Homeless people living on the street in Boston had a death toll three times higher than those living in shelters and nearly ten times more than the general population of Massachusetts, a new study found
The study, published Monday online in The JAMA Internal Medicine journal reviewed 445 unprotected homeless adults "sleeping" in 2000 and following what happened to them over 1
"Mortality rates for non-disabled homeless adults in this study were higher than those for the adult population of Massachusetts and a sheltered adult homeless cohort with equivalent services." This study suggests that this different subpopulation of homeless people deserves special attention to their to meet unique clinical and psychosocial needs, "said the study, whose lead author Jill S. Roncarati, a researcher at Harvard TH (19659004) The results show "how much more vulnerable this group is," Roncarati said in an email.
Researchers said they found that the leading causes of death were noncommunicable diseases (such as cancer and heart disease), alcohol abuse disorder and chronic liver disease.
Earlier studies have shown that there are higher mortality rates among the homeless, but these considered rates for the subgroup of on-the-street survivors, a "population wandering through our urban landscapes," which made data hard to collect  An estimate of one night in January 2017 found that nearly 193,000 were sleeping outside in the United States, the study said.
The study said "a patient-centered, outreach service model will be delivered with integrated medical and behavior directly to the unprotected population".
Researchers' recommendations also included "greater availability and access to treatment for substance abuse, including smoking cessation, and a continuum of housing models with flexible social services to meet individual needs for successful tenancies."
In a related commentary in the journal said Mitchell Katz, President and Chief Executive of New York City Health and Hospitals: There will always be those who, through their personal choices, decompensated mental health or substance use disorders, develop behaviors that expose them to premature death. "
" Roncarati and others remind us of the heterogeneity of the homeless population and document the deadly effects of rough sleeping. Their work shows that while access to housing remains the linchpin for tackling homelessness, urgent, diverse and innovative solutions are urgently needed, "he wrote.