{"title":"医学法律心血管疾病死亡的早期死亡率和医疗复杂性：比较有住房和没有住房的死者。","authors":"Ben King, Shriya Swamy, Shaya Khorsandi","doi":"10.1093/geront/gnaf056","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Method: </strong>Utilizing 2021 and 2022 data from the Harris County Medical Examiner, investigators analyzed CVD-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.</p><p><strong>Results: </strong>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 and congestive heart failure were more common in CVD deaths of people experiencing homelessness.</p><p><strong>Discussion: </strong>These findings reemphasize 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.</p>","PeriodicalId":51347,"journal":{"name":"Gerontologist","volume":" ","pages":""},"PeriodicalIF":4.6000,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Early Mortality and Medical Complexity Among Medicolegal Cardiovascular Disease Deaths: Comparing Housed and Unhoused Decedents.\",\"authors\":\"Ben King, Shriya Swamy, Shaya Khorsandi\",\"doi\":\"10.1093/geront/gnaf056\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>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.</p><p><strong>Method: </strong>Utilizing 2021 and 2022 data from the Harris County Medical Examiner, investigators analyzed CVD-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.</p><p><strong>Results: </strong>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 and congestive heart failure were more common in CVD deaths of people experiencing homelessness.</p><p><strong>Discussion: </strong>These findings reemphasize 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.</p>\",\"PeriodicalId\":51347,\"journal\":{\"name\":\"Gerontologist\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":4.6000,\"publicationDate\":\"2025-04-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Gerontologist\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/geront/gnaf056\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Gerontologist","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/geront/gnaf056","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERONTOLOGY","Score":null,"Total":0}
Early Mortality and Medical Complexity Among Medicolegal Cardiovascular Disease Deaths: Comparing Housed and Unhoused Decedents.
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 CVD-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 and congestive heart failure were more common in CVD deaths of people experiencing homelessness.
Discussion: These findings reemphasize 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.
期刊介绍：
The Gerontologist, published since 1961, is a bimonthly journal of The Gerontological Society of America that provides a multidisciplinary perspective on human aging by publishing research and analysis on applied social issues. It informs the broad community of disciplines and professions involved in understanding the aging process and providing care to older people. Articles should include a conceptual framework and testable hypotheses. Implications for policy or practice should be highlighted. The Gerontologist publishes quantitative and qualitative research and encourages manuscript submissions of various types including: research articles, intervention research, review articles, measurement articles, forums, and brief reports. Book and media reviews, International Spotlights, and award-winning lectures are commissioned by the editors.
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