Self-Reported Comorbidities, Perceived Needs, and Sources for Usual Care for Older and Younger Homeless Adults
Article first published online: 13 JUN 2005
Journal of General Internal Medicine
Volume 20, Issue 8, pages 726–730, August 2005
How to Cite
Garibaldi, B., Conde-Martel, A. and O'Toole, T. P. (2005), Self-Reported Comorbidities, Perceived Needs, and Sources for Usual Care for Older and Younger Homeless Adults. Journal of General Internal Medicine, 20: 726–730. doi: 10.1111/j.1525-1497.2005.0142.x
- Issue published online: 26 JUL 2005
- Article first published online: 13 JUN 2005
- Received for publication March 15, 2004 and in revised form September 12, 2004 Accepted for publication February 22, 2005
- health care utilization;
- chronic medical conditions;
- substance abuse
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.