RESEARCH TOPICS

RESEARCH BY TOPIC

As with other specific areas of research regarding street youth, literature regarding illness and health care issues directs service providers to focus on the specific needs and circumstances of the individual street youth. For instance, one study discussed the health care issues for youth who are lesbian, gay or bisexual (LGB). Specifically, the authors note that the nature of being homeless entails multiple risk factors, and many such risk factors increase significantly by being LGB as well.¹ Another study suggested that policies and programs focused on improving the health of homeless youth need to address the differences in illness experiences by age, gender and sampling site.² For instance, the authors discuss gender-specific health care services for male street youth. They suggest that having male outreach workers as well as male clinic staff and medical providers can help increase access to care for male youth. Similarly, with respect to female health care issues, the authors provide examples of interventions which are female-focused, such as allowing a friend to accompany the sick street youth in the examination room and developing safety plans for the next illness. The authors of "Embracing Street Culture: Fitting Health Care into the Lives of Street Youth" argue for the use of youth-centric, rather than youth-friendly, programs.³ In this vein, they note: "Our client-centered orientation responds to what our patients require from us rather than our deciding what they need in advance. However, we do provide services that often they do not request initially but which we think are important to have available to them. These services include mental health and substance use services. The key to successfully integrating these services is in presenting them to the youth in a casual manner and in having people who can tailor their approach and services to the individual client." The organization at the center of the above study constantly seeks input and ongoing evaluation of the clinic from the street youth which the authors believe is at the core of a youth-centric program.

Preventative health strategies are the focus of much of the research in this area. One author suggests that combining street outreach programs and drop-in centers will assist with improving health and reducing emotional distress among homeless youth. Specifically, the author states: "[e]ssential services include development of caring relationships, case management services, life skills training, support groups, and community health referrals. Services such as these that help the adolescent feel more connected have been advanced as protective for risk behaviors such as depression/suicide, violence, substance abuse, and sexuality."⁴

One of the major and critical themes within this particular area of research is the barriers that street youth face when accessing health care services. Some of these barriers include: confidentiality issues, distrust of adults and professional agencies, denial of need for care, and lack of coordinated services and outreach. One author suggests some solutions in order to alleviate some of the barriers to health care services: "Developmental issues of adolescents need to be addressed in any teen clinic, and structural issues such as providing low-cost services at times and locations convenient to the population being served are essential."⁵ In one study, the major barrier to health care was related to those youth under the age of 18 who were not always able to consent for their own care. The authors suggest that "[i]t is important for health care providers working with homeless adolescents to advocate for saner adolescent consent laws. The results of this study also highlight the need to educate providers, as well as the young people and people who work with them, about a young person's right to consent for needed health care while homeless."⁶

Coordination among health care providers is also a relevant topic in street youth literature. In one study in Seattle, integration and coordination between the medical van and the clinics has yielded positive results. As well, the three agencies providing health care services for homeless youth meet on a regular basis to coordinate activities and perform health advocacy work. The coalition recently developed a "health care passport" brochure with information on the three agencies, as well as maps and bus route information, to give out to youth.⁷

_{¹J.M. Van Leeuwen et. al, "Lesbian, Gay and Bisexual Homeless Youth: An Eight-City Public Health Perspective," Child Welfare Journal, Vol. 85(2), pp. 151-170, March-April 2006. Special issue: LGBTQ Youth in Child Welfare.
²J. Ensign and M. Bell, "Illness Experiences of Homeless Youth," Qualitative Health Research, Vol. 14(9), pp. 1239-1254, November 2004.
³P. Barry et. al, "Embracing Street Culture: Fitting Health Care into the Lives of Street Youth," Journal of Transcultural Learning, Vol. 13, No. 2, pp. 145-152, April 2002.
⁴M.A. Taylor-Seehafer, "Positive Youth Development: Reducing the Health Risks of Homeless Youth," MCN: The American Journal of Maternal/Child Nursing, Vol. 29(1), pp. 36-40, Jan.-Feb. 2004. Special Issue: Special Issue on Adolescence.
⁵G.M. Geber, "Barriers to Health Care for Street Youth," Journal of Adolescent Health, Vol. 21, No. 5, pp. 287-290, November 1997.
⁶J. Ensign and M. Bell, "Illness Experiences of Homeless Youth," Qualitative Health Research, Vol. 14(9), pp. 1239-1254, November 2004.
⁷J. Ensign and M. Bell, "Illness Experiences of Homeless Youth," Qualitative Health Research, Vol. 14(9), pp. 1239-1254, November 2004.}