The most comprehensive study to date on the health of the homeless in New York City found their condition to be far worse than even the doctors who interact with them daily had thought. The survey of more than 100,000 adults who spent at least one night in a homeless shelter from 2001 through 2003 was released yesterday. Study data show the death rate for the homeless is twice that of other New Yorkers. AIDS and substance abuse account for one-third of all homeless deaths but less than 5 percent of deaths in the general population.

The study is part of an effort by the Bloomberg administration to collect reliable information on the homeless, and then base policy decisions on the data, which were compiled by the Department of Homeless Services and the Department of Health and Mental Hygiene. Fran S. Winter, acting commissioner for DHS, said the report shows "a willingness to hold ourselves accountable through the collection of data."

A major concern is the spread of infectious diseases measured by the survey, said city officials. The report found a homeless person was seven times as likely to die from AIDS as someone in the general population, and the rate of new HIV diagnosis was 16 times higher among the homeless. It also revealed that women had higher HIV rates than men - to the surprise of some public health officials.

In response, the city will expand HIV surveillance among the homeless and increase the use of rapid HIV tests, which are currently only available in men's shelters.

By matching the names of those who stayed in a city shelter with those listed on the TB registry, the survey found the TB rate among the homeless to be 11 times that of other New Yorkers. From 2001 through 2003, there were 3,436 TB cases reported in the city, with 117 cases among adults who spent at least one night in a homeless shelter.

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