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Cited by 116Homelessness and Social IssuesHIV, Drug Use, Sexual RiskFood Security and Health in Diverse Populations

Self-reported comorbidities, perceived needs, and sources for usual care for older and younger homeless adults

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Garibaldi, Brian, Conde-Martel, Alicia, O’Toole, Thomas P.·2005·Journal of General Internal Medicine
DOI 10.1111/j.1525-1497.2005.0142.xPMC PMC1490194
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Abstract

Background While older individuals who are homeless tend to be in poorer health, it is less clear how they view their health care needs and whether their self-reported patterns for accessing health services differ from younger homeless counterparts.Methods Cross-sectional, community-based survey of homeless adults in Pittsburgh and Philadelphia using face-to-face interviews from population proportionate sampling of sites and random sampling of subjects. Survey questions included physical and mental health comorbidities, self-reported health care, social services and personal needs, means of economic support, and sources for usual health care. For analysis purposes, respondents were grouped by age 18 to 49 years old and 50 years old or older.Results Overall, 531 adults were interviewed, with 74 respondents 50 years old or older (13.9%). Older homeless persons were 3.6 times more likely to report a chronic medical condition, 2.8 times more likely to have health insurance, and 2.4 times more likely to be dependent on heroin than homeless persons less than 50 years old. However, they also tended to use shelter-based clinics and street outreach teams more commonly as their source of usual care (20.9% vs 10.6%, P=.02) and were significantly less likely to report a need for substance abuse treatment despite high rates of abuse.Conclusion Older homeless adults have a greater disease burden than their younger counterparts. However, it is unclear whether these needs are being appropriately identified and met. There is a need for specific and targeted outreach to connect them to appropriate services.

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  • Since a 2012 systematic review, two new tuberculosis studies reported prevalence between 4% and 8%, and one New York City HIV study reported a rate of 1.8%.

    “Since a 2012 systematic review,56 two new studies69,70 of tuberculosis that reported a prevalence of between 4% and 8%, and one study71 of HIV (from New York City) reporting rates of HIV of 1·8% have been published (appendix).”

    From The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations (2014) · cites this paper as [70]

    The Methods section (page unavailable) says this paper surveyed homeless adults in Pittsburgh and Philadelphia in 1997, not New York City. Published in 2005, it also cannot be one of the studies published since the 2012 review. The passages do not report an HIV prevalence of 1.8%. (LLM, conf=0.88)

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Research works printed but not linked: 4

  1. Cohen CI, Sokolovsky J. Old Men of the Bowery. New York, NY: Guilford Press; 1989.
  2. Filardo T. Chronic disease management in the homeless. In: Brickner PW, Scharer LK, Conanan B, Elvy A, Savarese M, eds. Health Care of Homeless People. New York, NY: Springer Publishing Company; 1985: 19-34.
  3. Lehman AF, Cordray DS. Prevalence of alcohol, drug and mental disor- ders among the homeless: one more time. Contemp Drug Problems. 1993;20:355-83.
  4. Abdul-Hamid W. The elderly homeless men in Bloomsbury hostels: their needs for services. Int J Geriatr Pshyciatry. 1991;12:724-7.

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Authors
Garibaldi, B., Conde-Martel, A., & O’Toole, T. P.
Affiliations
Johns Hopkins University (US)
ORCID
Garibaldi, Brian
Venue
Journal of General Internal Medicine
Publisher
Springer Science and Business Media LLC
Published
2005-08
Volume
20
Issue
8
Pages
726-730
ISSN
  • 0884-8734 (ISSN-L)
  • 1525-1497
DOI
10.1111/j.1525-1497.2005.0142.x
PMC
PMC1490194
OpenAlex
W2080959983
Cited by
116
References
24
Citations by year
2026: 1 · 2025: 5 · 2024: 3 · 2023: 6 · 2022: 6 · 2021: 4 · 2020: 8 · 2019: 6 · 2018: 3 · 2017: 6 · 2016: 9 · 2015: 7 · 2014: 10 · 2013: 11 · 2012: 6
FWCI
3.50
Type
journal article
Language
en
Open access
Locations
  • Journal of General Internal Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
Funders
National Institute on Drug Abuse (K23DA013988, K23DA 13988-01)
Topics
  • Health Sciences › Health Professions › General Health Professions › Homelessness and Social Issues
  • Health Sciences › Medicine › Epidemiology › HIV, Drug Use, Sexual Risk
  • Health Sciences › Health Professions › General Health Professions › Food Security and Health in Diverse Populations
Keywords
homeless adults, older adults, health care access, usual care, chronic disease, comorbidities, health insurance, heroin addiction, addiction treatment, street outreach, health care needs, age differences
MeSH terms
Adolescent, Adult, Age Factors, Cross-Sectional Studies, Female, Health Services Accessibility, Health Status, Ill-Housed Persons, Humans, Male, Middle Aged, Pennsylvania, Urban Population, Comorbidity, Logistic Models

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