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Drop in violent death Rotterdam homeless

The improved living conditions of homeless people in Rotterdam, along with the Action Plan for Social Relief, have made a potentially significant contribution to reducing the number of deaths by suicide or murder among this group.

Daklozen Rotterdam
Intentional injury
Rotterdam launched the Action Plan in 2006 to reduce the substantial number of homeless people in the city and to provide them with healthcare, work, and housing. General practitioner and 'street doctor' Marcel Slockers, along with Erasmus MC researchers, published their findings in the European Journal of Public Health this week. The study shows that the number of deaths due to intentional injury have dropped by half since the policy was put in place.

Homeless people are a vulnerable group in society. Compared with other Rotterdam residents, homeless people have a higher mortality rate regardless of the cause of death. Adult homeless people in Rotterdam live 11 to 16 years less long than other Rotterdam residents. As with other groups, cardiovascular diseases and cancer are among the most common causes of death among the homeless.

The greatest differences can be found in non-natural causes, infectious diseases, and psychiatric disorders. The cause of death is non-natural in more than a quarter of cases among homeless people, compared to only four percent among other residents of the Dutch port city. Half of non-natural deaths can be ascribed to suicide and murder. Such cases have been cut in half in recent years, according to the study.

The researchers used data gleaned from 2,130 homeless people who made use of Rotterdam shelters in 2001. The researchers collected data on these individuals over a time span of a decade. A total of 265 homeless people in the study cohort died between 2001 and 2010. The researchers compared mortality figures provided by Statistics Netherlands covering the period prior to the introduction of the new policy measures in 2006, and thereafter.

Vulnerable individuals
"The statistics show a clear decline, but we cannot attribute the drop directly to the policy", says co-author and associate professor Ed van Beeck from Erasmus MC. "For one thing, we do not have a control group. Moreover, we do not know which of the homeless people in 2001 were affected by the policy measures put in place five years later. Nevertheless, we feel it is plausible that the policy did result in improved mental health among this group of vulnerable individuals, less of a sense of hopelessness, and a decreased propensity to self-harm and suicide."

The study was made possible thanks to funding from the GGD Rotterdam-Rijnmond Municipal Health Service and ZonMw, the Netherlands Organisation for Health Research and Development.

Date published: 6 February 2018.

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