Physical and Reproductive Health

Youth who have run away and youth affected by homelessness experience negative physical and reproductive health consequences as a result of their experiences and face a range of barriers in accessing health care. Homeless teens are more than twice as likely to go to school hungry and nearly five times as likely to get fewer than 4 hours of sleep. These factors can contribute to a variety of negative health outcomes, including increased risk of illness, chronic stress, and a greater risk of obesity and diabetes.¹ In addition, in some states, youth do not have the right to consent to health care, which limits access to both preventive and emergency health care.² As a result of many barriers, youth experiencing homelessness are less likely to have access to medical care.

Health

• Youth experiencing homelessness face higher rates of chronic health problems compared with their peers, and a lack of health care often results in more advanced stages of chronic health problems.³
• Youth experiencing homelessness have a higher incidence of trauma-related injuries.⁴
• Accessing basic health care and dental services can be a challenge for young people experiencing homelessness or housing instability. One study found that among youth experiencing homelessness, only 37 percent reported seeing a doctor or nurse, and only 53 percent reported seeing a dentist in the last 12 months.⁵
• Studies of youth experiencing homelessness in families also primarily reported poorer health compared with other youth experiencing poverty and the general population.⁶

Teen Pregnancy and Parenting

• Among young people ages 18 to 25 who experience homelessness, 44 percent of the women are pregnant or mothers, and 28 percent of the men have a pregnant partner or are fathers.⁷
• Youth may experience homelessness as a result of family conflict resulting from teen pregnancy.⁸
• Relatively few homeless service providers serve pregnant and parenting young people. A survey among providers found that of 142 homeless youth service providers, 35 percent served parents ages 18 to 25, and 21 percent served parents under age 18.⁹
• Young parents struggle to maintain relationships while trying to obtain shelter or transitional housing because homeless service providers in their community only serve single mothers or married couples with children.¹⁰
• A majority of pregnant and parenting unaccompanied youth experiencing homelessness cite affordable child care as a current need that is unmet.¹¹

HIV/STIs

• Youth experiencing homelessness have a higher risk of contracting sexually transmitted infections (STIs) resulting from engaging in risky sexual behaviors, such as unprotected sex, multiple partners, and exchange sex.¹²
• People experiencing homelessness or housing instability are more likely to engage in activities associated with increased chances of HIV transmission, including injection drug use and risky sexual behaviors.¹³ Young people with unstable housing experience up to 12 times greater risk of HIV infection,¹⁴ and young people with HIV experience higher rates of homelessness than do people living with HIV in other age groups.¹⁵
• Among Ryan White HIV/AIDS Program clients receiving medical care, youth clients with HIV who experience unstable housing have lower rates of viral suppression (75.3 percent) compared with the national average for all youth (83.8 percent).¹⁶
• In a study of youth experiencing homelessness, 57 percent of the respondents reported having a medical issue, and of those, 6 percent had a STI and 3 percent had HIV.¹⁷

Barriers

Runaway youth and youth experiencing homelessness face a range of barriers that make access to health care more difficult. Examples of these include

• a lack of transportation,
• address requirements for paperwork,
• lengthy processing time for paperwork,
• a lack of financial resources or health insurance,
• a lack awareness about where and how to access health care supports,
• confidentiality issues,
• a need for parental consent,
• distrust of adults and professional agencies,
• denial on the part of the youth of need for care, and
• a lack of coordinated services and outreach for youth experiencing homelessness.¹⁸

In addition, for many of these young people, health care may not be a priority over day-to-day survival issues.19

Federal programs and shelters can help provide services to youth or connect them to appropriate services to ensure that they receive the health care supports they need and prevent chronic health issues. The Centers for Disease Control and Prevention (CDC) and U.S. Department of Health and Human Development (HUD) are exploring ways to integrate HIV/STD testing, prevention, and treatment into HUD programs for unstably housed youth and young adults. Maternity group homes provide additional services for pregnant and parenting youth to educate them in taking care of a child. Learn more about the different types of federal programs. A range of prevention efforts also focus on preventing HIV and other STDs among youth experiencing homelessness and runaway youth. One example is Street Smart, which you can learn more about on the CDC website.

Resources

Health Coverage for Homeless and At-Risk Youth (PDF, 4 pages)
This fact sheet describes what federal health care coverage youth experiencing homelessness are eligible for, what services are covered, and how to sign up.

Primer on How to Use Medicaid to Assist Persons Who are Homeless to Access Medical, Behavioral Health, and Support Services (PDF, 113 pages)
This document from the Centers for Medicare and Medicaid Services provides information to help connect people experiencing homelessness with critical Medicaid benefits.

The Administration for Children and Families: Maternity Group Homes
The Maternity Group Home Program (MGH) supports community-based, adult-supervised, transitional living arrangements for homeless pregnant or parenting young people between the ages of 16 and under 22, as well as their dependent children. Services are provided for up to 21 months or until a young person turns 18 years old if they enter a program at age 16. MGH grantees must teach young people parenting skills as well as child development, family budgeting, health and nutrition, and other skills.

Housing-Unstable Youth and HIV Resources Webinar
Hosted by HUD and the CDC, this webinar provides various resources.

HRSA National Training and Technical Assistance Partners
HRSA funds two organizations—the National Health Care for the Homeless Council and the Corporation for Supportive Housing—to provide training and technical assistance to health professionals to improve awareness of, screening for, and interventions to remove barriers to health care access and tailor services to the unique needs of youth experiencing homelessness. The training materials are publicly available.

Chapin Hall: Youth Experiencing Homelessness Who Are Pregnant or Parenting
This comprehensive and easy to read report from Chapin Hall discusses recent data and findings on youth experiencing homelessness while also pregnant or parenting. It addresses common causes, current challenges in serving this population, and provides recommendations for moving forward.

Ryan White HIV/AIDS Program Compass Dashboard
This dashboard provides users an opportunity to interact with and visualize the reach, impact, and outcomes of the Ryan White HIV/AIDS Program.

Homelessness Programs and Resources: SAMHSA
The Homeless and Housing Resource Center, supported by the Substance Abuse and Mental Health Services Administration (SAMHSA) shares state-of-the-art knowledge and promising practices to prevent and end homelessness through the following:

• Training and technical assistance
• Publications and materials
• Online learning opportunities
• Networking and collaboration

Runaway and Homeless Youth Training and Technical Assistance Center
This centralized national resource for Runaway and Homeless Youth (RHY) grantees is funded by the Family and Youth Services Bureau at the U.S. Department of Health and Human Services. Training and technical assistance services are directed at assisting RHY grantees to engage in continuous quality improvement of their services and to build their capacity to effectively serve runaway youth and youth experiencing homelessness.

Connecting Unaccompanied Youth Experiencing Homelessness to Social Security Disability Benefits (PDF, 8 pages)
This issue brief, developed by the SAMHSA SOAR TA Center, explores how using the SOAR model can increase access to income and health insurance, facilitate housing stability, and support unaccompanied youth pursing education and vocational goals.

References