Homeless people 16 times more likely to die early, study finds

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A recent study conducted by UC San Francisco has uncovered a deeply concerning issue: homeless individuals face a significantly higher risk of sudden death, including heart attacks and other unforeseen causes.

This research, which focused on San Francisco County, an area with a high number of homeless residents, indicates that the rate of sudden cardiac death among the homeless is seven times higher than that of the general population.

These tragic deaths may have been preventable with the implementation of measures such as defibrillators and other public policies to enhance the health of this vulnerable group.

The Study and Its Goals

The study, published in JAMA Internal Medicine, aimed to understand the rate and causes of sudden death among homeless individuals in San Francisco County.

Researchers analyzed autopsy data from 868 individuals who experienced sudden deaths, of which 151 were homeless.

Key Findings

The study brought to light several critical findings:

High Rate of Sudden Death: Homeless individuals face a significantly higher rate of sudden death, with an average age of 50 years at the time of death. This rate is 16 times higher than that of the general population.

Variety of Causes: Sudden deaths among the homeless population were attributed to both cardiac and non-cardiac causes.

These non-cardiac causes included drug overdoses, gastrointestinal disorders, and infections, which were more common among homeless individuals.

Risk Factors: Homeless individuals who experienced sudden death were typically younger (56 years old compared to 61) and more likely to be male.

They had a higher prevalence of alcohol and substance use and a higher likelihood of psychiatric conditions, particularly schizophrenia and bipolar disorder.

Comparison to Housed Individuals: The study found that housed individuals were more likely to experience sudden death from arrhythmic causes, and they more closely resembled the classic profile of sudden death that modern medical systems aim to prevent and resuscitate.

Paramedic Response: Paramedic response times were similar for both the homeless and housed populations, highlighting the need for interventions beyond emergency medical care.

Implications and Recommendations

The study’s authors underscore the urgent need for public health interventions to address the alarming rates of sudden death among the homeless population. These interventions could include:

  • Increasing the availability of automatic external defibrillators in areas with high homeless populations.
  • Enhancing efforts to treat substance use disorders among homeless individuals.
  • Implementing targeted immunization programs to reduce the risk of infectious diseases among this vulnerable group.

The study emphasizes the significant impact of homelessness on the risk of sudden death and its underlying causes.

Addressing the complex health needs of homeless individuals is essential to improving their overall well-being and reducing preventable deaths in this population.


This study sheds light on the distressing reality of sudden deaths among homeless individuals in San Francisco County.

The findings highlight the urgent need for comprehensive public health strategies and interventions to address the specific health challenges faced by this vulnerable population.

By implementing measures to prevent sudden deaths and improve overall health, we can work towards a more equitable and compassionate society for all.

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The research findings can be found in JAMA Internal Medicine.

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