947de93782dd3cc3ba090c92826383d6 pmc_33670288.pdf 9d61ec27b9b475fae628514b4040991f951b94ff pmc_33670288.pdf 8ed686620e7f902a67e15a110c14c5038ac1d94658d1a502a6a9dac44013ad9e pmc_33670288.pdf Title: Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study Subject: (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. Keywords: homelessness; mortality; infectious disease; immigration; mental health; drug use disorder; alcohol use disorder; type 2 diabetes Author: 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-Olmo and Xavier Carbonell Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Feb 23 03:42:19 2021 CET ModDate: Tue Feb 23 03:51:38 2021 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 10 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 585467 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UCXPKO+VnURWPalladioL Type 1 Custom yes yes no 10 0 AYFBOT+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 RYWBUU+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 XASQXJ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 MJPLRG+VnURWPalladioL-Bold Type 1 Custom yes yes no 28 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 36 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 39 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 61 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 65 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 69 0 URYLRZ+URWPalladioL-BoldItal Type 1 Custom yes yes no 87 0 WVWPDJ+PazoMath-Italic Type 1 Builtin yes yes no 91 0 RLWFJE+VnURWPalladioL-Italic Type 1 Custom yes yes no 118 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:28:42 CEST RepresentationInformation: pmc_33670288.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:09:04 CEST Size: 585467 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 251 FreeObjects: 3 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design Destination: subsection.2.1 Item: Title: Population and Sample Destination: subsection.2.2 Item: Title: Procedure Destination: subsection.2.3 Item: Title: Sample Information Destination: subsection.2.4 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Children: Item: Title: Main Mortality Figures Destination: subsection.4.1 Item: Title: The Effect of Origin Destination: subsection.4.2 Item: Title: References Destination: subsection.4.2 Info: Title: Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study Author: 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-Olmo and Xavier Carbonell Subject: (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. 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