SHELTER-BASED HOMELESS YOUTH - HEALTH AND ACCESS TO CARE

Objectives: To compare the self-reported risk-taking behaviors, health status, and access to care issues of 2 samples of shelter-based homel ess youth who had previously been street youth (youth on streets or do ubling-up with friends or lovers) and systems youth (youth involved in foster care) and to examine information on the etiology of homelessne ss, including parent or family of origin risk factors for both samples . Design: The study population consisted of 109 shelter-based homeless youth: 41 street youth and 68 systems youth. A chart audit was comple ted on all youth, noting documentation of past health problems, reason s for shelter placement, and parental risk factors. Adolescents from b oth samples completed a health history questionnaire followed by a phy sical examination. Differences between the 2 samples for behaviors and disease diagnoses were examined using chi(2) and 2-tailed t tests. Re sults: The street youth exhibited greater risk-taking behaviors and su ffered from poorer health status and access to care than did systems y outh. The main differences were in substance using and high-risk sexua l behaviors. The street youth were more likely to report previous expo sure to violence and having been victims of forced sex. Self-reported risk behaviors, including sexual activity and substance abuse were cor roborated by more objective information on these items from medical re cord information. The street youth were more likely to be medically un insured, to have used an emergency department in the past year, and to have used an emergency department for their last care. Conclusions: T here are important variations in health needs between samples of homel ess youth, often overlooked in health planning for this population. Kn owledge of parent or family of origin risk factors and causes of homel essness provides important contextual information for understanding th e risk behaviors and health states of homeless youth.