{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T04:01:38Z","timestamp":1793332898247,"version":"4.5.0"},"reference-count":21,"publisher":"F1000 Research Ltd","license":[{"start":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T00:00:00Z","timestamp":1552262400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/S003797\/1"],"award-info":[{"award-number":["MR\/S003797\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["13\/156\/10"],"award-info":[{"award-number":["13\/156\/10"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["DRF-2018-11-ST2-016"],"award-info":[{"award-number":["DRF-2018-11-ST2-016"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["ICA-CDRF-2016-02-042"],"award-info":[{"award-number":["ICA-CDRF-2016-02-042"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["206602"],"award-info":[{"award-number":["206602"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Health Data Research UK"}],"content-domain":{"domain":["wellcomeopenresearch.org"],"crossmark-restriction":false},"short-container-title":["Wellcome Open Res"],"abstract":"<ns4:p>\n                    <ns4:bold>Background<\/ns4:bold>\n                    : Homelessness has increased by 165% since 2010 in England, with evidence from many settings that those affected experience high levels of mortality. In this paper we examine the contribution of different causes of death to overall mortality in homeless people recently admitted to hospitals in England with specialist integrated homeless health and care (SIHHC) schemes.\u00a0\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Methods<\/ns4:bold>\n                    : We undertook an analysis of linked hospital admission records and mortality data for people attending any one of 17 SIHHC schemes between 1st November 2013 and 30th November 2016. Our primary outcome was death, which we analysed in subgroups of 10th version international classification of disease (ICD-10) specific deaths; and deaths from amenable causes. We compared our results to a sample of people living in areas of high social deprivation (IMD5 group).\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Results<\/ns4:bold>\n                    : We collected data on 3,882 individual homeless hospital admissions that were linked to 600 deaths. The median age of death was 51.6 years (interquartile range 42.7-60.2) for SIHHC and 71.5 for the IMD5 (60.67-79.0).\u00a0 The top three underlying causes of death by ICD-10 chapter in the SIHHC group were external causes of death (21.7%; 130\/600), cancer (19.0%; 114\/600) and digestive disease (19.0%; 114\/600).\u00a0 The percentage of deaths due to an amenable cause after age and sex weighting was 30.2% in the homeless SIHHC group (181\/600) compared to 23.0% in the IMD5 group (578\/2,512).\n                  <\/ns4:p>\n                  <ns4:p>\n                    <ns4:bold>Conclusion<\/ns4:bold>\n                    : Nearly one in three homeless deaths were due to causes amenable to timely and effective health care. The high burden of amenable deaths highlights the extreme health harms of homelessness and the need for greater emphasis on prevention of homelessness and early healthcare interventions.\n                  <\/ns4:p>","DOI":"10.12688\/wellcomeopenres.15151.1","type":"journal-article","created":{"date-parts":[[2019,3,11]],"date-time":"2019-03-11T05:50:09Z","timestamp":1552283409000},"page":"49","update-policy":"https:\/\/doi.org\/10.12688\/wellcomeopenres.crossmark-policy","source":"Crossref","is-referenced-by-count":149,"title":["Causes of death among homeless people: a population-based cross-sectional study of linked hospitalisation and mortality data in England."],"prefix":"10.12688","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0542-0816","authenticated-orcid":false,"given":"Robert W","family":"Aldridge","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1628-1228","authenticated-orcid":false,"given":"Dee","family":"Menezes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3698-7196","authenticated-orcid":false,"given":"Dan","family":"Lewer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Cornes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Evans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth M","family":"Blackburn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Byng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9612-7791","authenticated-orcid":false,"given":"Spiros","family":"Denaxas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Fuller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nigel","family":"Hewett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alan","family":"Kilmister","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6260-4606","authenticated-orcid":false,"given":"Serena","family":"Luchenski","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Manthorpe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0121-9683","authenticated-orcid":false,"given":"Martin","family":"McKee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1502-5983","authenticated-orcid":false,"given":"Joanne","family":"Neale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alistair","family":"Story","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Tinelli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Whiteford","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Wurie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hayward","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2560","published-online":{"date-parts":[[2019,3,11]]},"reference":[{"key":"ref-1","article-title":"Rough sleeping in England: autumn 2018","year":"2019"},{"key":"ref-2","doi-asserted-by":"crossref","first-page":"407-410","DOI":"10.1007\/BF03405026","article-title":"Is homelessness hazardous to your health? 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Avoidable mortality revisited","author":"E Nolte","year":"2004"},{"key":"ref-15","first-page":"295-303","article-title":"The specificity of association in epidemiological study: an age-standardised proportional mortality ratio.","volume":"8","author":"R West","year":"1986","journal-title":"Community Med."},{"key":"ref-16","article-title":"Healthcare for Single Homeless People","year":"2010"},{"key":"ref-17","doi-asserted-by":"publisher","first-page":"266-280","DOI":"10.1016\/S0140-6736(17)31959-1","article-title":"What works in inclusion health: overview of effective interventions for marginalised and excluded populations.","volume":"391","author":"S Luchenski","year":"Elsevier; 2018","journal-title":"Lancet."},{"key":"ref-18","article-title":"Staircases, elevators and cycles of change: \u201cHousing First\u201d and other housing models for homeless people with complex support needs","author":"S Johnsen","year":"2010"},{"key":"ref-19","article-title":"WHO | Essential medicines","year":"2018"},{"key":"ref-20","doi-asserted-by":"publisher","first-page":"1-8","DOI":"10.1016\/j.puhe.2017.03.002","article-title":"'When you are homeless, you are not thinking about your medication, but your food, shelter or heat for the night': behavioural determinants of homeless patients' adherence to prescribed medicines.","volume":"148","author":"V Paudyal","year":"2017","journal-title":"Public Health."},{"key":"ref-21","doi-asserted-by":"publisher","first-page":"215-227","DOI":"10.1007\/s11096-019-00789-4","article-title":"Perceived roles and barriers in caring for the people who are homeless: a survey of UK community pharmacists.","volume":"41","author":"V Paudyal","year":"2019","journal-title":"Int J Clin Pharm."}],"container-title":["Wellcome Open Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-49\/v1\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-49\/v1\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-49\/v1\/iparadigms","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,11,20]],"date-time":"2019-11-20T23:07:07Z","timestamp":1574291227000},"score":1,"resource":{"primary":{"URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-49\/v1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,11]]},"references-count":21,"URL":"https:\/\/doi.org\/10.12688\/wellcomeopenres.15151.1","relation":{"has-review":[{"id-type":"doi","id":"10.21956\/wellcomeopenres.16531.r35038","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.16531.r35037","asserted-by":"subject"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.16531.r35037","asserted-by":"object"},{"id-type":"doi","id":"10.21956\/wellcomeopenres.16531.r35038","asserted-by":"object"}]},"ISSN":["2398-502X"],"issn-type":[{"value":"2398-502X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3,11]]},"assertion":[{"value":"Indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-49\/v1#article-reports","order":0,"name":"referee-status","label":"Referee status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.21956\/wellcomeopenres.16531.r35037, Danny Dorling, School of Geography and the Environment, University of Oxford, Oxford, UK, 14 Mar 2019, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-49\/v1#referee-response-35037","order":0,"name":"referee-response-35037","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.21956\/wellcomeopenres.16531.r35038, Glen Bramley, I-SPHERE, Heriot-Watt University, Edinburgh, UK, 04 Apr 2019, version 1, indexed","URL":"https:\/\/wellcomeopenresearch.org\/articles\/4-49\/v1#referee-response-35038","order":1,"name":"referee-response-35038","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This work was supported by the Wellcome Trust through a Clinical Research Career Development Fellowship to RWA [206602]. This study was supported by the National Institute for Health Research (NIHR), [Project number: 13\/156\/10 to HS & DR]. We also acknowledge the support from the Health Data Research (HDR) UK which receives its funding from HDR UK Ltd funded by the UK Medical Research Council, Engineering and Physical Sciences Research Council, Economic and Social Research Council, Department of Health and Social Care (England), Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Health and Social Care Research and Development Division (Welsh Government), Public Health Agency (Northern Ireland), British Heart Foundation (BHF) and the Wellcome Trust. ACH\u2019s salary is provided by Central and North West London NHS Community Trust. AS is funded by UCLH Foundation Trust. DL is funded by the NIHR [DRF-2018-11-ST2-016]. JN is part-funded by the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London. RBl is supported by a UK Research and Innovation Fellowship funded by a grant from the Medical Research Council [MR\/S003797\/1]. MW is part funded by Liverpool Clinical Commissioning Group. SL is funded by NIHR [ICA-CDRF-2016-02-042]. This article is based on independent research commissioned and funded by the NIHR Health Service and Delivery Programme. The views expressed in the publication are those of the author(s) and not necessarily those of the NHS, the NIHR, the Wellcome Trust, the Department of Health and Social Care, Public Health England or its arm\u2019s length bodies or other government departments. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}