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Home » Mortality among people who have experienced homelessness: A systematic review and meta-analysis

Mortality among people who have experienced homelessness: A systematic review and meta-analysis

Principal Investigator

Prof James White

Co-Investigators

Ms Yvonne Moriarty, Dr Rebecca Cannings-John, Prof Alison L Weightman, Dr Meg Kiseleva, Prof G. David Batty


Background

People experiencing homelessness are at an increased risk of premature mortality compared to the general population. The majority of studies have been conducted in high-income countries with rough sleepers and those attending homeless shelters, with some studies indicating mortality rates may be as high as 10 times those apparent in the general population.

A systematic review by Aldridge et al examined the association between homelessness and mortality across three studies. In this review, homelessness was associated with elevated mortality in comparison to the general population, but homelessness is associated with other risk factors for mortality like mental illness, substance use, and unemployment. The extent to which elevated rates of mortality can be ascribed to homelessness, as opposed to these exposures, which may have preceded it, is not well understood.

The aims of this project are to first conduct a systematic review of all published findings (peer review and grey literature); second, address any evidence gaps revealed by this review using individual participant analyses of unpublished (raw) data in other studies; and third, aggregate the results using meta-analysis.


Aims and Objectives

This systematic review sets out to answer three questions:

1. What is the risk of death among people experiencing homelessness compared to the general population, and does this vary across different forms of homelessness?

2. Are there specific causes of death that are elevated among people experiencing homelessness compared to the general population, and does this vary across different forms of homelessness?

3. Are associations between homelessness and death materially changed when using a socioeconomically deprived versus a general population comparator group?


Start date

1st April 2023

End date

1st January 2025

Funders

Centre for Homelessness Impact

Amount

£51,427


Further information

NIHR: Mortality among people who have experienced homelessness: protocol for a systematic review and meta-analysis using published and unpublished data