Homeless people can expect to die 30 years before the average person, research has found.
A study showed that homeless men are dying at an average of 47 years and homeless women at 43, in stark contrast to the average age of death for the general population, 77 years.
The research, carried out by Sheffield University on behalf of homelessness charity Crisis, found that drug and alcohol abuse counts for just over a third of all deaths among homeless people.
Suicide is also nine times more likely among people living rough than the general population.
Meanwhile it found that deaths as a result of traffic accidents are three times as likely, infections twice as likely and falls are more than three times as likely to result in death.
The study, Homelessness: A silent killer, showed that as expected, the causes of death for homeless people differ from those of the wider population, where disease is the biggest killer.
The links between drug and alcohol abuse and homelessness are well established and drugs and alcohol are known to be both a cause and consequence of living on the streets, it said.
Previous research has found that four out of five people start using at least one new drug after becoming homeless.
Leslie Morphy, chief executive of Crisis, said: "It is shocking, but not surprising, that homeless people are dying much younger than the general population.
"Life on the streets is harsh and the stress of being homeless is clearly taking its toll.
"This report paints a bleak picture of the consequences homelessness has on people's health and wellbeing.
"Ultimately, it shows that homelessness is killing people."
The research by Dr Bethan Thomas at the University of Sheffield estimates the average age of death not just for rough sleepers, but for the wider homeless population including those who reside in night shelters, homeless hostels and use day centres.
Dr Thomas said: "The size of the gap in average age of death between homeless people and the general population is shocking.
"It is appalling that in 21st century England people are dying in early middle age because they do not have a home."
Seyi Obakin, chief executive of youth homelessness charity Centrepoint, said: "This research highlights why the 80,000 young people a year who suffer homelessness need help now.
"In these increasingly tough times for young people the Government and local councils must not lose sight of the need to support homeless young people.
"By dealing effectively with the health, housing and educational problems of homeless young people first time round they can live successful lives and fulfil their potential."
A Department of Health spokesman said: "We know that many homeless people have acute and often multiple health needs. That is why we have established the Inclusion Health programme, which focuses on improving access to healthcare, and the results it achieves, for vulnerable groups such as rough sleepers.
"The National Inclusion Health Board is working closely with Ministers, charities, the NHS, and other experts in the causes of homelessness, to ensure that we do better in the future addressing the health needs of homeless people - for example making sure that nobody is discharged from hospital without a bed to sleep in that night."
Housing Minister Grant Shapps added: "The plight of homeless people should be on our minds all year round - not just at Christmas.
"We're fortunate to have some of the toughest laws in the world to prevent people from ending up on our streets and while homelessness remains lower than in 28 of the last 30 years I'm always anxious to do more.
"That's why today I'm announcing £20 million of new funding which for the first time will specifically help single homeless people, who all too often slip through the safety net. This money will be used to help prevent homelessness at an earlier stage."