Deaths among homeless in northern Tunisia: a 10-year study (2005-2014)

Public Health. 2018 Sep;162:41-47. doi: 10.1016/j.puhe.2018.04.016. Epub 2018 Jun 27.


Objective: To analyze the victims profile related to death among homeless people.

Study design: A descriptive, retrospective, and cross-sectional study.

Methods: We included all deaths among homeless people that occurred during a 10-year period (2005-2014) that were autopsied in the Department of Legal Medicine of the Charles Nicolle Hospital of Tunis. Causes of death were classified according to the International Statistical Classification of Diseases and Related Health Problems 10th Revision. Data were classified in three sections: sociodemographic data, circumstances of death, and autopsy findings. A univariate data analysis was performed.

Results: The sex ratio (M/F) was of 7.45. The average age was of 59 years. The majority of deaths (80.9%) occurred in the metropolis of Tunis with a significant occurrence of cases in other governorates after the 2011 revolution (P = 0.002). Deaths occurred more often during winter (34.8%). The bodies were frequently discovered in public places (36.0%) and private locations (34.0%). The deaths of 55.3% of cases were attributed to natural causes, significantly affecting the elderly, whereas the accidental causes (25.7%) were more frequent before the age of 49 years, followed by suicides (3.9%) and homicides (3.3%).

Conclusions: Our study highlighted a phenomenon not yet studied in Tunisia. Our results highlight an urgent need for preventive measures focused on the improvement of healthcare measures among homeless people.

Keywords: Death; Developing countries; Epidemiology; Homeless persons; Mortality.

MeSH terms

  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Aged, 80 and over
  • Cause of Death / trends*
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Ill-Housed Persons / statistics & numerical data*
  • Male
  • Middle Aged
  • Retrospective Studies
  • Seasons
  • Sex Distribution
  • Tunisia / epidemiology
  • Young Adult