Homeless women have higher illness and mortality rates.

TORONTO -- Homeless people are at higher risk for illness and have higher death rates than the general population. However, mortality rates for homeless women are even higher, according to a report in the Canadian Medical Journal, "Risk of death among homeless women: a cohort study and review of the literature." The rate is highest among the younger women.

The researchers studied the reported mortality rates and causes of death in a cohort of women who used homeless shelters in Toronto. They also compared their results with those of other published studies, of homeless women and with data for women in the general population.

The cohort included 1981 women not accompanied by dependent children who used homeless shelters in Toronto. They also analyzed data from published studies of mortality rates among homeless women in 6 other cities (Montreal, Copenhagen, Boston, New York, Philadelphia and Brighton, UK).

In Toronto, mortality rates were 515 per 100,000 person-years among homeless women 18-44 years of age and 438 per 100,000 person-years among those 45-64 years of age. Homeless women 18-44 years of age were 10 times more likely to die than women in the general population of Toronto.

In studies of the seven cities, the risk of death among homeless women was greater than that among women in the general population by a factor of 4.6 to 31.2 in the younger age group and 1.0 to 2.0 in the older age group.

In six of the seven cities, the mortality rates among younger homeless women and younger homeless men were not significantly different. In contrast, in four of the six cities, the mortality rates were significantly lower among older homeless women than among older homeless men.

The researchers conclude that excess mortality is far greater among homeless women under age 45 years than among older homeless women. Mortality rates among younger homeless women often approach or equal those of younger homeless men. Efforts to reduce deaths of homeless women should focus on those under age 45.

The research group included: Angela M. Cheung, Women's Health Program, University Health Network; and Stephen W. Hwang, Inner City Health Research Unit, St. Michael's Hospital; and both researchers are members of the Department of Medicine, University of Toronto.