1.Homelessness and mortality: gender, age, and housing status inequity in Korea
Gum-Ryeong PARK ; Dawoon JEONG ; Seung Won LEE ; Hojoon SOHN ; Young Ae KANG ; Hongjo CHOI
Epidemiology and Health 2024;46(1):e2024076-
OBJECTIVES:
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS:
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS:
The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.
2.Homelessness and mortality: gender, age, and housing status inequity in Korea
Gum-Ryeong PARK ; Dawoon JEONG ; Seung Won LEE ; Hojoon SOHN ; Young Ae KANG ; Hongjo CHOI
Epidemiology and Health 2024;46(1):e2024076-
OBJECTIVES:
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS:
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS:
The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.
3.Homelessness and mortality: gender, age, and housing status inequity in Korea
Gum-Ryeong PARK ; Dawoon JEONG ; Seung Won LEE ; Hojoon SOHN ; Young Ae KANG ; Hongjo CHOI
Epidemiology and Health 2024;46(1):e2024076-
OBJECTIVES:
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS:
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS:
The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.
4.Homelessness and mortality: gender, age, and housing status inequity in Korea
Gum-Ryeong PARK ; Dawoon JEONG ; Seung Won LEE ; Hojoon SOHN ; Young Ae KANG ; Hongjo CHOI
Epidemiology and Health 2024;46(1):e2024076-
OBJECTIVES:
We compared mortality rates among various housing statuses within the homeless population and investigated factors contributing to their deaths, including housing status, gender, and age.
METHODS:
Using a comprehensive multi-year dataset (n=15,445) curated by the National Tuberculosis Screening and Case Management Programs, matched with the 2019-2021 Vital Statistics Death Database and National Health Insurance claims data, we calculated age-standardized mortality rates and conducted survival analysis to estimate differences in mortality rates based on housing status.
RESULTS:
The mortality rate among the homeless population was twice as high as that of the general population, at 1,159.6 per 100,000 compared to 645.8 per 100,000, respectively. Cancer and cardiovascular diseases were the primary causes of death. Furthermore, individuals residing in shelter facilities faced a significantly higher risk of death than those who were rough sleeping, with an adjusted hazard ratio of 1.70 (95% confidence interval, 1.37 to 2.11). This increased risk was especially pronounced in older adults and women.
CONCLUSIONS
The study highlights the urgent need for targeted interventions, as the homeless population faces significantly higher mortality rates. Older adults and women in shelter facilities are at the highest risk.
5.Epidemiological Characteristics of Nontuberculous Mycobacterial Pulmonary Disease in South Korea: A Meta-analysis of Individual Participant Data
Geunin LEE ; Sol KIM ; Shihwan CHANG ; Hojoon SOHN ; Young Ae KANG ; Youngmok PARK
Tuberculosis and Respiratory Diseases 2024;87(3):386-397
Background:
Despite the global increase in nontuberculous mycobacterial pulmonary disease (NTM-PD), clinical characteristics show geographical variations. We investigated the clinical characteristics of patients with NTM-PD in South Korea.
Methods:
We systematically reviewed articles concerning patients with NTM-PD in South Korea until February 2022. Individual participant data, regardless of treatment, were collected using a standard case report form.
Results:
Data of 6,489 patients from 11 hospitals between 2002 and 2019 were analyzed. The mean age was 61.5±11.7 years, of whom 57.7% were women. Mycobacterium avium (41.4%) and Mycobacterium intracellulare (38.4%) comprised most of the causative species, followed by Mycobacterium abscessus subspecies abscessus (8.6%) and M. abscessus subspecies massiliense (7.8%). Bronchiectasis (59.4%) was the most common pulmonary comorbidity. Although reported cases of NTM-PD increased over the years, the proportions of causative species and radiologic forms remained similar. Distinct clinical characteristics were observed according to age and sex. Men were older at the time of diagnosis (median 63.8 years vs. 59.9 years, p<0.001), and had more cavitary lesions than women (38.8% vs. 21.0%, p<0.001). The older group (≥65 years) had higher proportions of patients with body mass index <18.5 kg/m2 (27.4% vs. 18.6%, p<0.001) and cavitary lesions (29.9% vs. 27.6%, p=0.009) than the younger group.
Conclusion
We conducted a meta-analysis of the clinical characteristics of patients with NTM-PD in South Korea, and found age- and sex-related differences in disease- specific severity. Further investigation would enhance our comprehension of the nature of the disease, and inherited and acquired host factors.