Citation

Song J, Grey CNB, Davies AR. J. Public Health (Oxford) 2022; 44(4): 805-809.

Copyright

(Copyright © 2022, Oxford University Press)

DOI

10.1093/pubmed/fdab180

PMID

34121112

PMCID

PMC9715293

Abstract

BACKGROUND: Homelessness is an extreme form of social exclusion, with homeless people experiencing considerable social and health inequities. Estimates of morbidity and mortality amongst homeless populations is limited due to the lack of recording of housing status across health datasets. The aim of this study is to: (i) identify a homelessness e-cohort by linking routine health data in Wales, and (ii) explore whether a period of reported past homelessness, places this population at greater risk of morbidity and mortality.
METHODS: Homelessness identified through linkage across primary, secondary care and substance misuse datasets in the Secure Anonymised Information Linkage (SAIL) Databank. Mortality was examined through linkage to the Office for National Statistics mortality data.
RESULTS: E-cohort of 15 472 individuals with lived experience of homelessness identified. Of those, 21 individuals died between February and July 2020 involving coronavirus disease of 2019 (COVID-19). Those with lived experience of homelessness had increased mortality from many causes including accidents, liver diseases and suicides.
CONCLUSION: Linking multiple routine datasets provides a more comprehensive dataset of a marginalized population, including individuals who are not included in government homeless statistics. Application of the cohort demonstrated that individuals with lived experience of homelessness have increased mortality involving COVID-19 and other causes. The underlying reasons, health needs and causes of death warrant further exploration.

Language: en

Keywords

Humans; COVID-19; Suicide; mortality; homelessness; Social Problems; housing; Wales; Ill-Housed Persons; record linkage