Counting the homeless: A previously incalculable tuberculosis risk and its social determinants

M.L. Feske, L.D. Teeter, J.M. Musser and E.A. Graviss

American Journal of Public Health, 2013, vol. 103, issue 5, 839-848

Abstract: Tuberculosis (TB) surveillance among the homeless is not supported by the political will necessary for TB elimination. We merged the first stakeholder-accepted enumeration of homeless persons with existing surveillance data to assess TB risk among the homeless in Houston, Texas. The average incidence per 100 000 was 411 among homeless and 9.5 among housed persons. The homeless were more likely than the housed to be US-born, clustered, and in a larger-sized cluster. Multivariate analysis revealed that TB rates among the homeless were driven not by comorbidities but by social determinants. Homeless patients were hospitalized more days than the housed and required more follow-up time. Reporting of TB rates for populations with known health disparities could help reframe TB prevention and better target limited funds.

Keywords: addiction; adolescent; adult; article; comorbidity; economics; female; health disparity; health survey; homelessness; human; Human immunodeficiency virus infection; incidence; male; methodology; middle aged; multivariate analysis; questionnaire; retrospective study; risk factor; statistics; tuberculosis; United States, Adolescent; Adult; Comorbidity; Female; Health Status Disparities; HIV Infections; Homeless Persons; Humans; Incidence; Male; Middle Aged; Multivariate Analysis; Population Surveillance; Questionnaires; Retrospective Studies; Risk Factors; Substance-Related Disorders; Texas; Tuberculosis; Young Adult (search for similar items in EconPapers)
Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2012.300973_2

DOI: 10.2105/AJPH.2012.300973

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