This article in the American Journal of Public Health caught my eye.Most clinicians know that poverty and homelessness is associated with tuberculosis infection and disease. Here is a unique article that attempts to quantify the risk and incidence of tuberculosis in a cohort of homeless persons in Houston, Texas.
What emerged was rather lopsided incidence of tuberculosis in homeless people. The average incidence per 100 000 was 411 among homeless and 9.5 among housed persons. The homeless were more likely than the housed to be US-born, clustered, and in a larger-sized cluster. Using multivariable analysis, independent risk factors for TB rates were social determinants and not comorbidities.
Homelessness is urban blight.
