Homeless People Die Young

by Jessica Blanchard/Seattle Times staff reporter

A study of some homeless deaths in King County showed most of those people died prematurely and suffered from numerous treatable health problems.

The average person died at age 47 and had three medical problems, according to the study released yesterday by Public Health — Seattle & King County, which reviewed 77 deaths from 2003.

Some homeless people had as many as eight health problems, the study says. Roughly two-thirds had a history of alcohol or substance abuse, more than half had a cardiovascular disease and a quarter had a mental-health problem, the study says.

The most common cause of death was acute intoxication, followed by cardiovascular disease and homicide. More than half of the deaths occurred outside, according to the study.

While those findings are not surprising, they are disturbing, said Janna Wilson, a lead author of the study and a program manager for Health Care for the Homeless, a community-based program associated with Public Health — Seattle & King County.

"This study really sheds light on the complexity of health issues that homeless people face," Wilson said.

She cautioned that the study was not a comprehensive review of all homeless deaths in King County because it included only deaths reviewed by the King County Medical Examiner's Office, meaning the person either died without being in the presence of a physician or died under suspicious circumstances. She said it's difficult to determine the total number of homeless people who died, in part because some received medical services at the time they died.

In a letter accompanying the study, a Health Care for the Homeless advocate recommended several ways to reduce the number of deaths, such as expanding outreach programs and continuing annual reviews of homeless deaths in the county.

The study drives home the importance of the county having a holistic approach to helping the homeless, because it's common for them to simultaneously suffer from medical problems, mental-health issues and substance abuse, Wilson said.

Homeless advocates have seen a rise in the kinds of health problems that require constant monitoring, such as diabetes, Wilson said. As diabetes diagnoses have increased dramatically in the general population in recent years, the rates have been even higher among homeless people, Wilson said.

But few homeless people have the means to treat such chronic illnesses, she said.

"And they often have other priorities," she said. "When you're homeless, securing a shelter bed for the night is going to be more important in many cases than getting to the doctor."

The King County findings mirror those of studies from other cities, which indicate that nationally, at least 47 percent of homeless people have at least one chronic condition, Wilson said.

Homelessness continues to rise, with an estimated 7,980 people homeless each night in King County, according to the Seattle-King County Coalition for the Homeless.

But ever-tightening county and city budgets and rising health-care costs mean the county isn't able to do much to expand programs that try to coordinate health-care services for the homeless, Wilson said.

"We absolutely struggle to maintain services," she said. "We know there's a lot more need out there, but we're doing everything we can to maintain what we have."

Health Care for the Homeless has had some success with getting federal grants to do "targeted expansions" of services. The program recently joined with the YWCA and Harborview Medical Center to get a federal grant to increase health services for the homeless in downtown Seattle. The result, the Opportunity Place Wellness Center, is set to open in January.

Also, the Committee to End Homelessness, a regional advisory group of representatives of government, United Way, churches and local businesses, has been studying ways to eradicate homelessness in King County within the next 10 years. It is expected to release its report later this month.