chronic disease; homeless; HIV; Hepatitis C; back pain; physical health


Community-Based Research | Community Health and Preventive Medicine | Public Health | Public Health Education and Promotion | Public Policy | Translational Medical Research | Urban Studies



Objective: Morbidity and mortality among homeless individuals is higher than the general population. This study aims to determine the prevalence of current self-reported, chronic physical health conditions in a large sample of homeless people with sub-samples from shelters and street in British Columbia, Canada. Methods: Cross-sectional survey applying modified version of the ‘National Survey of Homeless Assistance Providers and Clients (NSHAPC)’ questionnaire in multiple sites in Vancouver, Victoria and Prince George, British Columbia, Canada. Sample: Five hundred homeless individuals were surveyed between May and September of 2009. A person was defined as homeless if he/she had a self-identified living status of being without permanent housing prior to study entry for a minimum duration of one month. The main outcome measures were prevalence rates of self-reported chronic physical health conditions. A chronic physical health condition was defined as a condition, expected to last or had already lasted 6 months or more, which had been diagnosed by a health professional. Results: The most commonly self-reported, chronic, physical health condition in this group of homeless participants was history of head injury with subsequent loss of consciousness, dizziness, confusion, or disorientation (63.6%) followed by back problems (38.8%), chronic hepatitis (34.6%), migraine headaches (29.2%), and arthritis (28.4%). Chronic obstructive lung disease was reported by 15.8% of the participants, and high blood pressure by 15.6%. 7.6% indicated they were HIV-positive and/or had AIDS. Conclusion: Homeless people have a high prevalence of chronic physical health condition, in the following areas: neurological, musculoskeletal, infectious and respiratory diseases. Precarious living conditions and housing, poor nutrition, psychosocial stress, smoking, and substance use are among common detrimental risk factors for many of these conditions.

Keywords: chronic disease, homeless, HIV, Hepatitis C, back pain, physical health