The homeless population is of particular concern as they are often immunocompromised, underserved, and disenfranchised from the traditional medical system. As a result, tuberculosis is most prevalent in cities among homeless individuals and has suffered from a twenty percent increase since 1985 (Bloom, 1995). Combined with the HIV epidemic and increased intravenous drug use, tuberculosis has become one of the leading causes of morbidity and mortality among homeless populations as a reemerging killer.

Currently, a combination of five primary drugs are used for chemoprophylaxis, as drug resistant bacteria have made single drug treatments obsolete. However, social and residential instability in homeless persons are a major obstacle in completion of the drug treatm

The results of the research into the policies of the cities is as follows. New York is hardest hit by the reemergence of the disease, and suffers four times as many cases as other major cities. Due to the sheer size of the homeless population, the New York City Department of Health has issued a “Comissioner’s Order for Directly Observed Therapy” (CODOT) to ensure the expansion of the treatment in highly infectious areas such as homeless shelters. As a last resort, patients may even be detained until an adequate course of treatment is completed. An additional organization has been created: The Education and Training Unit. Conceived by the Bureau of tuberculosis control, health care providers perform “grand rounds”, visiting the many shelters throughout the city to diagnose potential cases and educate the homeless and shelter staff members. The city’s health department may also be noted for its extensive use of formerly homeless volunteers to execute policies.

Upon completing the project, we have found that the deliverance of health care to the homeless is less about management and planning than logistics. The ability to provide treatment.

Although San Francisco’s population is much smaller than other major cities, it has the fifth highest tuberculosis rate in the country. The city’s Health Care for the Homeless program has extended PPD skin testing in homeless shelters

Some topics in this essay:
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