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