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Lack of housing, hospital treatment and premature mortality: a cohort study of people in Counties Manukau district

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Summary:

This analysis of risk factors for mortality amongst people admitted to Counties Manukau inpatient facilities included 1182 individuals aged 15–75 years between 2002 and 2014, all of whom were identified by medical staff as having insufficient housing. During a median 5.7-year follow-up, 126 people (10.7%) died. Median survival of the cohort was 63.5 years, approximately 20 years less than the general population. The strongest associations with premature mortality in this study cohort were among people with cannabis-related disorders (adjusted HR 2.15; 95% CI, 1.10 to 4.22), diabetes (1.75; 1.05 to 2.93) and Māori ethnicity, compared to European and other ethnic groups, except Asian and Pacific (1.80; 1.14 to 2.85).

Comment:
Census results confirm that rates of homelessness are increasing; and more so for Māori than non- Māori. This paper provides important information on what this means for our health system. International studies have shown that the prevention of and early interventions for homelessness benefit those affected as well as wider society. Hopefully, this paper stirs activity in the right places.
Reference: NZ Med J. 2016;129(1440):84-93
Independent commentary by Dr. Matire Hardwood

Dr Matire Harwood (Ngapuhi) has worked in Hauora Māori, primary health and rehabilitation settings as clinician and researcher since graduating from Auckland Medical School in 1994. She also holds positions on a number of boards, committees and advisory groups including the Health Research Council. Matire lives in Auckland with her whānau including partner Haunui and two young children Te Rangiura and Waimarie.

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