Cardiovascular disease burden in the homeless population

Introduction The burden of cardiovascular disease (CVD) among the homeless population has been rising, driven by factors such as lack of healthcare access, rising mental health disorders and substance use. This study aims to systematically analyse the CVD burden among homeless adults and characteris...

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Main Authors: Jeffrey R Harris, Samhita Korukonda, Nikith Erukulla, Pranitha Kovuri, Kenneth Tyler Wilcox
Format: Article
Language:English
Published: BMJ Publishing Group 2025-05-01
Series:Open Heart
Online Access:https://openheart.bmj.com/content/12/1/e003190.full
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author Jeffrey R Harris
Samhita Korukonda
Nikith Erukulla
Pranitha Kovuri
Kenneth Tyler Wilcox
author_facet Jeffrey R Harris
Samhita Korukonda
Nikith Erukulla
Pranitha Kovuri
Kenneth Tyler Wilcox
author_sort Jeffrey R Harris
collection DOAJ
description Introduction The burden of cardiovascular disease (CVD) among the homeless population has been rising, driven by factors such as lack of healthcare access, rising mental health disorders and substance use. This study aims to systematically analyse the CVD burden among homeless adults and characterise its prevalence and risk factors. Additionally, our literature review revealed a significant lack of cardiac-focused interventions in this population, thus we build on existing models to propose new CVD-specific interventions.Methods A comprehensive systematic review and meta-analysis were performed on data collected from PubMed and Scopus until 22 October 2024. All observational studies that assessed homeless populations and met inclusion criteria were analysed. The primary outcomes reported were mortality, morbidity and hospitalisation due to CVD. These measures were collectively analysed to evaluate the overall CVD burden.Results Our search strategy identified 22 studies, of which 12 were suitable for meta-analysis. We analysed data from 226 205 adults spanning more than 1 000 000 person-years and sought to characterise CVD distribution by demographic subgroups. Our findings indicate that homeless adults experience greater morbidity and mortality due to CVD than non-homeless adults (pooled OR 2.77; 95% CI 1.93 to 3.93; p<0.001; I2=96.2%). Subgroup analyses by age, sex and geographic region were performed, but no significant differences in CVD morbidity and mortality were found.Conclusion Homeless adults have approximately three times greater odds of CVD than the general population. We found that the risk of CVD remains elevated regardless of demographic subgroup. Our findings emphasise the urgent need for targeted interventions within this population and highlight its associated risk factors, providing a foundation for the development of targeted interventions and policies.
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spelling doaj-art-db881285c40546d9addce52a67c4c72d2025-08-20T01:51:00ZengBMJ Publishing GroupOpen Heart2053-36242025-05-0112110.1136/openhrt-2025-003190Cardiovascular disease burden in the homeless populationJeffrey R Harris0Samhita Korukonda1Nikith Erukulla2Pranitha Kovuri3Kenneth Tyler Wilcox4Health Systems and Population Health, University of Washington, Seattle, Washington, USADepartment of Biological Sciences, Cornell University, Ithaca, New York, USAUniversity of Illinois College of Medicine at Chicago, Chicago, Illinois, USAOSF HealthCare, Peoria, Illinois, USADepartment of Statistics and Data Science, Cornell University, Ithaca, New York, USAIntroduction The burden of cardiovascular disease (CVD) among the homeless population has been rising, driven by factors such as lack of healthcare access, rising mental health disorders and substance use. This study aims to systematically analyse the CVD burden among homeless adults and characterise its prevalence and risk factors. Additionally, our literature review revealed a significant lack of cardiac-focused interventions in this population, thus we build on existing models to propose new CVD-specific interventions.Methods A comprehensive systematic review and meta-analysis were performed on data collected from PubMed and Scopus until 22 October 2024. All observational studies that assessed homeless populations and met inclusion criteria were analysed. The primary outcomes reported were mortality, morbidity and hospitalisation due to CVD. These measures were collectively analysed to evaluate the overall CVD burden.Results Our search strategy identified 22 studies, of which 12 were suitable for meta-analysis. We analysed data from 226 205 adults spanning more than 1 000 000 person-years and sought to characterise CVD distribution by demographic subgroups. Our findings indicate that homeless adults experience greater morbidity and mortality due to CVD than non-homeless adults (pooled OR 2.77; 95% CI 1.93 to 3.93; p<0.001; I2=96.2%). Subgroup analyses by age, sex and geographic region were performed, but no significant differences in CVD morbidity and mortality were found.Conclusion Homeless adults have approximately three times greater odds of CVD than the general population. We found that the risk of CVD remains elevated regardless of demographic subgroup. Our findings emphasise the urgent need for targeted interventions within this population and highlight its associated risk factors, providing a foundation for the development of targeted interventions and policies.https://openheart.bmj.com/content/12/1/e003190.full
spellingShingle Jeffrey R Harris
Samhita Korukonda
Nikith Erukulla
Pranitha Kovuri
Kenneth Tyler Wilcox
Cardiovascular disease burden in the homeless population
Open Heart
title Cardiovascular disease burden in the homeless population
title_full Cardiovascular disease burden in the homeless population
title_fullStr Cardiovascular disease burden in the homeless population
title_full_unstemmed Cardiovascular disease burden in the homeless population
title_short Cardiovascular disease burden in the homeless population
title_sort cardiovascular disease burden in the homeless population
url https://openheart.bmj.com/content/12/1/e003190.full
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