The health of individuals experiencing homelessness: a 15-year retrospective cohort study

ABSTRACT

People experiencing homelessness (IEHs) and housing exclusion have more chronic diagnoses and lower life expectancy than the general population. There are no studies of large samples of IEHs in Spain, especially studies that analyze health records and diagnoses. The objective of this study was to analyze the health of IEHs in Spain. We conducted an observational retrospective cohort study of the health of 3,854 IEHs, according to age and gender, using diagnoses registered in the health service, over the 15 years between 2006 and 2020. The results obtained indicated that 40% of the IEHs studied suffered from a physical disorder. Between 4.1% and 13.2% had some type of infection, and between 4.0% and 13.8% a chronic pathology. Of the total population, 13.2% died during the period of analysis. The main causes of death were suicide, cirrhosis of the liver, overdose, chronic obstructive pulmonary disease flare-up, cardiopathy, AIDS, cancer, and meningitis. Older people had more health problems. Women were in poorer health and had a higher mortality rate than men. These results, the first ones from a large sample of IEHs in Spain, highlight health problems of IEHs, especially women.

KEYWORDS:

• Homelessness
• homeless people
• health
• mortality
• gender

Acknowledgements

Data collection contributors: Mercè Salvans, Anna Julià, Carles Fàbregas, Sandra Castillejos, Anna Calvet, Cristina Giralt, Marissa Ramírez, Laura Masferrer. Dr. Susan Frekko provided feedback and English-language support for this article.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.

Notes on contributors

Fran Calvo

Dr. Fran Calvo, PhD, is lecturer and researcher in Pedagogy Studies Department of Universitat de Girona, Catalonia, Spain.

Rebeca Alfranca

Dr. Rebeca Alfranca, MD, is medical doctor in the Santa Clara primary care center of the Institut Català de la Salut in Girona, Catalonia, Spain.

Xavier Carbonell

Dr. Xavier Carbonell, PhD, is professor in Psychology Studies Department of the School of Psychology, Education and Sport Sciences of Universitat Ramon Llull, Barcelona, Catalonia, Spain.

Elda Molina

Mrs. Elda Molina, MS, is master student in the master of Drug-Dependences of the Universitat of Barcelona and collaborator of the Department of Quality Assessment and Projects Promotion, of Health and Community Foundation, Barcelona, Catalonia, Spain.

Sílvia Font-Mayolas

Dr. Sílvia Font-Mayolas is professor in Psychology Studies Department and the Quality of Life Research Institute Director of Universitat de Girona, Catalonia, Spain.