Los Angeles County Department of Health Services
Public Health Programs and Services
Tuberculosis Control Program
1999 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 are 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 1999, 82 cases (7%) of the 1,170 confirmed cases of tuberculosis were homeless. This is a 20% decrease in the number of homeless cases from 1998 (103 cases).
- The highest percentage of homeless TB cases was the 35-to-44-year-old age group (36.6%, 30 cases) followed by the 45-to-54-year-old age groups (28.0%, 23 cases). There were 3 cases (3.7%) in the elderly (65+). There were no cases reported as homeless in the pediatric TB population.
- The majority (91.5%) of the homeless TB cases were male (75 cases).
- The largest proportion of homeless TB cases were Hispanic (53.7%, 44 cases) followed by Blacks (26.8%, 22 cases), Whites (14.6%, 12 cases), Asians (3.7%, 3 cases) and Native American (1.2%, 1 cases).
- In 1999, the greatest number of homeless cases (34 cases, 41.5%) 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 8 (9.8%).
- Ninety-two percent (69 cases) of all homeless TB cases placed on anti tuberculosis treatment were started on DOT (Directly Observed Therapy) at the initiation of therapy. This is an increase compared to the 87% initially placed on DOT in 1998.
- In 1999, the most frequently cited country of birth in the homeless TB population was the United States, comprising 51.2% (42 cases), followed by Mexico with 31.7% (26 cases). Fifty-two percent (22 cases) of the U.S. born homeless TB cases were African American, followed by Whites with 23.8% (10 cases) , Hispanics with 21.4% (9 cases) and Native American with 2.4% (1 case). There were three Asian homeless TB cases, all of which were foreign born.
- In the homeless TB case population, approximately 87.8% (72 cases) were offered an HIV test and 80.5% (66 cases) were tested for HIV infection. Of the 82 homeless TB cases, 15.9% (13 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.