Physical diseases among homeless people: Gender differences and comparisons with the general population

Aim: To study morbidity amongst homeless men and women by comparing prevalence of hospital care for somatic diseases and injuries with a control group of men and women from the general population. Methods: A cohort of 1,364 men and 340 women were documented as homeless in 1996. Comparisons are made concerning hospital care for somatic diseases and injuries (1996-2002) among 3,750 men and 1,250 women from the general population. Results: The relative risk (RR) for homeless men and women of being hospitalised was double that of the men and women in the controls (1.93 and 1.96 respectively). Homeless women had a slightly, not significant, increased risk compared to homeless men (RR 1.10). Younger homeless women had a significant higher risk. Among diagnostic categories, the highest prevalence was found among homeless men in the diagnosis group injury/poisoning (22%). The highest risk was found for skin diseases (RR 36.96) and concerned homeless women. There were a number of gender specific diagnoses, where risks were considerably elevated, such as diseases of the genital organs, viral hepatitis, and poisoning for homeless women, and cerebrovascular diseases, diseases of the liver, and concussion for homeless men. Conclusions: Homeless people had twice the risk of being hospitalised for physical diseases compared to the general population. Younger women were particularly at risk compared to homeless men and to women in the controls. There were a number of gender specific diagnoses that are important to take into account when planning services for homeless people.