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Liver-related Mortality in Homeless-experienced Adults over a 16-year Period

J Health Care Poor Underserved. 2025;36(4):1287-1299. doi: 10.1353/hpu.2025.a975588.

ABSTRACT

INTRODUCTION: The objective of this study was to examine liver-related mortality trends in a large cohort of homeless-experienced adults.

METHODS: We linked a cohort of 60,092 adults who received care at Boston Health Care for the Homeless Program (BHCHP) from 2003-2017 to death occurrence files. We evaluated temporal trends in age-standardized liver-related mortality and identified leading causes of liver-related death compared with the Massachusetts population, reporting standardized mortality rate ratios (SRRs).

RESULTS: Of the 7,130 deaths in the cohort, 652 (9.1%) were liver-related. Liver-related mortality decreased on average 3.5% annually, though remained significantly higher than the Massachusetts population. Leading causes of liver-related death were cirrhosis (n=157, SRR 3.2), liver cancer (n=148, SRR 2.4), alcohol-related liver disease (n=140, SRR 4.4), and viral hepatitis (n=99, SRR 7.2).

CONCLUSION: Efforts to address alcohol use disorder and viral hepatitis in this population may reduce the substantial disparity seen in liver-related mortality in this population.

PMID:41355644 | DOI:10.1353/hpu.2025.a975588

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