Objective: To determine how the physical health of homeless adults varies by the demographic characteristics of age, gender, ethnicity, lifetime length of homelessness, and work status.
Participants: A community-based sample of 529 homeless adults.
Study design: In multivariate analyses, the authors studied the independent contributions of five demographic groups to variations in 12 physical health measures (based on self-reports from face-to-face interviews, screening physical examinations, and venous blood samples).
Measurements and main results: Older persons were more likely to have a functional disability (p < 0.001), chronic disease (p < 0.001), and greater risk of dying (p < 0.001), but less likely to abuse substances (p < 0.001). Men were more likely than women to be substance users (p < 0.001) and to have a greater risk of dying (p < 0.001). Whites and blacks were less likely than respondents in other ethnic groups to have an abnormal blood test (p < 0.001). Persons homeless longer were more likely to be substance users (p < 0.001) and to have experienced trauma (p < 0.001). Working for pay was not related to any of our health measures.
Conclusions: Age and gender contributed most to the understanding of differences in health status among homeless adults. Since the homeless have a wide variety of physical, mental, social, and substance-abuse problems, primary care providers are in the best position to provide the broad-based care needed by such persons.