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Among women 18-44 years of age in Toronto, those who were homeless were ten times more likely to die, according to a study published in the Canadian Medical Association Journal. And many of the younger homeless women died of preventable causes. This study shows that homelessness is a potent risk factor among younger women. Study authors point out that the risks are largely ones that could be minimized by effective interventions for depression and drug use.
Authors Angela Cheung and Stephen Hwang note that in the general population, there is "a survival advantage" that females have over males, and that the young have, compared with those who are older. Females and the young have lower death rates than those in the general population. The results of the Canadian study show that homelessness eradicates both of these advantages. The authors conclude that "the adverse health effects of the social environment and health behaviours of younger homeless women must be particularly severe." In contrast, the death rate among older homeless women (45-64 years of age) in Toronto was only 20% higher than the rate among women of those ages in the general population.
The authors tracked "single women 18-64 years of age who had stayed at homeless shelters in Toronto in 1995." They estimate that only 7% of homeless women in Toronto did not use a shelter at any time during the year. The group that they tracked would therefore comprise about 93% of the total population of single homeless women. (They did not study homeless women with dependent children, nor those staying only at domestic violence shelters.) They then examined all death certificates issued from 1995-1997 in the province of Ontario to determine how many of the homeless single women had died, and to identify how they died. The authors also examined results of six other studies of mortality rates among homeless women and men. These studies had been conducted in Boston, Brighton (United Kingdom), Copenhagen, Montreal, New York, and Philadelphia.
There were 1,981 women who stayed at homeless shelters in Toronto at some time during 1995. The mean age was 35 years. Of those 18-44 years of age, 21 died by the end of 1997, an average of 2.6 years after they had been identified. Of the 21 deaths in the younger group, seven were from poisoning by opiates, tranquilizers, or unspecified drugs. (Of those seven, one was determined to be a suicide, three were accidental, and three were undetermined.) Three others died of physical diseases; three of HIV/AIDS; one from an infection; one from a motor vehicle accident, one from a firearm (whether by accident or intent was not determined), and five died of unknown causes. Among those 45-64 years of age, five died during this period: two by suicide; one by a heart attack, and two of unknown causes.
Among all women in Canada 18-44 years of age, the rate of death is about 51 per year, per 100,000. The rate among the single homeless women of these ages in this study was 515. Among all Canadian women of age 45-64, the rate of death is about 365 per year, per 100,000. The rate among those of these ages in the study was 438.
Younger homeless women are therefore much more at risk of death than older homeless women. The most frequent cause of death among the younger women - accidental or purposeful poisoning - was preventable.
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Reference
Cheung, A.M., & Hwang, S.W. (2004, April 13). Risk of death among homeless women: A cohort study and review of the literature. Canadian Medical Association Journal, 170 (8).
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