Los Angeles County Department of Health Services
Public Health Programs and Services
Tuberculosis Control Program
1997 Homeless Fact Sheet
Tuberculosis Epidemiology Update
- Annual estimates of the number of homeless persons in Los Angeles County indicate that in the course of one year, there are approximately 236,000 homeless people in Los Angeles County and up to 84,000 persons homeless on any given night.1
- Approximately 25 to 50% of the total homeless population has a severe mental disorder such as schizophrenia, depression or bipolar affective disorder. Forty percent is addicted to both alcohol and drugs and 60 to 80% of the adult homeless population with mental illness have a concurrent disorder such as alcohol or drug addiction.1
- In 1997, 115 cases (9%) of the 1,347 confirmed cases were homeless. This is a 9% decrease in the number of homeless cases from 1996 (127 cases). However, the proportion of homeless TB cases has remained consistent over the past three years comprising 9% of the total TB case population.
- Thirty-two percent (37 cases) of the homeless cases were in the 35- to -44 -year-old age group followed by 25% (29 cases) in the 45- to -54 -year -old age group. Six percent (7 cases) was in the elderly (65+). There were no cases reported as homeless in the pediatric TB population.
- The majority (89%) of the homeless TB cases were male (102 cases).
- The largest proportion of homeless TB cases was Hispanic (43%, 49 cases) followed by Blacks (37%, 42 cases), Whites (18%, 21 cases) and Asians (3%, 3 cases). This represents a slight demographic shift from 1996, where Blacks predominated with 50% of the homeless TB cases followed by Hispanics with 33%.
- In 1997, the greatest number of homeless cases (52 cases, 45%) were located in the Central Health District, a region characterized by high population density, severe poverty and large numbers of persons with other risk factors for TB such as HIV infection, injection/non-injection drug use and severe alcohol abuse. Hollywood Health District has the second highest number of homeless TB cases with 11 (10%).
- Seventy-eight percent of all homeless TB cases placed on anti tuberculosis treatment were started on DOT (Directly Observed Therapy) at the initiation of therapy. This is a slight decrease compared to the 80% initially placed on DOT in 1996.
- In 1997, the most frequently cited country of birth in the homeless TB population was the United States, comprising 68% (78 cases), followed by Mexico with 21% (24 cases). Fifty percent (39 cases) of the U.S. born homeless TB cases were African American, followed by Whites with 26% (20 cases) and Hispanics with 24% (19 cases). There were three Asian homeless TB cases, all of which were foreign born.
- In the homeless TB case population, approximately 86% (99 cases) were offered an HIV test and 84% (97 cases) were tested for HIV infection. Of the 115 homeless TB cases, 20% (23 cases) were co-infected with HIV. 2
1 The Number of Homeless People in Los Angeles City and County July 1993 to June 1994; Shelter Partnership, Inc.; November 1995.
2 The number of cases offered HIV testing is indirectly calculated using reported HIV test results of refused, positive and negative.