Los Angeles County Department of Health Services
Public Health Programs and Services
Tuberculosis Control Program
2000 Fact Sheet
Tuberculosis Epidemiology Update

1. 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] It is estimated that 34-37% of the national homeless population is comprised of women and children, and 84% of the homeless families are headed by women.^[2]
2. In the United States, approximately 19-45% of the total homeless population has a severe mental disorder such as schizophrenia, depression or bipolar affective disorder. According to the City of Los Angeles Community Development Department estimates, 33-50% of the homeless population suffer from mental illness. Nationally, 31-50% of homeless adults abuse alcohol or drugs. Forty-six percent of the homeless adults, nationally, suffer from a chronic health condition.
3. In 2000, 76 cases (7.1%) of the 1,065 confirmed cases of tuberculosis were homeless. This is a 7.3% decrease in the number of homeless cases from 1999 (82 cases).
4. The highest percentage of homeless TB cases were between the ages of 45 to 54 (27 cases, 35.5%). The next highest number of homeless cases was in the 35-to-44 year-old age group (23 cases, 30.3%). A total of three elderly (65+) homeless TB cases (4%) were reported in 2000. There were no cases reported as homeless in the pediatric TB population.
5. The majority (90.8%) of the homeless TB cases were male (69 cases). In 2000, the largest proportion of homeless TB cases were Black (57.9%, 44 cases) followed by Hispanics (26.3%, 22 cases).
6. The majority of the homeless TB cases (54 cases, 71%) were US-born. 21 cases (27.6%) were Foreign-born, 18 of whom had immigrated more than 2 years prior to being diagnosed with TB.
7. The greatest number of homeless cases (29 cases, 38.2%) 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. Inglewood and South West Health Districts each have the second highest number of homeless TB cases with 7 (9.2%), followed closely by South with 6 cases (7.9%).
8. Eighty-seven percent (66 cases) of all homeless TB cases placed on anti tuberculosis treatment were placed on DOT (Directly Observed Therapy) at some point during their treatment. A similar proportion was started on DOT in the previous report year as well. The Los Angeles County TB Control program has been using food and housing incentives since 1989 to increase the treatment completion rate among the homeless. The TB treatment completion rate is highest in this population and the need for hospitalization of TB patients has been drastically reduced by using these incentives.
9. In 2000, the most frequently cited country of birth in the homeless TB population was the United States, comprising 71.1% (54 cases), followed by Mexico with 13.2% (10 cases).
10. In the homeless TB case population, approximately 90.8% (69 cases) were offered an HIV test, 89.5% (68 cases) were tested and 21.1% (16 cases) were identified as co-infected with HIV.

             ^[1} The Number of Homeless people in Los Angeles City and County, July 1993 to June 1994; Shelter Partnership, Inc.; November 1995.

             ^[2] Just the facts: Who is Homeless in Los Angeles; Institute for the Study of Homelessness and Poverty at the Weingart Center, June 2000.