TB in the Homeless Population

Background

Homeless

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.

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.
• Working to improve TB control activities in partnership with healthcare agencies addressing the needs of people experiencing homelessness.

In the fall of 2015, CDC hosted a “Workshop on Tuberculosis (TB) and Homelessness: Infection-Control Measures in Homeless Shelters and Other Overnight Facilities that Provide Shelter.” The workshop brought together homeless service providers, TB controllers, and public health department staff to engage in strategic planning around improving TB control among persons experiencing homelessness and prevent new TB incidence among those utilizing and providing services (i.e., clients, staff and volunteers). A summaryCdc-pdf of the workshop held on September 28-29, 2015 is now available.

Highlights from the Workshop

Administrative Controls – TB Control in Overnight Homeless Facilities Quick Reference Guide

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. Various resources for homeless shelter staff, health care providers working with the homeless population, TB programs, and TB patients can be found below.

For Homeless Shelter Staff

The Curry International TB Center’sExternal database of materials and resources, including presentations.

Rutgers Global TB Institute’sExternal webinar on strategies for the prevention and control of tuberculosis among homeless persons.

The United States Interagency Council on Homelessness’External fact sheet on TB and why it is a concern for people experiencing homelessness and those working with homeless populations.

For TB Programs & Health Care Providers

CDC’s Latent TB Infection Online Resource Hub with guidelines, education and training resources, and other tools.

The Curry International TB CenterExternal website with tools and resources about TB for providers.

Heartland National TB Center’sExternal educational flipchart facilitates the work of community outreach and public health workers involved in the care of individuals with TB. The flipchart includes material in English and Spanish.

For Patients - Basic TB Information

The CDC’s Basic TB Facts Series which provides information for the general public in both English and Spanish.

The CDC’s Questions and Answers about Tuberculosis for the general public in both English and Spanish.

For additional CDC resources on TB:

Find TB Resources is a searchable database of TB-related education and training materials.

Additional CDC Resources on the Homeless Population

The MMWR series is the agency’s primary vehicle for scientific publication of timely, reliable, authoritative, accurate, objective, and useful public health information and recommendations.
Notes from the Field: Tuberculosis Cluster Associated with Homelessness — Duval County, Florida 2004–2012 MMWR 2012; 61 (No. 28)
Tuberculosis Outbreak Associated with a Homeless Shelter – Kane County, Illinois 2007–2011 MMWR 2012; 61 (No. 11, 186-189)
Tuberculosis Transmission in a Homeless Shelter Population – New York, 2000-2003 MMWR 2005; 54 (No. 06)

The CDC provides summary data for verified tuberculosis cases in the United States, including TB cases in the homeless population.
Reported Tuberculosis in the United States, 2016

The CDC National Prevention Information Network (NPIN) is the U.S. reference and referral service for information on HIV/AIDS, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB).
HIV/AIDS and the Homeless
Fact sheet on Hepatitis A Outbreaks Among People Who are Homeless and People Who Use Drugs

Page last reviewed: July 2, 2018