associated with more DSM-IV symptomatology. We have an opportunity to observe this cohort longitudinally and examine if there are changes in substance use based on treatment assignment and commensurate changes in housing stability, community integration, health status, and quality of life.

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“…Se ha documentado que las principales causas de mortalidad en esta población están vinculadas con el uso de sustancias y los trastornos mentales, como los daños no-intencionados (caídas, quemaduras, accidentes de tránsito), las conductas autolesivas, los intentos de suicidio, el envenenamiento (por consumo de medicamentos o sustancias ilícitas) y los traumas cráneo-encefálicos (Beijer, Andreasson, Ågren, & Fugelstad, 2011;Fazel et al, 2008;Nielsen et al, 2011;Pascual et al, 2008;Topolovec-Vranic et al, 2012;Unger et al, 1997).…”

Section: Epidemiologíaunclassified

Patología dual en poblaciones especiales: una revisión narrativa

Szerman¹,

Marín-Navarrete²,

Fernández-Mondragón³

et al. 2015

RIIAD

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RESUMENIntroducción: la patología dual se refiere a la concurrencia de un trastorno por consumo de sustancias con otro trastorno psiquiátrico. Estudios epidemiológicos en población general reportan una alta prevalencia de patología dual. Sin embargo, la información disponible sobre el tema en poblaciones especiales es limitada. Objetivo: revisar la evidencia disponible sobre la epidemiología, la atención y los aspectos relevantes para la salud pública acerca de la patología dual en las siguientes poblaciones especiales: personas en situación de indigencia, en prisión, con VIH, VHB y VHC, mujeres y adultos mayores. Método: búsqueda en bases de datos bibliográficos (PubMed, Science Direct, EBSCO y OVID) de reportes de investigación enfocados en la prevalencia y el tratamiento de patología dual en las poblaciones mencionadas. Resultados: la prevalencia de la patología dual se presenta de manera diferenciada en estas poblaciones, en comparación con la población general; además está altamente asociada con mayores tasas de morbilidad y mortalidad. La mayoría de los estudios específicos sobre patología dual y las poblaciones especiales, tanto de epidemiología como de tratamientos, se ha realizado en países de alto ingreso. Discusión y conclusiones: se requiere de políticas públicas que contemplen la medición epidemiológica de la patología dual en estas poblaciones, sobre todo en países de mediano y bajo ingreso, e incluyan intervenciones integradas adecuadas a las necesidades específicas de cada población.Palabras clave: patología dual; grupos minoritarios; epidemiología; revisión. ABSTRACTBackground: dual disorders is a term that refers to the co-occurrence of a substance use disorder with other mental disorders. Epidemiological studies have reported a high prevalence of dual disorders in the general population. However, information on dual disorders in special population is limited. Objective: to give an overview of the available evidence on the epidemiology, care and other relevant aspects for public health of dual disorders in the following special populations: homeless, prison inmates, people with sexually-transmitted infections, and the elderly. Method: search in peer-review publication databases (PubMed, Science Direct, EBSCO and OVID) for research reports on the epidemiology and treatment of dual pathology in the aforementioned populations. Results: prevalence of dual disorders in these populations appears to be different than in the general population; and it is highly associated with higher mortality and morbidity rates. The majority of studies aimed specifically on the epidemiology and treatment of dual disorders and special populations has been conducted in high-income countries. Discussion and conclusions: there is a need for public policies that consider the epidemiological assessment of dual disorders in special populations, specially in low-and middle-income countries, and include integrated care interventions adequate to the specific needs of each population.

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Mortality and causes of death among homeless women and men in Stockholm

Abstract: The most important finding is that excess mortality among homeless men and women in Stockholm is entirely related to alcohol and drug abuse.

Cited by 84 publications

References 15 publications

Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia

Prolonged and persistent homelessness: multivariable analyses in a cohort experiencing current homelessness and mental illness in Vancouver, British Columbia

Daily Substance Use and Mental Health Symptoms among a Cohort of Homeless Adults in Vancouver, British Columbia

Patología dual en poblaciones especiales: una revisión narrativa

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