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Inverse Probability of Treatment Weighting Propensity Score using the Military Health System Data Repository and National Death Index
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Causes of Death Among the Undomiciled
Breanna Cuchara-Blagmon1, Francisco J Diaz2
1State of Connecticut Office of the Chief Medical Examiner: Investigations Unit Farmington, CT.
The American Journal of Forensic Medicine and Pathology
|November 19, 2025
Summary
Homelessness significantly increases premature death risk. In Washington D.C. (2019-2023), intoxication, particularly fentanyl, was the leading cause of death among the undomiciled, highlighting urgent public health needs.
Area of Science:
- Public Health
- Epidemiology
- Mortality Studies
Background:
- Homelessness is a major public health issue linked to increased premature mortality.
- Understanding mortality trends among the homeless population is crucial for targeted interventions.
Purpose of the Study:
- To examine mortality rates and contributing factors among homeless individuals in Washington, D.C. from 2019 to 2023.
- To identify demographic, historical, and cause-of-death patterns associated with mortality in this population.
Main Methods:
- Analysis of mortality data from the Washington, D.C. Office of the Chief Medical Examiner (2019-2023).
- Examination of factors including location, manner of death, and decedent history.
- Statistical analysis of demographic data and causes of death.
Main Results:
- 712 deaths recorded among the undomiciled population, predominantly males and African Americans (average age 49.4).
- 2020 saw the highest mortality rate, with significant fluctuations observed.
- Intoxication-related fatalities comprised 57.7% of deaths, with fentanyl as the primary substance; many decedents had chronic health conditions or substance use history.
Conclusions:
- Washington, D.C. mortality trends align with broader metropolitan patterns.
- Enhanced mortality surveillance using medical examiner data is vital for public health initiatives.
- Targeted social programs are needed to reduce preventable deaths among the homeless.
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