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Background:  Individuals experiencing homelessness have a high prevalence of infectious diseases that may result in hospitalization. Objectives:  This study uses risk factors at baseline to predict hospitalization at follow-up. This paper also presents the associations between reporting homelessness and selected infectious diseases. Research design:  Longitudinal study of baseline and follow-up conducted August 2000 through July 2014. Subjects:  4916 Not experiencing homelessness mean age 37.9 years, 29% female, and 2692 experiencing homelessness age 42.1 years, 29% female received services from a research/service center in a low-income, high-crime area of Long Beach, CA. Measures:  Risk Behavior Assessment, Risk Behavior Follow-up Assessment, laboratory testing for hepatitis A, hepatitis B, hepatitis C, syphilis, chlamydia, and gonorrhea. Results:  Predictors of hospitalization at follow-up were ever use of crack cocaine, income from Social Security or disability, reporting homelessness, female, and those who identify as Black race/ethnicity. Conclusions:  Income from the safety net of Social Security or disability provides participants with experience that transfers to being able to obtain healthcare. A higher proportion of those experiencing homelessness, compared to those not experiencing homelessness, appear to be hospitalized at follow-up. Our findings support use of the Frailty Framework when working with individuals experiencing both homelessness and hospitalization.

journal of social distress and homelessness

Application of the frailty framework among vulnerable populations to hospitalization outcomes of individuals experiencing homelessness in Long Beach, California