title: BRIEF REPORT: the aging of the homeless population: fourteen-year trends in San Francisco.
abstract: 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.
  
  
  METHODS
  Serial cross-sectional.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Epi-Center, Department of Medicine, San Francisco General Hospital, University of California, San Francisco, CA 94143-1372, USA. jhahn@epi-center.ucsf.edu
authors.forename: Judith A
authors.initials: JA
authors.lastname: Hahn
authors.forename: Margot B
authors.initials: MB
authors.lastname: Kushel
authors.forename: David R
authors.initials: DR
authors.lastname: Bangsberg
authors.forename: Elise
authors.initials: E
authors.lastname: Riley
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Moss
mesh_terms: D000375:Aging; D003430:Cross-Sectional Studies; D004435:Eating; D006703:Ill-Housed Persons / Q000145:classification*; D006798:Housing; D006801:Humans; D012495:San Francisco; D013997:Time Factors