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Original Articles

Risk Behaviors and Health Care Utilization Among Homeless Youth: Contextual and Racial Comparisons

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Pages 158-174 | Published online: 02 Jul 2015
 

ABSTRACT

This study analyzes survey and focus group data from 54 homeless youth from a drop-in center and residential shelter in the Los Angeles area. Youth from the drop-in center reported higher levels of risk-taking behaviors as well as less access, lower quality of care, and overall more negative views regarding health care utilization than those from the residential shelter. Effective interventions targeting homeless youth must be sensitive to the fact that this vulnerable population is heterogeneous. No single approach will address the specific needs, circumstances, and perspectives of all subgroups in the target population, necessitating a multifaceted design.

Acknowledgments

The authors wish to thank the staff at the two research sites for assisting in interview design, subject recruitment, and providing the facilities for the focus group interviews. Also, our research would have been impossible without the willingness of participating youth to share their insights with us.

This research was funded by a grant from the UCLA AIDS Institute (“Enhancing Receipt of Health and Drug-Related Preventive Services for Homeless Youth”; PI Adeline Nyamathi). The first author was supported by the National Institute of Mental Health (T32 MH-19127, PI Oscar Grusky) through UCLA's Postdoctoral Fellowship in Psychosocial Issues and Mental Health Services for Persons Living with HIV/AIDS Research Training Program.

Notes

*p < .05

**p < .01.

1. See Smereck and Hockman (1998) for further discussion of this tendency to treat homeless youth as a homogenous group, ignoring specific living situations (i.e., shelter versus street).

2. Bivariate and multiple regression analyses yielded little useful information, constrained by a small sample size, and therefore are not reported here.

3. Ideally we would control for the confounding effect of study site on the relationship between race and risk behaviors, but the modest sample size in this study precludes such an analysis.

4. It should be noted that the philosophy of and requirements set by the shelter are likely major factors in the degree of risk behaviors reported. The shelter we studied, like many others, required sobriety among residents. However, our findings would likely have been different had we studied residents of a shelter working under a harm-reduction model.

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