Issue Brief: The Health Needs of Homeless Youth
Adolescence is a period of intense physical and mental growth that prepares young people for the transition to adulthood. Accordingly, young people have unique health needs during this time, including adequate sleep, balanced nutrition, and physical activity. The Office of Adolescent Health expects that the number of young people in the U.S. will rise to an estimated 45 million individuals by 2050, and this group is increasingly diverse. A healthy U.S. population requires a healthy youth population.
Obstacles to Good Health for Homeless Young People
Despite the importance of a healthy youth population, runaway and homeless youth face many barriers to physical health and many obstacles to obtaining care. According to Youth.gov, homeless young people experience higher rates of chronic health problems, trauma-related injuries, and nutritional problems, including starvation, obesity, and associated dental complications. Lack of health insurance also means that homeless young people’s conditions often go untreated. Even relative to other peers living in poverty, homeless youth in families have poor health outcomes.
Collectively, these realities can pose difficult challenges to youth health. A 2016 peer-reviewed study of homeless youth in San Francisco found that their mortality rate was more than ten times that of their non-homeless peers.
In part, these health problems are the result of homeless young people’s increased likelihood for risk behaviors, physical danger, and addiction problems. A 2014 study found that 50% of observed homeless youth met the psychological criteria for alcohol addiction, 49% qualified as substance dependent, and 60% were diagnosable as drug-addicted. Homeless youth are also more likely than their non-homeless peers to experience physical violence and sexual abuse, and more likely to get pregnant.
Obstacles to Care
The Health Resources & Services Administration (HRSA) reports that homeless youth face multiple systemic obstacles to obtaining care. These include a lack of health insurance, the inability for many to secure parental consent for treatment, and unsupportive attitudes of care providers and administrators:
These young people need extra help navigating a health care system that is often confusing even to homeless adults. Case management services must be comprehensive and address not only physical health needs, but also mental health and social service needs. For example, it may be beneficial for homeless youth to obtain early emancipation.
Another recent peer-reviewed study found that homeless young people’s most common reasons for not receiving medical care were, “I don’t have a ride,” “no insurance,” and “costs too much.” Less than 5% of the surveyed young people reported “fear-based barriers,” such as a lack of trust in their doctors. LGBT youth were more likely to have seen a doctor in the past year; young women were five times more likely than young men to have seen the doctor in that time.
Programs can help alleviate homeless youth health problems by providing accessible, affordable health care. Many programs partner with health services organizations to bring doctors and dentists to their centers. The federal government also funds nearly 300 community health centers, which serve thousands of homeless children every year. HRSA’s Find a Health Center tool is available to help locate nearby community health centers.
“Health Coverage for Homeless and At-Risk Youth,” a brief from the U.S. Department of Health and Human Services’ Office of the Assistant Secretary for Planning and Evaluation, explains homeless young people’s rights under the Affordable Care Act. Focusing on Medicaid and CHIP benefits, the brief provides an overview of available benefits by state, noting that “youth that are experiencing or at risk of homelessness are likely to be eligible for Medicaid coverage in the state they reside” if any of the following situations apply:
- Are under age 19, and earn less than 133% of the Federal Poverty Level (FPL) annually (many states cover children under 19 at higher income levels under Medicaid or CHIP)
- Are over 19 years of age, and earn less than 133% of the FPL annually, and live in a state that has expanded Medicaid to adults
- Are under age 26, have aged out of the foster care system in the state, and were enrolled in Medicaid in that state while in foster care
- Are pregnant or parenting
- Have a disability
The authors recommend that homeless youth or their advocates can enroll them by calling 1-800-318-2596 (TTY: 1-855-889-4325), visiting www.healthcare.gov, or contacting their state Medicaid agency.
About RHYi Issue Briefs
Issue Briefs, developed by the National Clearinghouse on Homeless Youth and Families, provide information about runaway and homeless youth and the issues that affect them.