{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:32:12Z","timestamp":1767652332121},"reference-count":25,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi220774-4\"><jats:title>Importance<\/jats:title><jats:p>A lack of timely and high-quality data is an ongoing challenge for public health responses to COVID-19 among people experiencing homelessness (PEH). Little is known about the total number of cases of COVID-19 among PEH.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220774-5\"><jats:title>Objective<\/jats:title><jats:p>To estimate the number of COVID-19 cases among PEH and compare the incidence rate among PEH with that in the general population.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220774-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cross-sectional study used data from a survey distributed by the Centers for Disease Control and Prevention to all US state, district, and territorial health departments that requested aggregated COVID-19 data among PEH from January 1, 2020, to September 30, 2021. Jurisdictions were encouraged to share the survey with local health departments.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220774-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The primary study outcome was the number of cases of COVID-19 identified among PEH. COVID-19 cases and incidence rates among PEH were compared with those in the general population in the same geographic areas.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220774-8\"><jats:title>Results<\/jats:title><jats:p>Participants included a population-based sample of all 64 US jurisdictional health departments. Overall, 25 states, districts, and territories completed the survey, among which 18 states (72.0%) and 27 localities reported COVID-19 data among PEH. A total of 26\u202f349 cases of COVID-19 among PEH were reported at the state level and 20\u202f487 at the local level. The annual incidence rate of COVID-19 among PEH at the state level was 567.9 per 10\u202f000 person-years (95% CI, 560.5-575.4 per 10\u202f000 person-years) compared with 715.0 per 10\u202f000 person-years (95% CI, 714.5-715.5 per 10\u202f000 person-years) in the general population. At the local level, the incidence rate of COVID-19 among PEH was 799.2 per 10\u202f000 person-years (95% CI, 765.5-834.0 per 10\u202f000 person-years) vs 812.5 per 10\u202f000 person-years (95% CI, 810.7-814.3 per 10\u202f000 person-years) in the general population.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi220774-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>These results provide an estimate of COVID-19 incidence rates among PEH in multiple US jurisdictions; however, a national estimate and the extent of under- or overestimation remain unknown. The findings suggest that opportunities exist for incorporating housing and homelessness status in infectious disease reporting to inform public health decision-making.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2022.27248","type":"journal-article","created":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T15:12:06Z","timestamp":1660835526000},"page":"e2227248","source":"Crossref","is-referenced-by-count":10,"title":["Incidence of COVID-19 Among Persons Experiencing Homelessness in the US From January 2020 to November 2021"],"prefix":"10.1001","volume":"5","author":[{"given":"Ashley A.","family":"Meehan","sequence":"first","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Thomas","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"},{"name":"Oak Ridge Institute for Science and Education Fellowship, Oak Ridge Associated Universities, Oak Ridge, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Libby","family":"Horter","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"},{"name":"Goldbelt C6, LLC, Chesapeake, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan","family":"Schoonveld","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"},{"name":"Oak Ridge Institute for Science and Education Fellowship, Oak Ridge Associated Universities, Oak Ridge, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea E.","family":"Carmichael","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"},{"name":"Oak Ridge Institute for Science and Education Fellowship, Oak Ridge Associated Universities, Oak Ridge, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mitra","family":"Kashani","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"},{"name":"Oak Ridge Institute for Science and Education Fellowship, Oak Ridge Associated Universities, Oak Ridge, Tennessee"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Diana","family":"Valencia","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Mosites","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, COVID-19 Emergency Response, Atlanta, Georgia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10","published-online":{"date-parts":[[2022,8,18]]},"reference":[{"issue":"22","key":"zoi220774r2","doi-asserted-by":"publisher","first-page":"2585","DOI":"10.1016\/j.jacc.2018.02.077","article-title":"Cardiovascular disease and homelessness.","volume":"71","author":"Baggett","year":"2018","journal-title":"J Am Coll Cardiol"},{"issue":"10","key":"zoi220774r3","doi-asserted-by":"publisher","first-page":"1078","DOI":"10.1176\/appi.ps.202000244","article-title":"COVID-19 emergency reforms in Massachusetts to support behavioral health care and reduce mortality of people with serious mental illness.","volume":"71","author":"Bartels","year":"2020","journal-title":"Psychiatr Serv"},{"issue":"5","key":"zoi220774r5","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1378\/chest.125.5.1719","article-title":"Obstructive lung disease among the urban homeless.","volume":"125","author":"Snyder","year":"2004","journal-title":"Chest"},{"issue":"11","key":"zoi220774r6","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofaa477","article-title":"Risk factors for severe acute respiratory syndrome coronavirus 2 infection in homeless shelters in Chicago, Illinois\u2014March-May, 2020.","volume":"7","author":"Ghinai","year":"2020","journal-title":"Open Forum Infect Dis"},{"issue":"1","key":"zoi220774r7","doi-asserted-by":"publisher","first-page":"42","DOI":"10.7326\/M20-3799","article-title":"Characteristics of COVID-19 in homeless shelters: a community-based surveillance study.","volume":"174","author":"Rogers","year":"2021","journal-title":"Ann Intern Med"},{"issue":"7","key":"zoi220774r8","doi-asserted-by":"publisher","first-page":"1470","DOI":"10.3201\/eid2607.200282","article-title":"High contagiousness and rapid spread of severe acute respiratory syndrome coronavirus 2.","volume":"26","author":"Sanche","year":"2020","journal-title":"Emerg Infect Dis"},{"issue":"21","key":"zoi220774r9","doi-asserted-by":"publisher","first-page":"2191","DOI":"10.1001\/jama.2020.6887","article-title":"Prevalence of SARS-CoV-2 infection in residents of a large homeless shelter in Boston.","volume":"323","author":"Baggett","year":"2020","journal-title":"JAMA"},{"issue":"2","key":"zoi220774r10","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1093\/cid\/ciaa1071","article-title":"Coronavirus disease 2019 outbreak in a San Francisco homeless shelter.","volume":"73","author":"Imbert","year":"2021","journal-title":"Clin Infect Dis"},{"key":"zoi220774r11","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.101032","article-title":"SARS-Cov-2 prevalence, transmission, health-related outcomes and control strategies in homeless shelters: systematic review and meta-analysis.","volume":"38","author":"Mohsenpour","year":"2021","journal-title":"EClinicalMedicine"},{"issue":"17","key":"zoi220774r12","doi-asserted-by":"publisher","first-page":"521","DOI":"10.15585\/mmwr.mm6917e1","article-title":"Assessment of SARS-CoV-2 infection prevalence in homeless shelters\u2014four US cities, March 27\u2013April 15, 2020.","volume":"69","author":"Mosites","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"17","key":"zoi220774r13","doi-asserted-by":"publisher","first-page":"523","DOI":"10.15585\/mmwr.mm6917e2","article-title":"COVID-19 outbreak among three affiliated homeless service sites\u2014King County, Washington, 2020.","volume":"69","author":"Tobolowsky","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"zoi220774r19","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1186\/1471-2458-7-320","article-title":"Socio-demographic and clinical characteristics of re-presentation to an Australian inner-city emergency department: implications for service delivery.","volume":"7","author":"Moore","year":"2007","journal-title":"BMC Public Health"},{"issue":"6","key":"zoi220774r20","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.15850","article-title":"COVID-19 case investigation and contact tracing in the US, 2020.","volume":"4","author":"Lash","year":"2021","journal-title":"JAMA Netw Open"},{"issue":"9","key":"zoi220774r21","doi-asserted-by":"publisher","first-page":"e2978","DOI":"10.1093\/cid\/ciaa1340","article-title":"Coronavirus disease 2019 (COVID-19) prevalences among people experiencing homelessness and homelessness service staff during early community transmission in Atlanta, Georgia, April-May 2020.","volume":"73","author":"Yoon","year":"2021","journal-title":"Clin Infect Dis"},{"issue":"27","key":"zoi220774r22","doi-asserted-by":"publisher","first-page":"864","DOI":"10.15585\/mmwr.mm6927a3","article-title":"Race\/ethnicity, underlying medical conditions, homelessness, and hospitalization status of adult patients with COVID-19 at an urban safety-net medical center\u2014Boston, Massachusetts, 2020.","volume":"69","author":"Hsu","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"42","key":"zoi220774r23","doi-asserted-by":"publisher","first-page":"1522","DOI":"10.15585\/mmwr.mm6942e2","article-title":"Excess deaths associated with COVID-19, by age and race and ethnicity\u2014United States, January 26-October 3, 2020.","volume":"69","author":"Rossen","year":"2020","journal-title":"MMWR Morb Mortal Wkly Rep"},{"issue":"4","key":"zoi220774r25","doi-asserted-by":"publisher","first-page":"344","DOI":"10.1016\/j.jclinepi.2007.11.008","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.","volume":"61","author":"von Elm","year":"2008","journal-title":"J Clin Epidemiol"},{"key":"zoi220774r14","author":"Mosites","year":"2022"},{"key":"zoi220774r1","unstructured":"US Department of Housing and Urban Development. 2020 AHAR: Part 1\u2014PIT estimates of homelessness in the US. Published March 2021. Accessed October 18, 2021. https:\/\/www.huduser.gov\/portal\/datasets\/ahar\/2020-ahar-part-1-pit-estimates-of-homelessness-in-the-us.html"},{"key":"zoi220774r4","unstructured":"Kuhn? R, Richards? J, Roth? S, Clair? K. Homelessness and public health in Los Angeles. March 31, 2020. Accessed October 28, 2021. https:\/\/escholarship.org\/uc\/item\/2gn3x56s"},{"key":"zoi220774r15","unstructured":"USAFacts. US COVID-19 cases and deaths by state. Accessed October 28, 2021. https:\/\/usafacts.org\/visualizations\/coronavirus-covid-19-spread-map"},{"key":"zoi220774r16","unstructured":"US Census Bureau. County population totals: 2010-2019. Accessed October 18, 2021. https:\/\/www.census.gov\/data\/datasets\/time-series\/demo\/popest\/2010s-counties-total.html"},{"key":"zoi220774r17","unstructured":"US Department of Housing and Urban Development Exchange. HDX FAQs: FAQ ID 1818. Published December 2014. Accessed October 28, 2021. https:\/\/www.hudexchange.info\/faqs\/reporting-systems\/homelessness-data-exchange-hdx\/pit\/pit-general\/for-purposes-of-the-point-in-time-pit-count-who-does-hud-consider\/#:~:text=HUD's%20PIT%20count%20is%20limited,the%20time%20of%20the%20count"},{"key":"zoi220774r18","unstructured":"Dean? AG, Sullivan? KM, Soe? MM. OpenEpi: open source epidemiologic statistics for public health. Updated April 6, 2013. Accessed June 28, 2022. http:\/\/www.OpenEpi.com"},{"key":"zoi220774r24","unstructured":"US Department of Housing and Urban Development Exchange. Homeless management information system. Accessed October 18, 2021. https:\/\/www.hudexchange.info\/programs\/hmis\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2795298\/meehan_2022_oi_220774_1659727477.50761.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,8,18]],"date-time":"2022-08-18T15:12:10Z","timestamp":1660835530000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2795298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,18]]},"references-count":25,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2022.27248","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,18]]}}}