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- Original article Homelessness and mortality: gender, age, and housing status inequity in South Korea
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Gum-Ryeong Park1
, Dawoon Jeong2
, Seung-Won Lee3
, Hojoon Sohn4
, Young Ae Kang3
, Hongjo Choi5
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Epidemiol Health 2024;e2024076
DOI: https://doi.org/10.4178/epih.e2024076 [Accepted]
Published online: September 12, 2024
2Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea, Seoul, Korea
3Institute for Immunology and Immunological Disease, Yonsei University College of Medicine, Seoul, Korea, Seoul, Korea
4Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea, Seoul, Korea
5School of Health Policy and Management, Korea University , Korea, Korea
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Corresponding author:
Young Ae Kang,
Email: hongjochoi@gmail.com
Hongjo Choi,
Email: hongjochoi@gmail.com
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Abstract
OBJECTIVES
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis (TB) Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS
The mortality rate among the homeless population was twice as high as that of the general population, at 1159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.702 (95% CI, 1.369-2.115). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.
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