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(Circulation. 2005;111:2555-2556.)
© 2005 American Heart Association, Inc.

Editorial

Health, Housing, and the Heart

Cardiovascular Disparities in Homeless People

Jessie M. McCary, MD; James J. O’Connell, MD

From the Boston Health Care for the Homeless Program (J.M.M., J.J.O.) and the Departments of Internal Medicine at Boston University (J.M.M., J.J.O.), Harvard Medical School, and Massachusetts General Hospital (J.J.O.), Boston, Mass.

Correspondence to Dr Jessie M. McCary, Boston Health Care for the Homeless Program, 729 Massachusetts Ave, Boston, MA 02118. E-mail jmccary@bhchp.org

Key Words: Editorials • cardiovascular diseases • homeless persons • prevention • public policy

An extract of the first 250 words of the full text is provided, because this article has no abstract.

The interaction between housing and health is intimate and complex, yet little evidence exists with regard to the healthcare outcomes for people struggling to survive without housing. The study in this issue by Lee and colleagues¹ not only exposes a resounding need for community-wide interventions to improve the cardiovascular health of homeless adults but also underscores the vexing challenges confronting researchers investigating the health disparities attendant to homelessness.

See p 2629

Mortality rates of homeless adults in the United States and Canada have been shown to be 3 to 5 times higher than those of the general population.^2,3 Homeless women in Toronto have a 10-fold risk of death when compared with housed women in that city.⁴ In our ongoing observational study of a cohort of 119 chronically homeless people living on the streets of Boston, almost one third died during a 5-year period from 2000 through 2004. Heart disease is a leading cause of death in older homeless people 45 to 64 years old, and despite other common causes of death in younger homeless people 25 to 44 years old, heart disease is 3 times more common in this group than in the age-matched general population.⁵

Risk factors for cardiovascular (CV) disease are potentially treatable targets in the prevention of morbidity and premature death in this high-risk subpopulation. The study by Lee et al shows, however, that CV risk factors and CV disease itself in homeless adults in Toronto are grossly undertreated. The authors report the prevalence and treatment of . . . [Full Text of this Article]

Related Article:

Risk Factors for Cardiovascular Disease in Homeless Adults

Tony C. Lee, John G. Hanlon, Jessica Ben-David, Gillian L. Booth, Warren J. Cantor, Philip W. Connelly, and Stephen W. Hwang
Circulation 2005 111: 2629-2635. [Abstract] [Full Text]

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