Health Issues in the Homeless Youth Population

Pediatric Annals (Impact Factor: 0.29). 04/2012; 41(4):154-6. DOI: 10.3928/00904481-20120307-12
Source: PubMed
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    ABSTRACT: HIV risk behaviors and seroprevalence are particularly high among street youth. Though many programs have been designed to serve them, street youth have low rates of service utilization. The aim of this street-based, ethnographic project was to study the social and cultural context of street life in this population. Data were collected by participant observation, exploratory interviews and semi-structured interviews. Twenty street youth (15-23 years old; six female), recruited from street sites in San Francisco, participated in the interviews. Field notes and transcriptions were analyzed using an inductive technique for model building. This analysis yielded a proposed model of the life cycle of youth homelessness. In the first on the street stage, youth face an intense psychological feeling of outsiderness, and an urgency to meet basic needs. These stresses either lead to an escape from street life or to a process of acculturation to the street. Initiation to the street is facilitated by street mentors, who provide youth with survival skills. In the stasis stage, youth reach a tenuous equilibrium in which they can meet their basic needs. A strong street ethic allows youth to rationalize significant conflicts and frequent physical suffering. Youth in stasis are repeatedly thrown into disequilibrium, crises that frequently cause them to come into greater contact with mainstream society. After repeated episodes of disequilibrium, some youth extricate themselves from street life, finding a new identity in mainstream society. Otherwise, youth return to the street, in an episode of recidivism. The life cycle model suggests that street youth who are most open to intervention are those who are in transitional states, i.e., those who have just arrived on the street or those who are in crisis (disequilibrium). If this model is validated in a larger population of youth, programs that are aimed at these two stages in the life cycle could potentially effectively complement existing programs, which are usually focused on youth in stasis.
    Social Science [?] Medicine 06/2002; 54(10):1497-512. DOI:10.1016/S0277-9536(01)00128-9 · 2.56 Impact Factor
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    ABSTRACT: The purposes of this evaluation project were to describe a group of homeless adolescents and street-involved youth who utilized a mobile unit that provided medical and mental healthcare services and to assess the efficacy of the services provided in reducing their health risk behaviors. The records of 95 youth aged 15-25 years who used the medical mobile unit for an average of 14 months were examined and evaluated according to the national health indicators related to risk reduction. Current literature related to health risk behavior among homeless youth was reviewed, synthesized, and provided the background for this article. Data were obtained from the records of mostly heterosexual youth with a mean age of 20.5 years. Approximately one third of the participants were high school graduates and most were without health insurance. Living situations were transient including friends, shelters, crash pads, or the streets. Abuse accounted for the majority leaving home. Psychiatric conditions and substance abuse were common. Medical conditions were related to transient living situations, substance abuse, and sexual activity. Success of the program was associated with sustained counseling, stabilizing youth on psychotropic medications, decreasing substance use, providing birth control and immunizations, and treating medical conditions. Homeless youth are one of the most underserved vulnerable populations in the United States with limited access and utilization of appropriate healthcare services. Nurse practitioners often serve as care providers but are also in a position to effectively lobby to improve health care for homeless youth through professional organizations and community activism. Furthermore, when designing and evaluating healthcare services, multidisciplinary teams need to consider risk reduction for homeless youth in the context of their environment.
    Journal of the American Academy of Nurse Practitioners 12/2008; 20(11):567-75. DOI:10.1111/j.1745-7599.2008.00358.x · 0.71 Impact Factor
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    ABSTRACT: The goal of this study was to identify differences between gay, lesbian, bisexual, and transgender (GLBT) homeless youths and their heterosexual counterparts in terms of physical and mental health difficulties. A sample of 84 GLBT adolescents was matched in regard to age and self-reported gender with 84 heterosexual adolescents. The 2 samples were compared on a variety of psychosocial variables. GLBT adolescents left home more frequently, were victimized more often, used highly addictive substances more frequently, had higher rates of psychopathology, and had more sexual partners than heterosexual adolescents. Homeless youths who identify themselves as members of sexual minority groups are at increased risk for negative outcomes. Recommendations for treatment programs and implications for public health are discussed.
    American Journal of Public Health 06/2002; 92(5):773-7. DOI:10.2105/AJPH.92.5.773 · 4.23 Impact Factor