Studies of homeless youth

Today, I present two articles related to youth homelessness. First, So, Davis, Barnes, Freese, Atella & Shlafer (2023) published “Health and Care Utilization among Youth with a History of Parental Incarceration and Homelessness” in Families, Systems, & Health. Here’s the edited abstract and impact statements:

Despite widespread recognition of the health and social risks posed by parental incarceration (PI) and homelessness, these challenges are rarely considered in unison. We sought to (a) assess the experiences of homelessness among youth with and without a history of PI and (b) compare the health and healthcare utilization among youth with a combined history of PI and homelessness. Examining data from eighth-, ninth-, and 11th-grade public school participants in the 2019 Minnesota Student Survey (N = 110,904), we calculated univariate and multivariate analyses to characterize the health status and care utilization of youth who have experienced PI, past-year homelessness, or both. We observed higher prevalence of homelessness among youth with a history of PI compared to those without. The group with dual PI-homelessness experience had a higher proportion of youth that were younger, male, and non-White; and living in poverty or urban areas compared to youth with PI history only. Even after accounting for demographic factors, the dual PI-homelessness group evidenced higher expected odds for several physical health conditions (e.g., asthma, diabetes), and differences in care utilization indicators relative to individual PI and homelessness groups. Findings suggest that PI may be overrepresented among recently homeless youth and that youth with such dual experience possess distinct, and often elevated, health service needs. Health, education, housing, and other systems may need intersectoral strategies to better identify and support this at-risk subset of youth through clinical and policy approaches. 

This study found higher rates of recent homelessness among youth who have ever had a parent incarcerated. Both homelessness and parental incarceration tracked with worse health and use of health care services, with a potentially compounding effect. Understanding and acting upon multiple marginalization among youth is a critical task to achieve health equity. 

This is a very large sample that makes sense in light of research on impacts of ACEs on health. The second study looks at a smaller sample. Bird, Jenzer & Read (2023) published “Youth Experiencing, and Youth at Risk of, Homelessness: Associations between trauma type, posttraumatic negative cognitions, and posttraumatic stress disorder” in Traumatology. Here’s the edited abstract:

Experiencing homelessness as an adolescent or young adult confers risk for trauma experiences and posttraumatic stress disorder (PTSD). Despite being a unique and at-risk group, research on the mechanisms that can impact PTSD symptom severity in this population is scant. One variable that has been found to follow both interpersonal trauma (IPT; e.g., acts of violence or neglect by a perpetrator) and noninterpersonal trauma (non-IPT; e.g., natural disasters, motor vehicle accidents) is posttraumatic cognitions (PTCs), or negative thoughts about the self, the world, and self-blame, following a traumatic experience. This study aimed to describe the experiences of IPT and non-IPT in this sample. Second, we aimed to be the first to identify how IPT and non-IPT impact PTCs for youth experiencing and youth at risk for homelessness. Finally, we examined the impact of PTCs on PTSD following both IPT and non-IPT. Data derived from a sample of youth at risk for homelessness and youth experiencing homelessness (N = 63) in Buffalo, New York, United States were analyzed. PTCs have been found to follow trauma exposure which was corroborated by mediation analyses in our study. Mediation models identified that PTCs about the self (β = .34, SE = 0.12, 95% confidence interval [CI] [.14, .6]), and self-blame (β = .14, SE = 0.07, [.01, .3]), partially mediated the relationship between IPT and PTSD. Significant mediation pathways of PTCs were not found between non-IPT and PTSD. 

Although it is not surprising that posttraumatic cognitions about the self and self-blame impact PTSD, what I find fascinating about this study is the power of interpersonal trauma. The numbers of unhoused young people is steadily growing and it may be helpful to gather information about both parental incarceration and interpersonal trauma.