TB and People Experiencing Homelessness
People experiencing homelessness are at an increased risk of becoming infected with TB germs compared to the general population. The increased risk of infection with TB germs is due to several factors, including substance use, HIV infection, and the homeless shelter environment such as crowding and the state of the ventilation system. This combination of factors is favorable for spreading TB. In addition, people experiencing homelessness often lack ready access to the medical care required to make an early diagnosis of TB disease.
Among persons aged 15 years of age or older with TB in 2021, 341 (4.5%) reported experiencing homelessness within the 12 months preceding TB diagnosis. This compares with 290 (4.3%) of TB cases in 2020 among persons aged 15 years of age or older with reported homelessness in the United States.
To address TB among people experiencing homelessness, 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.
People experiencing homelessness are an important group at increased risk of TB. To achieve TB elimination, ongoing efforts are needed to address the disproportionate number of TB cases among this population. Various resources for homeless shelter staff, health care providers working with people experiencing homelessness, TB programs, and TB patients can be found below.
The Curry International TB Center database of materials and resources, including presentations.
Rutgers Global TB Institute webinar on strategies for the prevention and control of tuberculosis among people experiencing homelessness.
Administrative Controls – TB Control in Overnight Homeless Facilities Quick Reference Guide
CDC’s Latent TB Infection Online Resource Hub with guidelines, education and training resources, and other tools.
The Curry International TB Center website with tools and resources about TB for providers.
Heartland National TB Center’s 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.
- TB in the Community
- Public Health and Homelessness Toolkit
CDC Foundation’s Centers of Excellence in Public Health and Homelessness Toolkit is designed to assist health departments and other public health organizations in their efforts to support public health for people experiencing homelessness in their jurisdictions. This toolkit provides tools, templates, program blueprints, and strategies to assist health departments in understanding, planning, and implementing program activities and objectives.
CDC’s Basic TB Facts Series provides information in both English and Spanish.
CDC’s Questions and Answers about Tuberculosis (available in multiple languages)
For additional CDC resources on TB:
Find TB Resources is a searchable database of TB-related education and training materials.
Published information about TB and people experiencing homelessness:
- Diagnosis, Treatment, and Prevention of Tuberculosis Among People Experiencing Homelessness in the United States: Current Recommendations. Public Health Reports. 2023;0(0).
- Estimating and Evaluating Tuberculosis Incidence Rates Among People Experiencing Homelessness, United States, 2007-2016. Med Care. 2021; 59(Suppl 2):S175–S181.
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP). Workshop on tuberculosis and homelessness: infection control measures in homeless shelters and other overnight facilities that provide shelter: summary of the workshop held September 28–29, 2015. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, Office of Infectious Diseases, NCHHSTP; 2018.
CDC provides summary data for verified tuberculosis cases in the United States, including TB cases among persons experiencing homelessness.
The CDC National Prevention Information Network (NPIN) is a reference and referral service for information on HIV, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB).