The Health of Homeless Adults in New York City

Key findings from this report: 
From 2001 through 2003, 55,914 single adults and 46,832 adults in families used the Department of
Homeless Services (DHS) shelter system for at least one night. There were 903 deaths among those who used the single adult shelter system and 267 deaths among adults who used the family shelters. These 1,170 deaths made up 0.7% of all adult deaths in NYC. Compared with the general NYC adult population, homeless adults who used DHS facilities had substantially higher death rates (all rates presented here are age adjusted). The death rate among those who used the single adult shelter system was twice as high as that of the general NYC adult population.

Deaths:
The death rate among adults who used the family shelter system was 1.5 times higher. Some leading causes of death were similar between adults who used DHS shelters and the NYC adult population, but stark differences were also present. As in the NYC adult population, heart disease and cancer were the leading causes of death among adults who used the shelter system. Among those who used the single adult shelter system, substance use and HIV/AIDS accounted for nearly one-third of all deaths, compared with less than 5% in the NYC adult population.

Among women who used the single adult system, the largest proportion of deaths was due to HIV/AIDS. Among men, the largest proportion was due to substance use.

The death rate due to heart disease was higher among adults who used family shelters than among those who used single adult shelters; death rates due to cancer, substance use, and HIV/AIDS were higher among those who used single adult shelters.

There were 80 exposure deaths in NYC from 2001 through 2003; 17 of these deaths (21%) occurred among homeless adults, all due to excessive cold.

Hospitalizations:
From 2001 through 2003, there were 48,045 non-HIV/AIDS hospitalizations among homeless adults in NYC. Homeless adults were disproportionately hospitalized, and on average stayed in the hospital longer than non-homeless adults.

While homeless adults made up less than 1% of adult New Yorkers, they accounted for 1.6% of adult hospitalizations.
Substance use, alcohol use, and mental illness accounted for 69% of hospitalizations among homeless adults, compared with 10% among non-homeless adults.
The average length of stay for homeless adults was 9 days, compared with 7 days for adults in the non-homeless population.

From 2001 through 2003, there were 98 cases of tuberculosis (TB) and 766 new HIV diagnoses among those who used the single adult shelter system; there were 19 cases of TB and 319 new HIV diagnoses among adults who used the family shelter system. Compared with the general NYC adult population, adults who used DHS shelters had higher rates of TB and new HIV diagnoses.

The average rates of TB and new HIV diagnoses were 11 and 16 times higher, respectively, among those who used the single adult shelter system than among the NYC adult population.

The average rates of TB and new HIV diagnoses were 3 and 8 times higher, respectively, among adults who used the family shelter system than among the NYC adult population.

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