In a study from UC San Francisco, scientists found a quarter of the participants in a long-term study of older people experiencing homelessness in Oakland died within a few years of being enrolled.
They tested people who were 50 and older and homeless and followed them for a median of 4.5 years.
By interviewing people every six months about their health and housing status, the team examined how things like regaining housing, using drugs, and having various chronic conditions, such as diabetes, affected their risk of dying.
They found that people who first became homeless at age 50 or later were about 60% more likely to die than those who had become homeless earlier in life.
But homelessness was a risk for everyone, and those who remained homeless were about 80% more likely to die than those who were able to return to housing.
The median age of death was 64.6 years old, and the most common causes of death for people in the study were heart disease (14.5%), cancer (14.5%), and drug overdose (12%).
The study is unique in its prospective design. Previous studies of mortality in homeless populations were retrospective and drew information from medical records.
By contrast, the current study followed a group of people, and whether or not they received health care. Many study participants had serious conditions that went untreated.
The researchers found that as of Dec. 31, 2021, 117 of the 450 people had died since the study began enrolling in 2013. Nearly 40% (45) occurred after the pandemic started in March of 2020, but just three of those deaths were from COVID-19.
Mortality rates were high compared to the general Oakland population. The risk of dying was three times higher for men and five times higher for women, compared to people of the same age and sex in Oakland.
The median age for participants entering the study was 58, and 80% were black; 76% were male, and 24% were female.
The study also contained detailed information about people’s use of drugs and alcohol, as well as their mental health. But drug and alcohol use itself was not independently associated with death.
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The study was conducted by Margot Kushel et al and published in JAMA Internal Medicine.
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