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Homelessness: a ‘cause of the causes’ of cardiovascular disease?
  1. Deirdre A Lane
  1. Liverpool Centre for Cardiovascular Science, University of Liverpool, Liverpool, UK
  1. Correspondence to Dr Deirdre A Lane, University of Liverpool, Liverpool L69 3BX, UK; deirdre.lane{at}

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Homelessness is a global crisis which has increased at an alarming rate over the last decade; worldwide it is estimated that nearly 1.6 billion people have inadequate shelter, resulting in the United Nations announcing its first-ever resolution on homelessness on 19 February 2020.1 In the current issue, a systematic review and meta-analysis shines the spotlight on homelessness and cardiovascular disease (CVD), reporting that homeless people have an almost threefold higher risk of CVD and greater risk of death from cardiovascular causes compared with housed individuals.2 This review also highlights the absence of any specific care pathways or interventions to manage CVD in this at-risk population.2

Unfortunately, there is no global definition of homelessness and consequently the true prevalence of the problem is unknown. On the streets of every city homelessness is evident, with people ‘sleeping rough’ but this is just the tip of the iceberg; many homeless people are what is termed the ‘hidden homeless’—people who do not have a home of their own but are ‘sofa-surfers’, moving between friends and family, or surviving in temporary accommodation.3

Homelessness is a complex, multifactorial problem and the reasons for this are numerous and each individual experience is unique. Marriage …

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  • Contributors DL is the sole author of this manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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