Authored By:
Corrina Marcotte, Michael
Whitworth, and Ryan Nelson
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This presentation will focus on:
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Tuberculosis
HIV/AIDS
Diabetes
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Facts and Figures will be presented from both
Oregon and the United States in general
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Why Chronic Disease & the Homeless?
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According to PBS, of the homeless who report health
problems:
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3% report having HIV/AIDS
26% report having Tuberculosis, Pneumonia, or Sexually
Transmitted Infections
46% report having other chronic health conditions,
such as Diabetes, High Blood Pressure, or Cancer
General health problems - Frostbite, leg ulcers and upper
respiratory infections threaten the homeless population
in Oregon, primarily in Multnomah county.
Chronic health problems - Tuberculosis, HIV/AIDS,
diabetes, hypertension, addictive disorders, and mental
disorders, all cause extreme hardship to those going
without basic necessities, let alone without
healthcare.
A person can become infected with TB when he/she
inhales minute particles of infected sputum from
the air. The bacteria get into the air through
coughs, sneezes, shouts, or spits
The antibiotic used for this purpose is called
isoniazid (INH). If taken for six to 12 months, it
will prevent the TB from becoming active in the
future.
TB can remain in an inactive (dormant) state for
years without causing symptoms or spreading to
other people.
•National rates experienced an
unprecedented drop from 2008 to
2009
•Oregon’s TB disease rate climbed
slightly from an all-time low in
2008 (from 75 cases to 85)
Source - Oregon Department of Human Services, 2010
•9 cases (10% of all cases) reported
homelessness in the year prior to
diagnosis.
•Spike in the number of homeless cases
occurred in 2001, due to a homeless
shelter outbreak in Lane County
•Genotyping has confirmed that one of the
nine homeless cases in 2009 is a possible
match to this outbreak strain
Source - Oregon Department of Human Services, 2010
•TB incidence historically has been higher
among males than females. In 2009, males
represented 69% of all TB cases in Oregon.
Source:http://public.health.oregon.gov/DiseasesConditions/CommunicableDisease/Dis
easeSurveillanceData/Tuberculosis/Documents/data/or2009data.pdf
Human Immunodeficiency Virus (HIV)
causes Acquired Immunodeficiency
Syndrome (AIDS)
HIV is most commonly transmitted
through sexual contact or the
sharing of unclean needles
There is no known vaccination for
HIV or cure for AIDS
Although the amount of people newly infected each year has
leveled off, the amount of people living with HIV/AIDS
continues to steadily increase.
The county with
the history of
having the highest
number of
infections has
been Multnomah (at
59% of all cases
recorded in
Oregon), mostly
because it is the
most populous
county in the
state. Portland,
Gresham, and
Troutdale are
cities in this
county.
Data From: http://public.health.oregon.gov/DiseasesConditions
/CommunicableDisease/DiseaseSurveillanceData/HIVData/Pages/epiprofile.aspx
The most atrisk males for
this illness
are
Blacks/African
Americans.
Data From: http://public.health.oregon.gov/DiseasesConditions
/CommunicableDisease/DiseaseSurveillanceData/HIVData/Pages/epiprofile.aspx
Diagnosis rates
among males for
all ethnicities
are generally
declining in
Oregon.
The most at
risk females
for this
illness are
also
Blacks/African
Americans
Data From: http://public.health.oregon.gov/DiseasesConditions
/CommunicableDisease/DiseaseSurveillanceData/HIVData/Pages/epiprofile.aspx
Over the past 20
years, the rates
have significantly
fluctuated for
American
Indians/Alaskan
Natives and
Blacks/African
Americans.
The CDC defines diabetes as a disease in which the
body either doesn’t produce insulin or cannot
use the insulin it produces effectively,
resulting in high blood glucose levels
Type 1 Diabetes (insulin-dependent) accounts for
around 5% of all diagnosed cases while Type 2
Diabetes (non-insulin-dependent) accounts for 9095% of all diagnosed cases.
Risk factors for Type 1 aren’t well defined, but
may include autoimmune, genetic, and
environmental factors. Risk factors for Type 2
include age, obesity, family history, impaired
glucose tolerance, physical inactivity and
race/ethnicity.
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One in 15 adult Oregonians is diagnosed with diabetes (higher than
the national average)
Economically disadvantaged Oregonians (household incomes at/below
Federal Poverty guidelines) have a higher rate of diabetes (9.7%)
than those with higher household incomes (5.7%)
14% of adult diabetic Oregonians in 2005 reported needing to see a
doctor but being unable to because they could not afford it
There may be over 76,000 adult Oregonians with undiagnosed diabetes
and over 592,000 with prediabetes, as indicated by national trends
Diabetes incidence by race in Oregon:
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African American – 13%
American Indian/Alaska Native – 12%
Asian/Pacific Islander – 7%
Caucasian – 6%
Hispanic/Latino – 10%
(statistics from 2008 Oregon Diabetes Progress Report and 2008 Oregon Diabetes Burden Report)
Rate per 100,000
30
25
20
15
Oregon
United States
10
5
0
1992
1994
1996
1998
2000
2002
In 2005, diabetes was the 6th leading cause of death in Oregon, and
accounted for 30% of deaths occurring in people under 30
Underlying (primary) cause of death of 1,072 Oregonians in 2005
Contributing cause of death of 2,256 Oregonians in 2005
Statistics from 2008 Oregon Diabetes Burden Report
20%
65+
45-64
18-44
16%
12%
8%
4%
0%
1996
1998
2000
2002
2004
Statistics from 2008 Oregon Diabetes Burden Report
Statistics from 2008 Oregon Diabetes Burden Report
These organizations work with either the
homeless or those with chronic disease:
Cascade AIDS Project (http://www.cascadeaids.org/)
American Diabetes Association (http://diabetes.org)
Quest Center for Integrative Health (http://www.quest-center.org/)
Central City Concern (http://centralcityconcern.org)
Essential Health Clinic (http://www.essentialhealthclinic.org)
Transition Projects (http://www.tprojects.org)
HIV Day Center (http://emoregon.org/HIV-day_center.php)
Kaiser Permanente Hospice Care
(http://www.permanente.net/homepage/kaiser/pages/f18418.html)
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“Basics about Diabetes." Diabetes Public Health Resource. Centers for Disease Control and Prevention,
05May2011. Web. <http://www.cdc.gov/diabetes/consumer/learn.htm>.
CDC. "HIV/AIDS." CDC.gov. Center for Disease Control and Prevention, 09 APR 2010. Web. 29 May 2011.
<http://www.cdc.gov/hiv/resources/qa/index.htm>.
CDC. "CDC HIV/AIDS." HIV in the United States | Factsheets | Resources by Format | CDC HIV/AIDS.
Centers for Disease Control and Prevention, 09 Apr. 2010. Web. 29 May 2011.
http://www.cdc.gov/hiv/resources/factsheets/us.htm.
"Facts and Figures: The Homeless." PBS: Public Broadcasting Service. Web. 07 June 2011.
<http://www.pbs.org/now/shows/526/homeless-facts.html>.
HandsOn. "List of Organizations." Handsongreaterportland.com. Hands On Greater Portland. Web. 29 May
2011. <http://www.handsonportland.org/HOC__Browse_Organizations_Page>.
Oregon Department of Human Services. Annual Tuberculosis Report - Oregon 2009. , 2010. Web. 31 May
2011.
<http://public.health.oregon.gov/DiseasesConditions/CommunicableDisease/DiseaseSurveillanceData/Tuber
culosis/Documents/data/or2009data.pdf>.
Mohsenifar, MD., Zab. "Tuberculosis Symptoms, Causes, Treatment." MedicineNet.com. N.p., 5/5/2010.
Web. <http://www.medicinenet.com/tuberculosis/page6.htm>.
Oregon Department of Human Services. Burden of Diabetes in Oregon. , 2008. Web.
<http://public.health.oregon.gov/DiseasesConditions/ChronicDisease/Diabetes/Documents/burdenreport200
8.pdf>.
Oregon Diabetes Coalition. Oregon Progress Report on Diabetes. Department of Human Services, Health
Services, Oregon Diabetes Program, Portland, Oregon, 2008.
Oregon Health Authority. "HIV/AIDS Reports and Data." Public.health.oregon.gov. Oregon Health
Authority, Dec. 2009. Web. 29 May 2011.
http://public.health.oregon.gov/DiseasesConditions/CommunicableDisease/DiseaseSurveillanceData/HIVDat
a/Pages/EpiProfile.aspx.