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

Investigations into the policies of three major U.S. cities (New York, San Francisco, Chicago ) have presented the current state of tuberculosis treatment amongst the homeless. Information about the disease and its epidemiology was first obtained through articles found in the library. The general history of public health policy against the disease was then also researched in published articles found in the library and on the internet. The current programs in each respective city were then researched by accessing the city's department of public health homepages on the internet and by calling faculty in the departments for specific information.

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.

There a few clearly needed improvements in public health policy against tuberculosis. Firstly, an increase in federal funding is imperative to the extension of DOT therapy. In addition, there is a great need for increased man-power in the homeless areas, and a need for more education amongst the homeless and their providers. Additional projects could explore specific aspects of public health policy such as the acquisition and allocation of funding, or the development of educational programs in the community and their actual effectiveness in preventing the spread of th

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Approximate Word count = 944
Approximate Pages = 4 (250 words per page double spaced)