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TB in the Homeless Population

Background

TB in the homeless population is a public health concern. While the reported number of TB cases in the United States decreased slightly in 2011, a disproportionate number of TB cases still occur among high-risk populations, including people experiencing homelessness.

In the United States, 1% of the population experiences homelessness in a given year, but more than 5% of people with TB reported being homeless within the year prior to diagnosis. These findings are not surprising, as people experiencing homelessness have a high occurrence of conditions that increase the risk of TB, including substance abuse, HIV infection, and congregation in crowded shelters. This combination of conditions is favorable for spreading TB. In addition, people who are homeless often lack ready access to the medical care required to make an early diagnosis of TB.

TB Cases by Homeless Status, Age ≥ 15, United States, 1993-2011. This graph shows the number of TB cases reported to be homeless within twelve months prior to their TB diagnosis from 1993 through 2011. Cases must have been above 14 years of age. The number of homeless cases has decreased from a high of 1379 cases in 1994 to 565 in 2011 and parallels the overall decline in cases during this time. This category has seen a continuous decrease in cases since 1994; the years 2003, 2006, and 2010 have been exceptions with a small increase in cases. Of total cases, 6.8% were homeless in 1994 and percentages have ranged between 7.5% in 1993 and 5.4% in 2009. Since 2009 there has been a small increase in 2010 (5.7%) and in 2011 (5.8%).

What CDC is Doing

To address TB among the homeless population, CDC is collaborating with other national and public health organizations to improve screening, diagnosis, and treatment for people experiencing homelessness. In addition, CDC is working to improve TB control activities in partnership with healthcare agencies addressing the needs of people experiencing homelessness.

The homeless population represents an important risk group among U.S.-born TB patients. To achieve TB elimination, ongoing efforts are needed to address the disproportionate number of TB cases among this high-risk population.

CDC Resources on the Homeless Population

Additional Resources

For Patients

  • Basic TB Information
    • TB Facts Series

    For Health Care Providers

 
Contact Us:
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    Division of Tuberculosis Elimination (DTBE)
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    MS E10
    Atlanta, GA 30333
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    TTY: (888) 232-6348
  • Contact CDC–INFO
USA.gov: The U.S. Government's Official Web PortalDepartment of Health and Human Services
Centers for Disease Control and Prevention   1600 Clifton Rd. Atlanta, GA 30333, USA
800-CDC-INFO (800-232-4636) TTY: (888) 232-6348 - Contact CDC–INFO
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