Lack of housing, hospital treatment and premature mortality: a cohort study of people in Counties Manukau district.

Aim: We considered risk factors for mortality in people admitted to Counties Manukau inpatient facilities, who were also identified by medical staff to have insufficient housing.

Method: A cohort study of people aged 15 to 75 years admitted to Counties Manukau inpatient facilities were selected between 2002 and 2014, with ICD-10 codes for insufficient housing. Diagnostic records identified people with substance use and other clinical conditions. Mortality records were used to track survival.

Results: During the study period, 1,182 individuals were identified, 126 (10.7%) of whom died during a median follow-up of 5.7 years. Median survival of the cohort was 63.5 years (95% confidence interval (CI): 58.7 to 69.9) which is about 20 years less than the general population. Of the cohort, the strongest associations with premature mortality were among people with cannabis-related disorders (adjusted hazard ratio [aHR] 2.15; 95% CI: 1.10 to 4.22), diabetes (aHR 1.75; 95% CI: 1.05 to 2.93) and Maaori, compared to European and other ethnic groups, except Asian and Pacific (aHR 1.80; 95% CI: 1.14 to 2.85).

Conclusion: This population has high mortality. Within this group, Māori and people diagnosed with substance use and diabetes are at even higher risk of premature death.