Early Mortality and Medical Complexity Among Medicolegal Cardiovascular Disease Deaths: Comparing housed and unhoused decedents

Document Type

Article

Publication Date

2-13-2025

Publication Title

The Gerontologist

Abstract

BACKGROUND: There are extreme psychosocial, environmental, and behavioral risks to the health and well-being of persons experiencing homelessness . Within this complex and hazardous environment, there is an opportunity to gain clearer perspective into the role of accelerating cardiovascular disease (CVD) progression alongside the aging cohort effect in this population. METHOD: Utilizing 2021 and 2022 data from the Harris County Medical Examiner, investigators analyzed cardiovascular disease-associated deaths for excess mortality and impact of age-related factors specific to persons experiencing homelessness. All medicolegal deaths involving CVD were examined to determine relative frequencies of secondary causes of death and the influence of age between housed individuals and individuals experiencing homelessness.Results: The examination of the CVD mortality cases among persons experiencing homelessness in 2021 (n=52) and 2022 (n=71) revealed important trends. The mean age for CVD deaths for persons experiencing homelessness was 58.6 and 60.6 years in 2021 and 2022 respectively. Despite this slight, recent increase, the average age for CVD death among persons experiencing homelessness is dramatically lower than the housed, medicolegal CVD deaths and the general population. Top-associated conditions were hypertension and atherosclerosis, regardless of housing status. However, Chronic Obstructive Pulmonary Disease (COPD) and Congestive Heart Failure (CHF) were more common in CVD deaths of people experiencing homelessness. DISCUSSION: These findings re-emphasize the uniqueness and complexity of the risks for premature mortality in people experiencing homelessness. This underscores the call for social services and healthcare systems to be more responsive to the challenges faced by persons experiencing homelessness, with more integrated and targeted health and aging care interventions to address the specific needs of these marginalized individuals.

PubMed ID

39945197

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