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

Marsha L. Feske; Larry D. Teeter; James M. Musser; Edward A. Graviss

doi:10.2105/AJPH.2012.300973

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

Marsha L. Feske, Larry D. Teeter, James M. Musser, Edward A. Graviss

Research output: Contribution to journal › Article

15 Scopus citations

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.

Original language	English (US)
Pages (from-to)	839-848
Number of pages	10
Journal	American Journal of Public Health
Volume	103
Issue number	5
DOIs	https://doi.org/10.2105/AJPH.2012.300973
State	Published - May 2013

ASJC Scopus subject areas

Public Health, Environmental and Occupational Health

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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.",

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