Gender Differences in Factors Associated with Unsheltered Status and Increased Risk of Premature Mortality among Individuals Experiencing Homelessness

In Women’s Health Issues, Ann Montgomery and colleagues, including Dennis Culhane, explore gender differences in health, access to care, and premature mortality among homeless populations. The researchers used survey data collected during the 100,000 Homes Campaign, and performed statistical analyses to identify differences in the characteristics of women, men, and transgender individuals. While men more frequently experienced unsheltered homelessness, women and transgender individuals more frequently met the criteria for risk of premature mortality. Among women, reports of substance use significantly increased the likelihood of unsheltered homelessness, while among men, mental health issues were a strong risk factor. In both genders, the experience of a violent attack while homeless was most strongly related to an increased risk of premature mortality. These findings suggest that interventions to reduce unsheltered homelessness among men should be sensitive to mental health issues, and interventions among women should pay attention to substance use. Additionally, a focus on experience of trauma, and the provision of trauma-informed care, is essential to address the increased risk of premature mortality among both men and women experiencing homelessness.