Original ArticlesIdentification of Cardiovascular Risk Factors in Homeless Adults
Section snippets
Methods
A retrospective chart review was performed after approval was received from the Institutional Review Board. One hundred patients, approximately 10% of all patients seen by the medical service in January 1998 and April 1999 at the Healthcare for the Homeless clinic in New Orleans, were randomly selected. These 2 months were chosen in an attempt to avoid any seasonal bias. Patients were age-, gender-, and race-matched to 200 nonhomeless patients attending an inner city primary care clinic. Twice
Results
We reviewed 300 charts, 100 from the Healthcare for the Homeless clinic and 200 from a primary care clinic. The demographics of the 2 populations are shown in Table 1. As can be seen, age, gender, and ethnicity were well matched.
Of the 4 reversible cardiac risk factors surveyed (Table 2), the prevalence of smoking and hypertension were greater in the homeless. Hypertension was present in 65% of the homeless but only 52% of the nonhomeless [P < 0.05; odds ratio 1.78 (CI, 1.09 to 2.9)]. Smoking
Discussion
The National Coalition for the Homeless estimates that more than 700,000 people experience homelessness every night and more than 2 million people experience homelessness every year. In a survey conducted by Link et al, 11 the 5-year (1985–1990) prevalence of true homelessness was estimated to be 5.7 million people. In New Orleans, 5000 people are believed to be homeless. 12 These numbers are vast underestimates of the true magnitude of the problem because efforts to count the homeless are
References (30)
- et al.
Health and nutrition survey in a group of homeless adults
J Am Diet Assoc
(1990) - et al.
Factors associated with the health care utilization of homeless persons
JAMA
(2001) - et al.
Hospitalization costs associated with homelessness in New York City
N Engl J Med
(1998) - et al.
Homelessness and health
(1987) - et al.
The community health nursing implications of the self-reported health status of a local homeless population
Public Health Nurs
(1998) - et al.
Unexpected factors predict control of hypertension in a hospital-based homeless clinic
Mt Sinai J Med
(1998) - et al.
Hypertension management in health care for the homeless clinics: results from a survey
Am J Public Health
(1991) - et al.
Types of epidemiology studies
Centers for Disease Control and Prevention
(2000)- et al.
Comparison of diabetes diagnostic categories in the U.S. population according to the 1997 American Diabetes Association and 1980–1985 World Health Organization diagnostic criteria
Diabetes Care
(1997)
Prevalence of high blood cholesterol among US adults. An update based on guidelines from the second report of the National Cholesterol Education Program Adult Treatment Panel
JAMA
Lifetime and five-year prevalence of homelessness in the United States
Am J Public Health
Socioeconomic status and health chartbook
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2019, Journal of Critical CareCitation Excerpt :According to the Organization for Economic Co-operation and Development database, the reported number of homeless individuals accounts for <1% of the population and has increased in recent years in Denmark, England, France, Ireland, Italy, the Netherlands, and New Zealand [1]. These homeless patients are vulnerable to several problems such as mental illness, substance abuse, trauma, cardiovascular disease, and infectious disease [2-9]. Homelessness results in significant health care costs for the public health system because it is difficult to achieve regular follow-up schedules for these patients, which results in frequent ER revisits.
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2018, Journal of the American College of CardiologyDisparities in Cancer Incidence, Stage, and Mortality at Boston Health Care for the Homeless Program
2015, American Journal of Preventive MedicineCitation Excerpt :About 2.3–3.5 million people experience homelessness annually in the U.S.1 Homeless people have a high burden of behavioral and environmental risk factors for developing cancer. An estimated 68%–80% are current cigarette smokers,2–7 and 29%–63% consume alcohol at problematic levels.7–14 Dietary inadequacy15–19 and prolonged sun exposure7 are common.
Cardiovascular Health Issues in Inner City Populations
2015, Canadian Journal of CardiologyCitation Excerpt :Although rates of smoking are consistently elevated in homeless populations in Canada, the United States, and Europe, rates of hyperlipidemia are lower and rates of diabetes are similar to those of the general population.40-46 Homeless individuals have elevated rates of hypertension in the United States but not in Canada or Europe.41,43,45,46 This difference most likely results from the overrepresentation of African Americans among America's homeless population,47 who have a greater baseline risk of hypertension than whites.48