安大略省多伦多市使用收容所的男性死亡率。

Mortality among men using homeless shelters in Toronto, Ontario.

作者信息

Hwang S W

机构信息

FK Morrow Inner City Health Research Unit, St Michael's Hospital, University of Toronto, Ontario, Canada.

出版信息

JAMA. 2000 Apr 26;283(16):2152-7. doi: 10.1001/jama.283.16.2152.

DOI:10.1001/jama.283.16.2152

PMID:10791509

Abstract

CONTEXT

Homeless persons in US cities have high mortality rates. However, few comparison data exist for death rates among homeless persons in other developed countries.

OBJECTIVES

To compare mortality rates among men using homeless shelters and the general population in Toronto, Ontario, and to determine whether mortality rates differ significantly among men using homeless shelters in Canadian and US cities.

DESIGN

Cohort study conducted from 1995 through 1997, with a mean follow-up of 2.6 years.

PARTICIPANTS

Men aged 18 years or older who used homeless shelters in Toronto in 1995 (n=8933).

MAIN OUTCOME MEASURE

Mortality rate ratios comparing age-specific mortality rates among men using homeless shelters in Toronto with those of men in the general population of Toronto and of men using homeless shelters in New York, NY; Boston, Mass; and Philadelphia, Pa.

RESULTS

Men using homeless shelters in Toronto were more likely to die than men in the city's general population. Mortality rate ratios were 8.3 (95% confidence interval [CI], 4.4-15.6) for men aged 18 to 24 years, 3.7 (95% CI, 3.0-4.6) for men aged 25 to 44 years, and 2.3 (95% CI, 1.8-3.0) for men aged 45 to 64 years. In most cases, however, the risk of death was significantly lower for men using homeless shelters in Toronto than for those in US cities. For men aged 25 to 44 years using homeless shelters, mortality rate ratios were 0.52 (95% CI, 0.41-0.65) for Toronto compared with Boston and 0.61 (95% CI, 0.44-0.85) for Toronto compared with New York City. For men aged 35 to 54 years using homeless shelters, the mortality rate ratio was 0.42 (95% CI, 0.27-0.66) for Toronto compared with Philadelphia.

CONCLUSIONS

Mortality rates among men who use homeless shelters in Toronto, while higher than in the general population of Toronto, are much lower than mortality rates observed among men using homeless shelters in 3 major US cities. Further study is needed to identify the reasons for this disparity.

摘要

背景

美国城市中的无家可归者死亡率很高。然而，关于其他发达国家无家可归者死亡率的比较数据很少。

目的

比较安大略省多伦多市使用收容所的男性与普通人群的死亡率，并确定加拿大和美国城市中使用收容所的男性死亡率是否存在显著差异。

设计

1995年至1997年进行的队列研究，平均随访2.6年。

参与者

1995年在多伦多使用收容所的18岁及以上男性（n = 8933）。

主要观察指标

比较多伦多使用收容所的男性与多伦多普通男性人群以及纽约市、马萨诸塞州波士顿市和宾夕法尼亚州费城使用收容所的男性按年龄划分的死亡率的死亡率比。

结果

多伦多使用收容所的男性比该市普通人群中的男性更容易死亡。18至24岁男性的死亡率比为8.3（95%置信区间[CI]，4.4 - 15.6），25至44岁男性为3.7（95%CI，3.0 - 4.6），45至64岁男性为2.3（95%CI，1.8 - 3.0）。然而，在大多数情况下，多伦多使用收容所的男性的死亡风险明显低于美国城市的男性。对于25至44岁使用收容所的男性，多伦多与波士顿相比的死亡率比为0.52（95%CI，0.41 - 0.65），多伦多与纽约市相比为0.61（95%CI，0.44 - 0.85）。对于35至54岁使用收容所的男性，多伦多与费城相比的死亡率比为0.42（95%CI，0.27 - 0.66）。