The demographic characteristics of medicolegal death among welfare recipients in Tokyo Metropolis (2008-2013).

Background The number of welfare recipients has steadily increased in Japan during recent years, although the number of homeless persons has decreased. Despite there being many reports regarding medicolegal death among homeless persons, medicolegal death among welfare recipients has not been fully investigated. Methods We identified 10,293 individuals who received welfare aid during their lifetime among the 81,867 cases that were examined by the Tokyo Medical Examiner's Office (2008-2013). We retrospectively compared the proportions of medicolegal death to total population, age, sex, family status, clinical history, and manners/causes of death among non-indigent persons (controls), homeless persons, and welfare recipients. Results A higher proportion of medicolegal death to total population was observed among the welfare recipients, compared with the controls. The welfare recipients (65.5 years) were younger than the controls (68.9 years), and the proportions of male sex and living alone were higher among the welfare recipients. Hypertension and circulatory disease were the leading clinical conditions among the welfare recipients. Death due to disease was the leading manner of death, and circulatory disease was the leading cause of death among the welfare recipients. The proportion of individuals with a long period between death and discovery (which made determining the cause of death difficult) was also higher among the welfare recipients. Conclusion Welfare recipients have a greater risk of sudden death compared with non-indigent persons. Preventive strategies should target middle-aged to elderly men who live alone, and should address their risks of circulatory diseases and solitary death.