HEALTH-STATUS AND SERVICE USE - COMPARISON OF ADOLESCENTS AT A SCHOOL-BASED HEALTH CLINIC WITH HOMELESS ADOLESCENTS

Objective: To examine the health status, risk-taking behaviors, and ac cess-to-care issues of shelter-based homeless adolescents compared wit h a domiciled adolescent population from the same large US city. Subje cts: The samples consisted of 109 youth (aged 12-17 years) in emergenc y shelters and 1010 youth using school-based inner-city clinics. Inter ventions: Adolescents completed a health history, which was followed b y a physical examination. Results: Homeless youth began sexual activit y at an earlier age (median, 12 vs 13 years for homeless vs school-bas ed youth), were less likely to have used birth control at their first sexual experience, and were twice as likely to have ever been pregnant . Oral and anal sex, same-sex activities (boys only), multiple sex par tners in the past 30 days, depression, and substance use behaviors wer e reported more often by the homeless sample. The homeless youth were twice as likely to have visited an emergency department in the past 12 months. After adjustment for other risk factors, homelessness was an independent predictor of depression (adjusted odds ratio [OR], 7.0; 95 % confidence interval [CI], 3.9-12.6), emergency department use in the past 12 months (adjusted OR, 1.8; 95% CI, 1.2-2.7), and history of pr egnancy (adjusted OR, 2.6; 95% CI, 1.3-5.2) in the final logistic regr ession models. Conclusion: This study confirms and extends past resear ch indicating that homeless youth exhibit more risk-taking behaviors a nd suffer from poorer overall health than do nonhomeless youth.