Chronic Medical Conditions Common Among Poor and Homeless Populations

A majority of First Step’s clients are poor and experience intermittent and/or permanent homelessness. Our clients experience far higher rates of both infectious and non‑infectious chronic diseases, driven by unstable shelter, poor nutrition, environmental exposure, limited access to care, and high stress. Below are the major categories documented in recent public‑health research.

 Cardiovascular Disease (Heart Conditions)

Poverty and homelessness are associated with increased morbidity from heart disease, which is one of the major causes of death in middle‑aged homeless adults.

• Heart disease is a leading cause of death for homeless individuals ages 45–64.
• Poor and homeless populations are at higher risk of chronic illnesses including cardiovascular disease due to environmental exposure and barriers to health care. [nhchc.org] [thelancet.com]

 Chronic Respiratory Conditions

Conditions such as COPD, asthma, and recurrent respiratory infections are more common.

• Poverty and homelessness increases morbidity from respiratory diseases.
• Congregate shelters and poor air quality increase risks for respiratory infections like tuberculosis and COVID‑19, which can worsen chronic lung conditions. [aafp.org] [cdc.gov]

 Diabetes

• Diabetes is specifically identified as a common chronic condition among people experiencing poverty and homelessness.
• Irregular meals, poor nutrition, lack of refrigeration for insulin, and limited monitoring make diabetes management particularly difficult. [cdc.gov]

 Chronic Liver Disease (Including Hepatitis)

• Homeless and poor populations have elevated risk for viral hepatitis, especially Hepatitis C, which can progress to chronic liver disease.
• Conditions like hepatitis and HIV are noted as common chronic illnesses in homeless and poor populations globally. [cdc.gov] [thelancet.com]

 HIV and Other Chronic Infectious Diseases

• Homeless and poor individuals are at increased risk for HIV, tuberculosis, and long‑term effects of COVID‑19. [cdc.gov]

 Mental Health Disorders

• Mental illnesses are among the most prevalent chronic conditions, often untreated.
• High rates of anxiety, depression, PTSD, and other mental illnesses are documented in homeless and poor communities.
• Mental health disorders are disproportionately prevalent and often intertwined with exposure to trauma, unstable conditions, and lack of support. [cdc.gov] [thelancet.com]

 Substance Use Disorders

• Alcohol and substance use disorders are specifically listed as common chronic conditions.
• Substance use issues significantly contribute to morbidity and mortality in homeless and poor populations.
• Drug toxicity/overdose is the leading cause of death in homeless individuals under age 45. [cdc.gov] [thelancet.com] [nhchc.org]

 Neurological Disorders (Including Epilepsy)

• Epilepsy is noted as one of the chronic illnesses homeless and poor individuals are at higher risk for developing. [thelancet.com]

 Chronic Musculoskeletal Pain and Mobility Issues

Although not always formally diagnosed due to lack of care, chronic pain disorders frequently develop from:

• exposure to harsh environmental conditions,
  • untreated injuries, and
  • chronic stress and poor sleeping conditions.

These conditions are noted indirectly via reports on traumatic injuries being major health issues in homeless groups. [nhchc.org]

 Cancer (Especially in Mid‑Life Individuals)

• Cancer is one of the top causes of death for homeless adults ages 45–64, alongside heart disease.
• Late diagnosis is common due to minimal routine screening. [nhchc.org]