People experiencing homelessness have lower incidence of COVID-19 than the general population

The COVID-19 pandemic has had an impact on people experiencing homelessness, although estimates remain unknown and highlight the need for more inclusive data.

According to a cross-sectional study published in JAMA. The researchers assessed the primary outcomes for the number of PEH COVID-19 cases and compared the incidence rates of COVID-19 cases between PEH and the general population of a shared geographic area.

Although PEH experienced these lower rates, the results show that PEH should be considered in future infectious disease surveillance to understand how it affects marginalized groups, according to the investigators.

“The findings suggest that there are opportunities to integrate housing and homelessness status into infectious disease reporting to inform public health decision-making,” said Ashley Meehan, head of the study, in a press release.

According to the study, PEHs are at a greater risk of contracting infectious diseases, having behavioral health problems and dealing with chronic health problems. The crowds and turnover of homeless shelters create an environment conducive to the spread of COVID-19. Although homeless shelters experienced severe outbreaks of COVID-19 in the first 6 months, researchers still do not fully understand the impact of the disease on CAP.

Limited high-quality, timely data on the total number of COVID-19 cases among PEHs led the researchers to conduct a cross-sectional study. The study authors aimed to estimate the number of COVID-19 cases among PEH and compare the incidence rate with the general population to better inform recommendations for prevention and care for this population.

The researchers collected data for a population-based sample of 64 U.S. jurisdictional health departments. A total of 25 states, districts and territories responded to the survey, which was released by the Centers for Disease Control and Prevention between January 1, 2021 and September 30, 2021. They surveyed a wide range of diverse racial groups and ethnic. The white PEH constituted the majority, followed by the black PEH.

State and district level survey results reported 26,349 cases of COVID-19 among PEHs. Locally, 20,487 cases of COVID-19 have been reported.

The statewide incidence rate of COVID-19 cases in PEH was 567 per 10,000 person-years. The general population has experienced 715 cases of COVID-19 per 10,000 person-years.

Locally, the incidence rate of COVID-19 is slightly higher at 799 per 10,000 person-years in PEH versus 812 per 10,000 person-years in the general population.

About 50% of US states have collected PEH data. This is a limited representation for all US geographies and does not account for the total number of PEHs. The study was also limited by duration of homelessness, ability to verify homelessness status, data viability, and seasonal/climatic impact on COVID-19 cases.

The findings further establish that future studies could be conducted to identify different degrees of homelessness, what individuals define as homelessness and how this population may impact future public health services, the authors say. of the study.

“The integration of these data systems can ease the burden on health services of collecting housing or homelessness information during case investigations or interviews and would further support data modernization initiatives in course,” the authors concluded in the review.


Meehan, Ashley, Thomas, Isabel, Horter, Libby, et al. Incidence of COVID-19 among people experiencing homelessness in the United States from January 2020 to November 2021. JAMA Netw Open. 2022;5(8):e2227248. doi:10.1001/jamanetworkopen.2022.27248. August 18, 2022. Accessed August 19, 2022.

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