BRIEF REPORT: The Aging of the Homeless Population: Fourteen‐Year Trends in San Francisco

• Published in: Journal of general internal medicine : JGIM Vol. 21; no. 7; pp. 775 - 778
• Main Authors: Hahn, Judith A., Kushel, Margot B., Bangsberg, David R., Riley, Elise, Moss, Andrew R.
• Format: Journal Article
• Language: English
• Published: Malden, USA Blackwell Publishing Inc 01-07-2006; Springer; Springer Nature B.V; Blackwell Science Inc
• Subjects: Aging; Biological and medical sciences; chronic health; Chronic illnesses; Cross-Sectional Studies; Eating; General aspects; health service utilization; Health services; homeless; Homeless people; Homeless Persons - classification; Hospitals; Housing; Humans; Internal medicine; Medical sciences; Miscellaneous; Original; Public health. Hygiene; Public health. Hygiene-occupational medicine; San Francisco; substance use; Time Factors; California; United States; North America; America; San Francisco; United States > US; San Francisco California; Human; Drug addiction; Senescence; chronic health; Use; Ageing; Trend; Health service; Substance abuse; health service utilization; Medicine; substance use; Chronic; Homeless; aging; Elderly; Age; Public health
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1111/j.1525-1497.2006.00493.x

BACKGROUND: Homelessness is associated with high rates of health and substance use problems.
OBJECTIVE: To examine trends in the age, housing, health status, health service utilization, and drug use of the homeless population over a 14‐year period.
DESIGN: Serial cross‐sectional.
PARTICIPANTS: We studied 3,534 literally homeless adults recruited at service providers in San Francisco in 4 waves: 1990–1994, 1996–1998, 1999–2000, and 2003.
MEASUREMENTS: Age, time homeless, self‐reported chronic conditions, hospital and emergency department utilization, and drug and alcohol use.
RESULTS: The median age of the homeless increased from 37 to 46 over the study waves, at a rate of 0.66 years per calendar year (P<.01). The median total time homeless increased from 12 to 39.5 months (P<.01). Emergency department visits, hospital admissions, and chronic health conditions increased.
CONCLUSIONS: The homeless population is aging by about two thirds of a year every calendar year, consistent with trends in several other cities. It is likely that the homeless are static, aging population cohort. The aging trends suggest that chronic conditions will become increasingly prominent for homeless health services. This will present challenges to traditional approaches to screening, prevention, and treatment of chronic diseases in an aging homeless population.