318332
Emergency Department Visits for Cold-related Injuries among Homeless Adults: A 5-Year Cohort Study in Toronto, Canada
Methods: Homeless men and women in Toronto, Canada, were recruited in the community, and their health care utilization was ascertained over a 5-year follow-up period (2005-9) using comprehensive administrative databases. An age- and sex-matched control group of persons living in low income neighborhoods of Toronto was selected. ED visits were identified if the diagnosis was an ICD-10 code associated with cold exposure (hypothermia, frostbite, or other effects of cold). ED visit rates were compared using Poisson means.
Results: There were a total of 16 ED visits for cold-related injuries during 2,228 person-years of observation among 587 homeless men and 1,129 person-years of observation among 296 homeless women. The rate of ED visits was 6.7 per 1000 person-years of observation (95% CI, 4.2-12.4) among homeless men and 0.9 (95% CI, 0.03-5.6) among homeless women. The rates among men and women in the low-income control groups were zero. ED visit rates were significantly higher among homeless men compared to low-income men (p<0.001) and significantly higher among homeless men compared to homeless women (p=0.026).
Conclusions: In Toronto, the absolute rate of ED visits for cold-related injuries among homeless persons was low. Homeless men appear to have the greatest risk of cold-related injuries.
Learning Areas:
Provision of health care to the publicPublic health or related laws, regulations, standards, or guidelines
Public health or related research
Learning Objectives:
Identify health services research methods to determine rates of cold-related injury in vulnerable populations
Determine incidence rates for cold-related injury in homeless men, homeless women, and low-income matched controls
Discuss how health services research can inform public health planning to reduce the risk of cold-related injury among homeless persons
Keyword(s): Homelessness, Policy/Policy Development
Qualified on the content I am responsible for because: I am the medical student conducting this project as part of a research course on Determinants of Community Health. As such, I contributed to the the research, design, and analysis of this project. My primary professional interests involve inner city health and advocacy for vulnerable populations.
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.