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12. (20 points) The homeless are a vulnerable population with limited access to health care and poor health outcomes. Boston Health Care for the Homeless
12. (20 points) The homeless are a vulnerable population with limited access to health care and poor health outcomes. Boston Health Care for the Homeless Program (BHCHP) analyzed deaths among homeless adults who were seen at their program from 1/1/2003 through 12/31/2008 (Baggett et al., 2014). A total of 1,302 deaths occurred during the observation period among the study population of 28,033 individuals. Mortality rates during 2003-2008 were compared to an earlier mortality study of homeless adults seen by BHCHP during 1988-1993 (Hwang et al., 1997). In the earlier cohort, there were 606 deaths among 17,292 individuals. Below are some crude cause-specific mortality rates from the two studies. Note these are true rates because there is person-time in the denominator. Crude Mortality Rates per 100,000 person-years 1988-1993 Study 2003-2008 Study N= 17,292 N=28,033 Crude mortality rate per 100,000 person-years Drug Overdose 80.7 242.1 Substance Use Disorder (SUD) 54.8 109.5 HIV/AIDS 280.0 84.0 a. Using both relative and absolute measures of association, compare the three cause-specific mortality rates for the 2003-2008 and 1988-1993 study populations. Use the 1988-1993 study population as the referent group. Show your work. State in words your interpretation of each of these measures. Drug Overdose Rate Ratio for 2003-2008 compared to 1988-1993: Interpretation: Drug Overdose Rate Difference for 2003-2008 compared to 1988-1993: Interpretation: SUD Rate Ratio for 2003-2008 compared to 1988-1993: Interpretation: SUD Rate Difference for 2003-2008 compared to 1988-1993: Interpretation: HIV Rate Ratio for 2003-2008 compared to 1988-1993: Interpretation: HIV Rate Difference for 2003-2008 compared to 1988-1993: Interpretation
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