Medical Comorbidities

High exposure to tobacco, alcohol, illicit drugs, violence and victimization, and street and shelter living increase the vulnerability to diseases and conditions that increase the risk of early mortality (Fazel et al., 2014). Excessive mortality results from infectious diseases like tuberculosis (TBC), human immunodeficiency virus (HIV), and hepatitis C (HCV), injuries resulting in traumatic brain injury, suicides, homicides, and accidental overdoses. The age-adjusted death rate for homeless men and women is two to five times higher than the general population’s (Baggett et al., 2013; Barrow et al., 1999; Fazel et al., 2014; Hwang, 2000). Mortality among homeless women and men under age 45 is nine to ten times higher than the general population’s (Baggett et al., 2013; Cheung & Hwang, 2004). Drug overdoses and HIV/AIDS have been common causes of death in this age group, underscoring the need for treatment of substance use disorder and efforts to prevent and treat HIV/AIDS. The high rate of psychiatric disorders and the risk for suicide underscore the need for improved access to mental health care (Baggett et al., 2013; Cheung & Hwang, 2004).

 
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