Homeless and runaway youths’ access to health care

Klein, Jonathan D.; Woods, Amie Hall; Wilson, Karen M.; Próspero, Moisés; Greene, Jody; Ringwalt, Christopher L.

doi:10.1016/s1054-139x(00)00146-4

Cited by 103 publications

(83 citation statements)

References 15 publications

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“…When compared to nonstreet youth, street youth suffer from higher rates of medical problems, such as trauma; infectious diseases and sexual transmitted diseases; and dermatological, gynecological, gastrointestinal, musculoskeletal, and other physical ailments (Ensign & Gittelsohn, 1998;McKay, 2000;Reuler, 1991;Haley et al, 1998). In sum, street youth are in high need of medical services (Ensign, 1998;Klein et al, 2000;Reuler, 1991).…”

Section: Medical Servicesmentioning

confidence: 99%

Interventions With Street Youth: A Commentary on the Practice-Based Research Literature

Karabanow¹,

Clement²

2004

Brief Treatment and Crisis Intervention

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Section: Medical Servicesmentioning

confidence: 99%

Interventions With Street Youth: A Commentary on the Practice-Based Research Literature

Karabanow¹,

Clement²

2004

Brief Treatment and Crisis Intervention

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“…19 Adolescents who participate in these programs may be able to obtain care at private doctor's offices, hospital outpatient clinics, community health centers, public health clinics, shelter clinics, free youth clinics, clinics for runaway youth, family planning clinics, and emergency departments. 20 Treatment for sexually transmitted infections and family planning are also often included in these settings because of the large proportion of youth who need these health care services. [21][22][23][24] Adolescents in different high-risk settings differ substantially in their actual and perceived access to health services.…”

Section: Health Care Services In High-risk Settingsmentioning

confidence: 99%

“…20 Many of these youth at high risk are not aware of the health care facilities in their neighborhood or the services these facilities offer. 9,10,20 Street youth lack transportation, insurance, and confidence in using the health care system, and those in shelters or other facilities lack knowledge about how to use insurance or other financing available for health care services outside of the place in which they board. When they reach health care facilities, language barriers, behavior problems, or socialization difficulties may lead to poor communication about their health.…”

Section: Health Care Services In High-risk Settingsmentioning

confidence: 99%

“…Medical care is frequently mandated for youth in shelters and juvenile residential facilities. 20 Two common barriers to vaccination, cost and access, can be overcome because both health care professionals and programs that subsidize vaccine and vaccine-administration fees are generally available in these facilities.…”

Section: Health Care Services In High-risk Settingsmentioning

confidence: 99%

“…Lack of partnership between the facility and the local health departments may limit knowledge of staff about recommended preventive services for adolescents, lack of medical charts, lack of consent procedures, and unreliability of the funding stream for facilities and prevention programs. 20,[28][29][30][31] …”

Section: Health Care Services In High-risk Settingsmentioning

confidence: 99%

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Vaccinating Adolescents in High-Risk Settings: Lessons Learned From Experiences With Hepatitis B Vaccine

Sneller¹,

Fishbein²,

Weinbaum³

et al. 2008

Pediatrics

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Meeting the health needs of adolescents who live in high-risk settings such as homeless shelters, migrant camps, juvenile detention centers, prisons, and other types of residential facilities presents many challenges. Although there is no doubt that adolescents in many high-risk settings are at increased risk for hepatitis B and human papillomavirus, acute medical and psychological problems may consume all of the provider's time and resources. Potential health threats such as vaccinepreventable diseases must necessarily be given lower priority. Lack of vaccination expertise, supplies, and access to records further complicate delivery of vaccines. Since the 1990s, a number of approaches have been used to deliver hepatitis B vaccine to adolescents in many high-risk settings. Close collaboration among state and federal programs, local health departments, and community-based organizations has been necessary to introduce and sustain the delivery of vaccines to these young people. Medicaid, Statute 317 of the Public Health Service Act, the Vaccines for Children program, and State Children's Health Insurance Program have been used to finance vaccinations for adolescents 18 years or younger, and the expanded Medicaid option in the Foster Care Independence Act of 1999 has been used for adolescents older than 18 years of age. A number of states allow adolescents under age 18 to consent to their own hepatitis B vaccination under laws passed to allow treatment of sexually transmitted infections without parental consent. In this article, we present the experiences of several model programs that developed successful hepatitis B vaccination programs in venues that serve adolescents at risk, the important role of state laws and state agencies in funding immunization and other preventive health services for adolescents in high-risk situations, and discuss barriers and means to resolve them. I N THEIR SENTINEL 1993 report, the National Research Council proposed that the focus for addressing high-risk behaviors by adolescents should move from the individual adolescents to the settings in which these adolescents live. 1 These settings include those that serve adolescents who are unauthorized migrants or homeless and those who are in alternative schools, detention centers, jails, and prisons (Table 1). [2][3][4][5][6] The populations served in these settings were formally defined in the McKinney-Vento Act, which was signed into law in 1987. 7 Many of these settings have long been the focus of special efforts to deliver hepatitis B vaccine and serve populations especially likely to benefit from new vaccines for adolescents, including those against human papillomavirus, pertussis, and meningococcal meningitis. This report excludes adolescents who are displaced as a result of natural or man-made disasters, refugees, and foreign students.Health care, including immunization, for the adolescents considered here is generally provided by local, state, and federal programs and their grantees. Unfortunately, missing vaccinations are b...

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Homelessness and Health Care Access After Emancipation

Kushel¹,

Yen²,

Gee³

et al. 2007

Arch Pediatr Adolesc Med

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Objective: To estimate the association between housing status and health care access and outcomes among young adults aging out of the child welfare system. Results: Among the 345 emancipated participants, 14.2% experienced homelessness and 39.4% were unstably housed. In multivariate analysis of emancipated participants, homelessness was associated with being uninsured (AOR, 3.41; 95% confidence interval, 1.52-7.63) and having unmet need for health care (AOR, 3.26; 95% confidence interval, 1.40-7.56); it was not associated with not having had ambulatory care. In multivariate analysis of all participants, housing status was not associated with reporting fair or poor health at follow-up or, among women, with having had a pregnancy. Conclusion:Having had an episode of homelessness after emancipation is associated with worse health access, but not worse outcomes, among youth emancipated from foster care.Arch Pediatr Adolesc Med. 2007;161(10):986-993

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Homeless and runaway youths’ access to health care

Cited by 103 publications

References 15 publications

Interventions With Street Youth: A Commentary on the Practice-Based Research Literature

Interventions With Street Youth: A Commentary on the Practice-Based Research Literature

Vaccinating Adolescents in High-Risk Settings: Lessons Learned From Experiences With Hepatitis B Vaccine

Homelessness and Health Care Access After Emancipation

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