Mortality Among Men Using Homeless Shelters in Toronto, Ontario

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Abstract
Homeless persons suffer from a high prevalence of physical disease, mental illness, and substance abuse.1-11 Homelessness is associated with exposure to the elements12 and an increased risk of infections such as tuberculosis and human immunodeficiency virus (HIV) disease.13-18 Among the homeless, access to health care is often suboptimal.19-23 Homeless persons also experience severe poverty and often come from disadvantaged minority communities, factors that are independently associated with poor health.24-29 The finding that mortality among homeless persons is much higher than among their counterparts in the general population is therefore not surprising.