{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T00:37:45Z","timestamp":1777855065446,"version":"3.51.4"},"reference-count":45,"publisher":"SAGE Publications","issue":"23-24","license":[{"start":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T00:00:00Z","timestamp":1734480000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Interpers Violence"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>\n                    Homelessness continues to be a serious public health problem in the United States. People experiencing homelessness (PEH) face stark health inequities, including high mortality rates and increased risk of violence victimization. Little is known about the risk factors around PEH dying violently. The objective of this study is to comprehensively describe these fatalities to inform future research and prevention efforts for this population. This retrospective study utilized data from the National Violent Death Reporting System from 2010 to 2021 to characterize and compare fatalities among PEH versus people who were not experiencing homelessness (PNEH). This study identified 7,231 PEH and 423,363 PNEH victims. Among PEH, the most common manners of death were suicide (44.9%) and homicide (31.0%), most were male (83.0%), and White, non-Hispanic (59.3%). Compared to PNEH, a significantly greater proportion of PEH had an alcohol problem (26.9% vs. 15.2%;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u2009.001) or other substance use problem (48.8% vs. 19.6%;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u2009.001). Among decedents who had a current mental health problem (PEH: 33.6% vs. PNEH: 36.7%), a smaller percentage of PEH were currently receiving treatment (PEH: 13.9% vs. PNEH: 20.7%;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt;.001). Among those who died by suicide, more PEH had a recent eviction\/loss of home that contributed to the death, compared to PNEH (21.0% vs. 2.8%;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u2009.001). Among individuals who died by homicide, PEH were significantly more likely to be killed by a random act of violence (PEH: 5.1% vs. PNEH: 2.6%;\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u2009.001). These findings highlight unique characteristics of violent deaths among PEH, including circumstances involving mental health and substance use problems, and identify key intervention points for suicide prevention among this population. Future research to help prevent violence-related deaths among PEH would benefit by improved data collection methods to reduce missing data and linkages with other data sources.\n                  <\/jats:p>","DOI":"10.1177\/08862605241303955","type":"journal-article","created":{"date-parts":[[2024,12,18]],"date-time":"2024-12-18T05:59:06Z","timestamp":1734501546000},"page":"5453-5474","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterizing Violent Fatalities Among People Experiencing Homelessness Using the National Violent Death Reporting System, 2010 to 2021"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0522-4615","authenticated-orcid":false,"given":"Bridget","family":"Duffy","sequence":"first","affiliation":[{"name":"Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4439-1723","authenticated-orcid":false,"given":"Saroj","family":"Bista","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2618-6440","authenticated-orcid":false,"given":"Nichole L.","family":"Michaels","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Policy, The Abigail Wexner Research Institute at Nationwide Children\u2019s Hospital, Columbus, OH, USA"},{"name":"Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH, USA"},{"name":"Division of Health Behavior and Health Promotion, The Ohio State University College of Public Health, Columbus, OH, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2024,12,18]]},"reference":[{"key":"e_1_3_4_2_1","doi-asserted-by":"crossref","unstructured":"Aldridge R. W. Story A. Hwang S. W. Nordentoft M. Luchenski S. A. Hartwell G. Tweed E. J. Lewer D. Vittal Katikireddi S. Hayward A. C. (2018). Morbidity and mortality in homeless individuals prisoners sex workers and individuals with substance use disorders in high-income countries: A systematic review and meta-analysis. The Lancet (London England) 391(10117) 241\u2013250. https:\/\/doi.org\/10.1016\/S0140-6736(17)31869-X","DOI":"10.1016\/S0140-6736(17)31869-X"},{"key":"e_1_3_4_3_1","doi-asserted-by":"crossref","unstructured":"Allegrante J. P. Sleet D. A. (2021). Investing in public health infrastructure to address the complexities of homelessness. International Journal of Environmental Research and Public Health 18(16) 8887. https:\/\/doi.org\/10.3390\/ijerph18168887","DOI":"10.3390\/ijerph18168887"},{"key":"e_1_3_4_4_1","doi-asserted-by":"crossref","unstructured":"Ayano G. Shumet S. Tesfaw G. Tsegay L. (2020). A systematic review and meta-analysis of the prevalence of bipolar disorder among homeless people. BMC Public Health 20(1) 731. https:\/\/doi.org\/10.1186\/s12889-020-08819-x","DOI":"10.1186\/s12889-020-08819-x"},{"key":"e_1_3_4_5_1","doi-asserted-by":"crossref","unstructured":"Ayano G. Tesfaw G. Shumet S. (2019). The prevalence of schizophrenia and other psychotic disorders among homeless people: A systematic review and meta-analysis. BMC Psychiatry 19(1) 370. https:\/\/doi.org\/10.1186\/s12888-019-2361-7","DOI":"10.1186\/s12888-019-2361-7"},{"key":"e_1_3_4_6_1","doi-asserted-by":"crossref","unstructured":"Breiding M. J. Basile K. C. Klevens J. Smith S. G. (2017). Economic insecurity and intimate partner and sexual violence victimization. American Journal of Preventive Medicine 53(4) 457\u2013464. https:\/\/doi.org\/10.1016\/j.amepre.2017.03.021","DOI":"10.1016\/j.amepre.2017.03.021"},{"key":"e_1_3_4_7_1","doi-asserted-by":"crossref","unstructured":"Broll R. Huey L. (2020). \u201cEvery time I try to get out I get pushed back\u201d: The role of violent victimization in women\u2019s experience of multiple episodes of homelessness. Journal of Interpersonal Violence 35(17\u201318) 3379\u20133404. https:\/\/doi.org\/10.1177\/0886260517708405","DOI":"10.1177\/0886260517708405"},{"key":"e_1_3_4_8_1","doi-asserted-by":"crossref","unstructured":"Carver H. Ring N. Miler J. Parkes T. (2020). What constitutes effective problematic substance use treatment from the perspective of people who are homeless? A systematic review and meta-ethnography. Harm Reduction Journal 17(1) 10. https:\/\/doi.org\/10.1186\/s12954-020-0356-9","DOI":"10.1186\/s12954-020-0356-9"},{"key":"e_1_3_4_9_1","unstructured":"Centers for Disease Control and Prevention. (2021). NVDRS frequently asked questions. https:\/\/www.cdc.gov\/violenceprevention\/datasources\/nvdrs\/faqs.html"},{"key":"e_1_3_4_10_1","unstructured":"Centers for Disease Control and Prevention. (2022). National violent death reporting system web coding manual version 6. https:\/\/www.cdc.gov\/violenceprevention\/datasources\/nvdrs\/resources.html"},{"key":"e_1_3_4_11_1","unstructured":"Centers for Disease Control and Prevention. (2023). National violent death reporting system (NVDRS). https:\/\/www.cdc.gov\/violenceprevention\/datasources\/nvdrs"},{"key":"e_1_3_4_12_1","doi-asserted-by":"crossref","unstructured":"Chan C. S. Sarvet A. L. Basu A. Koenen K. Keyes K. M. (2021). Associations of intimate partner violence and financial adversity with familial homelessness in pregnant and postpartum women: A 7-year prospective study of the ALSPAC cohort. PLoS One 16(1) Article e0245507. https:\/\/doi.org\/10.1371\/journal.pone.0245507","DOI":"10.1371\/journal.pone.0245507"},{"key":"e_1_3_4_13_1","doi-asserted-by":"crossref","unstructured":"Chang J. S. Saxton K. Bright G. Jorden M. A. Gutierrez A. Xia K. (2023). Deaths of profound despair: A retrospective cohort study of mortality among people experiencing homelessness. PLoS One 18(2) Article e0281912. https:\/\/doi.org\/10.1371\/journal.pone.0281912","DOI":"10.1371\/journal.pone.0281912"},{"key":"e_1_3_4_14_1","doi-asserted-by":"crossref","unstructured":"Doran K. M. Rahai N. McCormack R. P. Milian J. Shelley D. Rotrosen J. Gelberg L. (2018). Substance use and homelessness among emergency department patients. Drug and Alcohol Dependence 188 328\u2013333. https:\/\/doi.org\/10.1016\/j.drugalcdep.2018.04.021","DOI":"10.1016\/j.drugalcdep.2018.04.021"},{"key":"e_1_3_4_15_1","doi-asserted-by":"crossref","unstructured":"Fazel S. Geddes J. R. Kushel M. (2014). The health of homeless people in high-income countries: Descriptive epidemiology health consequences and clinical and policy recommendations. The Lancet 384(9953) 1529\u20131540. https:\/\/doi.org\/10.1016\/S0140-6736(14)61132-6","DOI":"10.1016\/S0140-6736(14)61132-6"},{"key":"e_1_3_4_16_1","doi-asserted-by":"crossref","unstructured":"Funk A. M. Greene R. N. Dill K. Valvassori P. (2022). The impact of homelessness on mortality of individuals living in the united states: A systematic review of the literature. Journal of Health Care for the Poor and Underserved 33(1) 457\u2013477. https:\/\/doi.org\/10.1353\/hpu.2022.0035","DOI":"10.1353\/hpu.2022.0035"},{"key":"e_1_3_4_17_1","doi-asserted-by":"crossref","unstructured":"Gilmer C. Buccieri K. (2020). Homeless patients associate clinician bias with suboptimal care for mental illness addictions and chronic pain. Journal of Primary Care & Community Health 11 2150132720910289. https:\/\/doi.org\/10.1177\/2150132720910289","DOI":"10.1177\/2150132720910289"},{"key":"#cr-split#-e_1_3_4_18_1.1","doi-asserted-by":"crossref","unstructured":"Hargrave A. S. Knight K. R. Dhatt Z. K. Taylor G. Martinez D. Kushel M. (2024). The impact of intimate partner violence on homelessness and returns to housing: A qualitative analysis from the California statewide study of people experiencing homelessness. Journal of Interpersonal Violence 0","DOI":"10.1177\/08862605241259006"},{"key":"#cr-split#-e_1_3_4_18_1.2","doi-asserted-by":"crossref","unstructured":"(0) 08862605241259006. Online published on July 15 2024. https:\/\/doi.org\/10.1177\/08862605241259006","DOI":"10.1177\/08862605241259006"},{"key":"e_1_3_4_19_1","doi-asserted-by":"crossref","unstructured":"Henkind R. Carmichael H. Stearns D. R. Thomas M. Abbitt D. Myers Q. W. O. Velopulos C. G. (2023). Suicide among persons experiencing homelessness. Journal of Surgical Research 284 213\u2013220. https:\/\/doi.org\/10.1016\/j.jss.2022.10.060","DOI":"10.1016\/j.jss.2022.10.060"},{"key":"e_1_3_4_20_1","doi-asserted-by":"crossref","unstructured":"Henkind R. Carmichael H. Stearns D. R. Thomas M. Abbitt D. Myers Q. W. O. Zakrison T. Velopulos C. G. (2024). Left out in the cold: Homicide amongst persons experiencing homelessness. American Journal of Surgery 227 204\u2013207. https:\/\/doi.org\/10.1016\/j.amjsurg.2023.09.052","DOI":"10.1016\/j.amjsurg.2023.09.052"},{"key":"e_1_3_4_21_1","doi-asserted-by":"crossref","unstructured":"Henwood B. F. Byrne T. Scriber B. (2015). Examining mortality among formerly homeless adults enrolled in Housing First: An observational study. BMC Public Health 15 1209. https:\/\/doi.org\/10.1186\/s12889-015-2552-1","DOI":"10.1186\/s12889-015-2552-1"},{"key":"e_1_3_4_22_1","doi-asserted-by":"crossref","unstructured":"Hwang S. W. (2000). Mortality among men using homeless shelters in Toronto Ontario. JAMA 283(16) 2152\u20132157. https:\/\/doi.org\/10.1001\/jama.283.16.2152","DOI":"10.1001\/jama.283.16.2152"},{"issue":"2","key":"e_1_3_4_23_1","first-page":"229","article-title":"Homelessness and health","volume":"164","author":"Hwang S. W.","year":"2001","unstructured":"Hwang S. W. (2001). Homelessness and health. CMAJ, 164(2), 229\u2013233.","journal-title":"CMAJ"},{"key":"e_1_3_4_24_1","volume-title":"Homelessness: A prevention-oriented approach","author":"Jahiel R. I.","year":"1992","unstructured":"Jahiel R. I. (1992). Homelessness: A prevention-oriented approach. Johns Hopkins University Press."},{"key":"e_1_3_4_25_1","doi-asserted-by":"crossref","unstructured":"Kleinman R. A. Morris N. P. (2023). Suicide homicide and other violent deaths among people experiencing homelessness in the United States: A cross-sectional study. Public Health Reports 138(2) 309\u2013314. https:\/\/doi.org\/10.1177\/00333549221087228","DOI":"10.1177\/00333549221087228"},{"key":"e_1_3_4_26_1","unstructured":"Los Angeles County Department of Public Health. (2023). Mortality rates and causes of death among people experiencing homelessness in los angeles county: 2014\u20132021. http:\/\/www.publichealth.lacounty.gov\/chie\/reports\/Homeless_Mortality_Report_2023.pdf"},{"key":"e_1_3_4_27_1","doi-asserted-by":"crossref","unstructured":"McVicar D. Moschion J. van Ours J. C. (2015). From substance use to homelessness or vice versa? Social Science & Medicine 136\u2013137 89\u201398. https:\/\/doi.org\/10.1016\/j.socscimed.2015.05.005","DOI":"10.1016\/j.socscimed.2015.05.005"},{"key":"e_1_3_4_28_1","doi-asserted-by":"crossref","unstructured":"Meinbresse M. Brinkley-Rubinstein L. Grassette A. Benson J. Hamilton R. Malott M. Jenkins D. (2014). Exploring the experiences of violence among individuals who are homeless using a consumer-led approach. Violence and Victims 29(1) 122\u2013136. https:\/\/doi.org\/10.1891\/0886-6708.VV-D-12-00069","DOI":"10.1891\/0886-6708.VV-D-12-00069"},{"key":"e_1_3_4_29_1","doi-asserted-by":"crossref","unstructured":"Morrison D. S. (2009). Homelessness as an independent risk factor for mortality: Results from a retrospective cohort study. International Journal of Epidemiology 38(3) 877\u2013883. https:\/\/doi.org\/10.1093\/ije\/dyp160","DOI":"10.1093\/ije\/dyp160"},{"key":"e_1_3_4_30_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18136729"},{"key":"e_1_3_4_31_1","unstructured":"National Health Care for the Homeless Council. (2021). Homeless mortality data toolkit: Understanding and tracking deaths of people experiencing homelessness. https:\/\/nhchc.org\/wp-content\/uploads\/2020\/12\/Homeless-Mortality-Toolkit-FULL-FINAL.pdf"},{"key":"e_1_3_4_32_1","unstructured":"O\u2019Connell J. (2005). Premature mortality in homeless populations: A review of the literature. https:\/\/sbdww.org\/wp-content\/uploads\/2011\/04\/PrematureMortalityFinal.pdf"},{"key":"e_1_3_4_33_1","doi-asserted-by":"crossref","unstructured":"Oppenheimer S. C. Nurius P. S. Green S. (2016). Homelessness history impacts on health outcomes and economic and risk behavior intermediaries: New insights from population data. Families in Society: The Journal of Contemporary Social Services 97(3) 230\u2013242. https:\/\/doi.org\/10.1606\/1044-3894.2016.97.21","DOI":"10.1606\/1044-3894.2016.97.21"},{"key":"e_1_3_4_34_1","doi-asserted-by":"crossref","unstructured":"Padgett D. K. (2020). Homelessness housing instability and mental health: Making the connections. BJPsych Bulletin 44(5) 197\u2013201. https:\/\/doi.org\/10.1192\/bjb.2020.49","DOI":"10.1192\/bjb.2020.49"},{"key":"e_1_3_4_35_1","doi-asserted-by":"crossref","unstructured":"Piat M. Polvere L. Kirst M. Voronka J. Zabkiewicz D. Plante M.-C. Isaak C. Nolin D. Nelson G. Goering P. (2015). Pathways into homelessness: Understanding how both individual and structural factors contribute to and sustain homelessness in Canada. Urban Studies 52(13) 2366\u20132382. https:\/\/doi.org\/10.1177\/0042098014548138","DOI":"10.1177\/0042098014548138"},{"key":"e_1_3_4_36_1","doi-asserted-by":"crossref","unstructured":"Romaszko J. Cymes I. Draga\u0144ska E. Kuchta R. Gli\u0144ska-Lewczuk K. (2017). Mortality among the homeless: Causes and meteorological relationships. PLoS One 12(12) Article e0189938. https:\/\/doi.org\/10.1371\/journal.pone.0189938","DOI":"10.1371\/journal.pone.0189938"},{"key":"e_1_3_4_37_1","doi-asserted-by":"crossref","unstructured":"Roncarati J. S. Baggett T. P. O\u2019Connell J. J. Hwang S. W. Cook E. F. Krieger N. Sorensen G. (2018). Mortality among unsheltered homeless adults in Boston Massachusetts 2000\u20132009. JAMA Internal Medicine 178(9) 1242\u20131248. https:\/\/doi.org\/10.1001\/jamainternmed.2018.2924","DOI":"10.1001\/jamainternmed.2018.2924"},{"key":"e_1_3_4_38_1","unstructured":"Saldua M. (2023). Addressing social determinants of health among individuals experiencing homelessness. https:\/\/www.samhsa.gov\/blog\/addressing-social-determinants-health-among-individuals-experiencing-homelessness#:~:text=Homelessness%20is%20associated%20with%20a (PDF%20%7C%20192%20KB)%20"},{"key":"e_1_3_4_39_1","doi-asserted-by":"crossref","unstructured":"Schiffler T. Kapan A. Gansterer A. Pass T. Lehner L. Gil-Salmeron A. McDermott D.T. Grabovac I. (2023). Characteristics and effectiveness of co-designed mental health interventions in primary care for people experiencing homelessness: A systematic review. International Journal of Environmental Research and Public Health 20(1) 892. https:\/\/www.mdpi.com\/1660-4601\/20\/1\/892","DOI":"10.3390\/ijerph20010892"},{"key":"e_1_3_4_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781119104780"},{"key":"e_1_3_4_41_1","doi-asserted-by":"crossref","unstructured":"Stanley J. L. Jansson A. V. Akinyemi A. A. Mitchell C. S. (2016). Characteristics of violent deaths among homeless people in Maryland 2003\u20132011. American Journal of Preventive Medicine 51(5) S260\u2013S266. https:\/\/doi.org\/10.1016\/j.amepre.2016.08.005","DOI":"10.1016\/j.amepre.2016.08.005"},{"key":"e_1_3_4_42_1","doi-asserted-by":"crossref","unstructured":"Taylor S. N. Munson D. (2023). Health care of people experiencing homelessness: Part II. NEJM Evidence 2(9) EVIDra2300175. https:\/\/doi.org\/10.1056\/EVIDra2300175","DOI":"10.1056\/EVIDra2300175"},{"key":"e_1_3_4_43_1","doi-asserted-by":"crossref","unstructured":"Tong M. S. Kaplan L. M. Guzman D. Ponath C. Kushel M. B. (2021). Persistent homelessness and violent victimization among older adults in the HOPE HOME study. Journal of Interpersonal Violence 36(17\u201318) 8519\u20138537. https:\/\/doi.org\/10.1177\/0886260519850532","DOI":"10.1177\/0886260519850532"},{"key":"e_1_3_4_44_1","doi-asserted-by":"crossref","unstructured":"Topolovec-Vranic J. Ennis N. Colantonio A. Cusimano M. D. Hwang S. W. Kontos P. Ouchterlony D. Stergiopoulos V. (2012). Traumatic brain injury among people who are homeless: A systematic review. BMC Public Health 12 1059. https:\/\/doi.org\/10.1186\/1471-2458-12-1059","DOI":"10.1186\/1471-2458-12-1059"},{"key":"e_1_3_4_45_1","unstructured":"United States Department of Housing and Urban Development (HUD). (2023). The 2023 annual homeless assessment report (AHAR) to congress. https:\/\/www.huduser.gov\/portal\/sites\/default\/files\/pdf\/2023-AHAR-Part-1.pdf"}],"container-title":["Journal of Interpersonal Violence"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08862605241303955","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08862605241303955","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08862605241303955","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T23:18:54Z","timestamp":1777504734000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08862605241303955"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,18]]},"references-count":45,"journal-issue":{"issue":"23-24","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1177\/08862605241303955"],"URL":"https:\/\/doi.org\/10.1177\/08862605241303955","relation":{},"ISSN":["0886-2605","1552-6518"],"issn-type":[{"value":"0886-2605","type":"print"},{"value":"1552-6518","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,18]]}}}