Takano T, Nakamura K, Takeuchi S, Watanabe M
Department of Public Health and Environmental Science, School of Medicine, Tokyo Medical and Dental University, Japan.
J Urban Health. 1999 Mar;76(1):73-84. doi: 10.1007/BF02344463.
In recent years, homelessness has been recognized as a growing urban social problem in various countries throughout the world. The health problems of the homeless are considerable. The purpose of this study was to elicit, with sociodemographic profiles, the disease patterns among Tokyo's homeless. The subjects were 1,938 men who stayed at a welfare institution from 1992 to 1996. Diagnosed diseases/injuries and sociodemographic profiles were analyzed. The disease patterns of the homeless were compared to those of the male general population. Of the subjects, 8.3% were admitted to the hospital; 64.0% received outpatient care. Their observed morbidity rates by disease category were greater than those of the male general population in both Japan and Tokyo. Comorbidity of alcoholic psychosis/alcohol-dependent syndrome to both liver disease and pulmonary tuberculosis were greater than the average (P < .01). Construction work brought a higher risk of pulmonary tuberculosis (odds ratio = 2.0) and dorsopathies (odds ratio = 1.4) than did other jobs (P < .05). Disease patterns among the homeless in Tokyo were characterized by alcoholic psychosis/alcohol-dependence syndrome; liver disease; pulmonary tuberculosis; diabetes mellitus; fractures, dislocations, sprains, strains; hypertension; and cerebrovascular disease. Although the sociodemographic backgrounds of Tokyo's homeless have become more diverse, the principal occupation of the homeless was unskilled daily construction work, which underlay the characteristics of their disease patterns.
近年来，无家可归现象在世界各国都被视为一个日益严重的城市社会问题。无家可归者的健康问题相当严重。本研究的目的是通过社会人口学特征，找出东京无家可归者的疾病模式。研究对象为1992年至1996年期间住在一家福利机构的1938名男性。对诊断出的疾病/损伤和社会人口学特征进行了分析。将无家可归者的疾病模式与男性普通人群的疾病模式进行了比较。在研究对象中，8.3%的人住院治疗；64.0%的人接受门诊治疗。他们按疾病类别观察到的发病率在日本和东京均高于男性普通人群。酒精性精神病/酒精依赖综合征与肝病和肺结核的合并症高于平均水平（P <.01）。与其他工作相比，建筑工作带来的肺结核（优势比 = 2.0）和背痛（优势比 = 1.4）风险更高（P <.05）。东京无家可归者的疾病模式特点为酒精性精神病/酒精依赖综合征、肝病、肺结核、糖尿病、骨折、脱位、扭伤、拉伤、高血压和脑血管疾病。尽管东京无家可归者的社会人口学背景日益多样化，但无家可归者的主要职业是无技能的日常建筑工作，这构成了他们疾病模式的特征基础。
