title: The impact of shelter use and housing placement on mortality hazard for unaccompanied adults and adults in family households entering New York City shelters: 1990-2002.
abstract: This study examines mortality among New York City (NYC) homeless shelter users, assessing the relationships between mortality hazard and time in shelter, patterns of homelessness, and subsequent housing exits for both adults in families and single adults. Administrative records from the NYC shelter system were matched with death records from the Social Security Administration for 160,525 persons. Crude mortality rates and life tables were calculated, and survival analyses were undertaken using these data. Life expectancy was 64.2 and 68.6 years for single adult males and single adult females, respectively, and among adults in families, life expectancy was 67.2 and 70.1 years for males and females, respectively. For both groups, exits to stable housing (subsidized or non-subsidized) were associated with reduced mortality hazard. And while mortality hazard was substantially reduced for the time adults were in shelters, extended shelter use patterns were associated with increased mortality hazard. Differences between single homelessness and family homelessness extend to disparities in mortality rates. Although causal links cannot be established here, results suggest that, for both subgroups of the homeless population, prompt resolution of homelessness and availability of housing interventions may contribute to reduced mortality.
authors.affiliation: Department of Health Policy and Public Health, University of the Sciences in Philadelphia, Philadelphia, PA, USA. s.metraux@usp.edu
authors.forename: Stephen
authors.initials: S
authors.lastname: Metraux
authors.forename: Nicholas
authors.initials: N
authors.lastname: Eng
authors.forename: Jay
authors.initials: J
authors.lastname: Bainbridge
authors.forename: Dennis P
authors.initials: DP
authors.lastname: Culhane
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D002648:Child; D005190:Family; D005260:Female; D006703:Ill-Housed Persons / Q000706:statistics & numerical data*; D018453:Homeless Youth / Q000706:statistics & numerical data; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D009519:New York City; D016016:Proportional Hazards Models; D011638:Public Housing / Q000706:statistics & numerical data*; D044469:Racial Groups; D012737:Sex Factors; D013997:Time Factors