Online Program

Sex-specific standardized mortality ratios for homeless youth: A meta-analysis

Wednesday, November 6, 2013

Andrea Parriott, MPH, PhD, Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA
Jessica Lin, MPH, Division of Adolescent Medicine, UCSF, San Francisco, CA
Colette Auerswald, MD, MS, Division of Adolescent Medicine, University of California, San Francisco, San Francisco, CA
Several studies have compared sex-specific mortality rates in homeless youth to the general youth population. Due to low numbers of observed events, confidence intervals have been wide. We combined sex-specific standardized mortality ratios (SMRs) across studies to produce more precise estimates. Articles published from 1997 to 2012 were identified by using PubMed MeSH terms “mortality” and “homeless persons” or “homeless youth.” Articles were included if they reported sex-specific standardized mortality ratios and confidence intervals (or observed and expected deaths) in homeless youth. We also included data from our own, unpublished study. Summary SMRs were calculated using inverse variance weighting. Cochrane's Q statistic was used to test the assumption of fixed effects. Eight studies in four Western, industrialized countries were identified. All provided SMRs for male youth; five provided SMRs for female youth. Summary SMRs were 8.4 (95% confidence interval: 6.4 to 11.0) for males and 13.5 (95% CI: 7.4 to 24.7) for females. The p-value for the null hypothesis of equality of the gender specific SMRs was 0.16.Both male and female youth are at excess risk for mortality relative to the general youth population. While the difference between male and female SMRs was not significant at the Α = 0.05 level, female point estimates were higher for the summary SMR measure and in all studies that examined both genders except one. The summary estimate for female youth is still imprecise. Additional data are needed to improve estimation of relative mortality in females.

Learning Areas:

Other professions or practice related to public health
Public health or related research
Social and behavioral sciences

Learning Objectives:
Compare SMRs for male and female homeless youth; Describe need for additional research on gender and mortality in homeless youth

Keyword(s): Homelessness, Youth

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a doctoral degree in epidemiology and experience in public health research, including research on the health of homeless youth. I have presented several previous abstracts at APHA and other professional meetings.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.