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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO112

Unequal survival in homelessness: a 15-year cohort study of health, mortality, and migration

UNEQUAL SURVIVAL IN HOMELESSNESS: A 15-YEAR COHORT STUDY OF HEALTH, MORTALITY, AND MIGRATION

People experiencing homelessness die at a very young age, with older age, alcohol dependence, and being born in Spain constituting independent risk factors.

The study aimed to describe health and mortality patterns in a 15-year cohort of people experiencing homelessness (PEH), compare these patterns by migration status (Spanish-born versus foreign-born), and identify factors independently associated with mortality. A total of 855 people who accessed specialized services in Girona in 2006 were followed from 2006 to 2021 in a prospective cohort study; social services, primary care, and mental health records were linked to assess all-cause mortality and cause of death. Analyses included descriptive statistics, group comparisons, Kaplan–Meier survival curves, and Cox regression models. Women accounted for 22% of the cohort, and the mean age at baseline was 46.5 years; at baseline, 41.3% had a substance use disorder (30.9% had alcohol dependence), 36.4% had other psychiatric disorders, 22.3% had a dual diagnosis, 30.6% had a chronic physical illness, and 22.3% had infections (HIV, HCV, tuberculosis, and similar conditions). During follow-up, 81 people died (10.4% of the cohort), with a very young mean age at death of 53.4 years; the leading causes of death were cancer (25.0%), suicide (17.3%), heart disease or myocardial infarction (17.1%), liver cirrhosis (11.1%), and overdose (10.0%). Spanish-born participants (n=482) had a poorer health profile than foreign-born participants (n=373): substance use disorders, 45.4% versus 35.9% (p<0.001); non-substance-related psychiatric disorders, 41.1% versus 30.8% (p<0.001); and dual diagnosis, 24.7% versus 18.8% (p=0.01). Rates of chronic illness and infections were also higher. By migration status, 15-year survival was lower among Spanish-born participants (log-rank test p=0.003), and Cox regression showed that age (hazard ratio, HR=1.02; 95% CI 1.02–1.04), alcohol dependence (HR=1.92; 95% CI 1.34–2.76), and being born in Spain (HR=1.42; 95% CI 1.10–2.38) were independently associated with all-cause mortality. The authors conclude that health and social inequalities linked to migration status contribute to unequal survival among people experiencing homelessness, and recommend integrating health and social care, prioritizing the prevention and treatment of alcohol dependence, and developing interventions tailored to high-risk groups. Note: the conference abstract reported deaths as 16.4% of the cohort and the proportion of deaths due to suicide as 21.7%; the values from the poster (10.4% and 17.3%) have been used here.

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