Eideard

Drug overdose was the leading cause of death among homeless adults in Boston from 2003 to 2008 and accounted for one-third of deaths among those ages 25 to 44. A study by investigators from Massachusetts General Hospital and the Boston Health Care for the Homeless Program compared rates and causes of death among those served by BHCHP with data from a similar 1997 study and found that, while drug overdose had replaced HIV as the leading cause of death, overall mortality rates had not changed.

The significant drop in deaths from HIV infection was offset by the increase in deaths from overdoses and other substance-abuse-related issues, resulting in no change in the overall mortality rates from the earlier study. Overall mortality was higher in white individuals than in black or Hispanic homeless people, which — the authors write — may be due to a disproportionate burden of substance abuse and mental illness among white homeless individuals as compared to homeless minorities.

“Our results highlight the dire need to expand addiction and mental health services and to better integrate them into primary care systems serving homeless people,” says Travis Baggett, who is also an instructor in Medicine at Harvard Medical School. “They also suggest that, while health care services like BHCHP can help improve the health of homeless people, they probably are not enough. Making a major impact on mortality for these patients will also require addressing the social factors that contribute to homelessness in the first place…”

“Our results highlight the dire need to expand addiction and mental health services and to better integrate them into primary care systems serving homeless people,” says Baggett, who is also an instructor in Medicine at Harvard Medical School. “They also suggest that, while health care services like BHCHP can help improve the health of homeless people, they probably are not enough. Making a major impact on mortality for these patients will also require addressing the social factors that contribute to homelessness in the first place.”

Somehow, I think the basic premises accepted by the medical staff and volunteers on this project need reordering. The portion of the homeless community they’re dealing with – who are junkies – probably ended up homeless as a result of being junkies not the other way round.

IMHO – and life’s experience on a certain number of very mean streets – social issues include family, friends, peers and most often lousy treatment by a government that doesn’t give a rats’ ass about mentally ill folks without money or insurance. Junkies are a separate category entirely.