The Contribution of Homelessness to Opioid Overdose Mortality and Associated Racial Disparities
Nora Anderson1, Vanessa M McMahan2,3, Irina Tomashevsky2
1San Francisco Department of Public Health, 25 Van Ness Ave, Suite 500, San Francisco, CA, 94102, USA. nora.anderson@sfdph.org.
Summary
Homelessness dramatically increases opioid overdose death risk by 33 times. Addressing the housing crisis is crucial to reduce overdose deaths and racial disparities in mortality.
Area of Science:
- Public Health
- Epidemiology
- Social Determinants of Health
Background:
- Racial disparities exist in opioid overdose mortality.
- Housing status is a potential contributing factor to these disparities.
Purpose of the Study:
- To investigate the association between housing status and opioid overdose mortality.
- To quantify the impact of homelessness on racial disparities in overdose deaths.
Main Methods:
- Cross-sectional study utilizing vital statistics, medical, and housing records in San Francisco (2021-2023).
- Calculated standardized mortality ratios (SMR) and excess deaths stratified by race/ethnicity and housing status.
Main Results:
- 47% of overdose decedents were recently homeless.
- People experiencing homelessness had a 33-fold increased rate of opioid overdose mortality (SMR 33.2) compared to the general population.
- A minimum of 244 excess deaths annually in San Francisco were linked to homelessness, disproportionately affecting Black individuals.
Conclusions:
- Homelessness is a significant driver of opioid overdose mortality.
- Addressing the housing crisis is essential for mitigating overdose deaths and reducing racial inequities in mortality.
- Interventions must consider housing status to effectively combat the opioid crisis.
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