{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T20:56:01Z","timestamp":1780347361338,"version":"3.54.1"},"reference-count":40,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2021,2,11]],"date-time":"2021-02-11T00:00:00Z","timestamp":1613001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>(1) Background: Current evidence suggests that mortality is considerably higher in individuals experiencing homelessness. The aim of this study was to analyze the mortality rate and the mortality risk factors in a sample of individuals experiencing homelessness in the city of Girona over a ten-year period. (2) Methods: We retrospectively examined the outcomes of 475 people experiencing homelessness with the available clinical and social data. Our sample was comprised of 84.4% men and 51.8% foreign-born people. Cox\u2019s proportional hazard models were used to identify mortality risk factors between origin groups. (3) Results: 60 people died during the ten-year period. The average age of death was 49.1 years. After adjusting for demographic characteristics and the duration of homelessness, the risk factors for mortality were origin (people born in Spain) (HR = 4.34; 95% CI = 1.89\u201310.0), type 2 diabetes (HR = 2.9; 95% CI = 1.62\u20135.30), alcohol use disorder (HR = 1.9; 95% CI = 1.12\u20133.29), and infectious diseases (HR = 1.6; 95% CI = 1.09\u20132.39). Our results show a high prevalence of infectious and chronic diseases. Type 2 diabetes emerges as an important risk factor in homelessness. The average age of death of individuals experiencing homelessness was significantly lower than the average age of death in the general population (which is greater than 80 years). (4) Conclusions: Foreign-born homeless people were generally younger and healthier than Spanish-born homeless people. Chronic diseases were controlled better in Spanish-born people, but this group showed an increased risk of mortality.<\/jats:p>","DOI":"10.3390\/ijerph18041762","type":"journal-article","created":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T18:45:00Z","timestamp":1613155500000},"page":"1762","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Mortality Risk Factors for Individuals Experiencing Homelessness in Catalonia (Spain): A 10-Year Retrospective Cohort Study"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0300-8548","authenticated-orcid":false,"given":"Fran","family":"Calvo","sequence":"first","affiliation":[{"name":"Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain"},{"name":"Department of Quality Assessment, Evaluation and Research, Health and Community Foundation, 08010 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8082-5755","authenticated-orcid":false,"given":"Oriol","family":"Turr\u00f3-Garriga","sequence":"additional","affiliation":[{"name":"Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carles","family":"F\u00e0bregas","sequence":"additional","affiliation":[{"name":"Centre d\u2019Acolliment i Serveis Socials \u201cla Sopa\u201d, Ajuntament de Girona, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2036-9943","authenticated-orcid":false,"given":"Rebeca","family":"Alfranca","sequence":"additional","affiliation":[{"name":"Centro de Atenci\u00f3n Primaria Santa Clara, Institut Catal\u00e0 de la Salut, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Calvet","sequence":"additional","affiliation":[{"name":"Unitat d\u2019Aguts, Institut d\u2019Assist\u00e8ncia Sanit\u00e0ria, 17190 Salt, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merc\u00e8","family":"Salvans","sequence":"additional","affiliation":[{"name":"Centro de Atenci\u00f3n Primaria Santa Clara, Institut Catal\u00e0 de la Salut, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina","family":"Giralt","sequence":"additional","affiliation":[{"name":"Centro de Atenci\u00f3n Primaria Blanes, Institut Catal\u00e0 de la Salut, 17300 Blanes, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Castillejos","sequence":"additional","affiliation":[{"name":"Departament de Pedagogia, Institut de Recerca Sobre Qualitat de Vida, Universitat de Girona, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merc\u00e8","family":"Rived-Oca\u00f1a","sequence":"additional","affiliation":[{"name":"Escola Universit\u00e0ria d\u2019Infermeria i Ter\u00e0pia Ocupacional, EUIT, Universitat Aut\u00f2noma de Barcelona, UAB, 08221 Terrassa, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula","family":"Calvo","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paz","family":"Castillo","sequence":"additional","affiliation":[{"name":"Unitat d\u2019Aguts, Institut d\u2019Assist\u00e8ncia Sanit\u00e0ria, 17190 Salt, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josep","family":"Garre-Olmo","sequence":"additional","affiliation":[{"name":"Ageing, Disability and Health Research Group of Girona Biomedical Research Institute [IdIBGi], 17190 Salt, Spain"},{"name":"Department of Medical Sciences, School of Medicine, University of Girona, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9714-1568","authenticated-orcid":false,"given":"Xavier","family":"Carbonell","sequence":"additional","affiliation":[{"name":"Facultat de Psicologia, Ci\u00e8ncies de l\u2019Educaci\u00f3 i l\u2019Esport Blanquerna, Universitat Ramon Llull, 08022 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"426","DOI":"10.1177\/0020764013491942","article-title":"Mortality and psychiatric disorders among public mental health care clients in Utrecht: A register-based cohort study","volume":"60","author":"Termorshuizen","year":"2014","journal-title":"Int. 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