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Barriers to health and social services for street-involved youth in a Canadian setting

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Abstract

Although street-involved youth contend with many health and social problems, the extent to which vulnerable youth engage with supportive services has not been well described. This study sought to examine the prevalence and correlates associated with having difficulty accessing health and social services among a prospective cohort of street-involved youth in Vancouver, Canada. Among 1019 street-involved youth, 650 (64 per cent) reported having difficulty accessing services during the study period. In a multivariate analysis, youth who reported having difficulty accessing services were significantly more likely to be socially and economically vulnerable. Specifically, they were more likely to report severe housing instability, high-intensity drug use, recent interactions with law enforcement, drug dealing, and histories of violence and physical abuse. Study findings point to opportunities to improve access to services among vulnerable youth through removal of blanket age restrictions for youth services, establishing youth-centric social housing, and supporting peer-driven, low-threshold services.

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References

  • Evenson, J. and Barr, C. (2009) Youth Homelessness in Canada: The Road to Solutions. Toronto, Canada: Raising the Roof.

    Google Scholar 

  • Reid, P. and Klee, H. (1999) Young homeless people and service provision. Health & Social Care in the Community 7 (1): 17–24.

    Article  Google Scholar 

  • Tyler, K.A. (2006) A qualitative study of early family histories and transitions of homeless youth. Journal of Interpersonal Violence 21 (10): 1385–1393.

    Article  Google Scholar 

  • Slesnick, N., Glassman, M., Garren, R., Toviessi, P., Bantchevska, D. and Dashora, P. (2008) How to open and sustain a drop-in center for homeless youth. Children and Youth Services Review 30 (7): 727–734.

    Article  Google Scholar 

  • Fowler, P., Toro, P. and Miles, B. (2009) Pathways to and from homelessness and associated psychosocial outcomes among adolescents leaving the foster care system. American Journal of Public Health 99 (8): 1453–1458.

    Article  Google Scholar 

  • Hudson, A.L. et al (2010) Health-seeking challenges among homeless youth. Nursing Research 59 (3): 212–218.

    Article  Google Scholar 

  • Hudson, A.L. and Nandy, K. (2012) Comparisons of substance abuse, high-risk sexual behavior and depressive symptoms among homeless youth with and without a history of foster care placement. Contemporary Nurse 42 (2): 178–186.

    Article  Google Scholar 

  • Green, H.D., de la Haye, K., Tucker, J.S. and Golinelli, D. (2013) Shared risk: Who engages in substance use with American homeless youth? Addiction 108 (9): 1–7.

    Google Scholar 

  • Esparza, N. (2009) Community factors influencing the prevalence of homeless youth services. Children and Youth Services Review 31 (12): 1321–1329.

    Article  Google Scholar 

  • Kral, A.H., Lorvick, J. and Edlin, B.R. (2000) Sex- and drug-related risk among populations of younger and older injection drug users in adjacent neighborhoods in San Francisco. Journal of Acquired Immune Deficiency Syndromes 24 (2): 162–167.

    Article  Google Scholar 

  • Lloyd-Smith, E., Kerr, T., Zhang, R., Montaner, J.S.G. and Wood, E. (2008) High prevalence of syringe sharing among street involved youth. Addiction Research & Theory 16 (4): 353–358.

    Article  Google Scholar 

  • Marshall, B.D.L., Shoveller, J.A., Wood, E., Patterson, T.L. and Kerr, T. (2011) Difficulty accessing syringes mediates the relationship between methamphetamine use and syringe sharing among young injection drug users. AIDS and Behavior 15 (7): 1546–1553.

    Article  Google Scholar 

  • Shannon, K. et al (2010) Survival sex work involvement as a primary risk factor for Hepatitis C virus acquisition in drug-using youths in a Canadian setting. Archives of Pediatrics & Adolescent Medicine 164 (1): 61–65.

    Article  Google Scholar 

  • Chesson, H.W., Blandford, J.M., Gift, T.L., Tao, G. and Irwin, K.L. (2000) The estimated direct medical cost of sexually transmitted diseases among American youth. Perspectives on Sexual and Reproductive Health 36 (1): 11–19.

    Article  Google Scholar 

  • Schackman, B.R. et al The lifetime cost of current human immunodeficiency virus care in the United States. Medical Care 44 (11): 990–997.

  • Baggett, T.P., Singer, D.E., Rao, S.R., O’Connell, J.J., Bharel, M. and Rigotti, N.A. (2011) Food insufficiency and health services utilization in a national sample of homeless adults. Journal of General Internal Medicine 26 (6): 627–634.

    Article  Google Scholar 

  • Slesnick, N., Kang, M.J., Bonomi, A.E. and Prestopnik, J.L. (2008) Six- and twelve-month outcomes among homeless youth accessing therapy and case management services through an urban drop-in center. Health Services Research 43 (1 Pt 1): 211–229.

    Google Scholar 

  • Wilson, M.E., Schwartz, R.P., O’Grady, K.E. and Jaffe, J.H. (2010) Impact of interim methadone maintenance on HIV risk behaviors. Journal of Urban Health 87 (4): 586–591.

    Article  Google Scholar 

  • Tran, B.X. and Nguyen, L.T. (2013) Impact of methadone maintenance on health utility, health care utilization and expenditure in drug users with HIV/AIDS. International Journal of Drug Policy 24 (6): 105–110.

    Article  Google Scholar 

  • Thompson, S.J., McManus, H., Lantry, J., Windsor, L. and Flynn, P. (2006) Insights from the street: Perceptions of services and providers by homeless young adults. Evaluation and Program Planning 29 (1): 34–43.

    Article  Google Scholar 

  • Krüsi, A., Fast, D., Small, W., Wood, E. and Kerr, T. (2010) Social and structural barriers to housing among street-involved youth who use illicit drugs. Health and Social Care in the Community 18 (3): 282–288.

    Google Scholar 

  • Wood, E., Stoltz, J-A., Montaner, J.S. and Kerr, T. (2006) Evaluating methamphetamine use and risks of injection initiation among street youth: The ARYS study. Harm Reduction Journal 3 (1): 18–24.

    Article  Google Scholar 

  • Haley, N. and Roy, E. (1999) Canadian street youth: Who are they? What are their needs? Paediatrics & Child Health 4 (6): 381–383.

    Google Scholar 

  • Hanley, J.A., Negassa, A., Edwardes, M.D.D. and Forrester, J.E. (2003) Statistical analysis of correlated data using generalized estimating equations: An orientation. American Journal of Epidemiology 157 (4): 364–375.

    Article  Google Scholar 

  • Pan, W. (2001) Akaike’s information criterion in generalized estimating equations. Biometrics 57 (1): 120–125.

    Article  Google Scholar 

  • Garrett, S., Higa, D., Phares, M., Peterson, P., Wells, E. and Baer, J. (2008) Homeless youths’ perceptions of services and transitions to stable housing. Evaluation and Program Planning 31 (4): 436–444.

    Article  Google Scholar 

  • Shannon, K, Ishida, T, Lai, C and Tyndall, M.W. (2006) The impact of unregulated single room occupancy hotels on the health status of illicit drug users in Vancouver. International Journal of Drug Policy 17 (2): 107–114.

    Article  Google Scholar 

  • McBain-Rigg, K.E. and Veitch, C. (2011) Cultural barriers to health care for Aboriginal and Torres Strait Islanders in Mount Isa. Australian Journal of Rural Health 19 (2): 70–74.

    Article  Google Scholar 

  • Cheng, T. et al (2013) Transitions into and out of homelessness among street-involved youth in a Canadian setting. Health & Place 23: 122–127.

    Article  Google Scholar 

  • Browne, A.J. and Fiske, J.A. (2001) First nations women’s encounters with mainstream health care services. Western Journal of Nursing Research 23 (2): 126–147.

    Article  Google Scholar 

  • Marshall, B., Kerr, T., Shoveller, J.A., Patterson, T., Buxton, J. and Wood, E. (2009) Homelessness and unstable housing associated with an increased risk of HIV and STI transmission among street-involved youth. Health & Place 15 (3): 753–760.

    Article  Google Scholar 

  • Roy, E., Haley, N., Leclerc, P., Sochanski, B., Boudreau, J. and Boivin, J. (2004) Mortality in a cohort of street youth in Montreal. JAMA: The Journal of the American Medical Association 292 (5): 569–574.

    Article  Google Scholar 

  • Goering, P. et al (2014) National at Home/Chez Soi Final Report. Calgary, Canada: Mental Health Commission of Canada.

    Google Scholar 

  • Phillips, M. et al (2014) Inability to access addiction treatment among street-involved youth in a Canadian setting. Substance Use & Misuse 49 (10): 1233–1240.

    Article  Google Scholar 

  • Baskin, C. (2007) Aboriginal youth talk about structural determinants as the causes of their homelessness. First Peoples Child and Family Review 3 (3): 31–42.

    Google Scholar 

  • Alavi, M. et al (2013) Assessment and treatment of Hepatitis C virus infection among people who inject drugs in the opioid substitution setting: ETHOS Study. Clinical Infectious Diseases 57 (s2): S62–S69.

    Article  Google Scholar 

  • Peiris, D., Brown, A. and Cass, A. (2008) Addressing inequities in access to quality health care for Indigenous people. Canadian Medical Association Journal 179 (10): 985–986.

    Article  Google Scholar 

  • Wood, E. et al (2004) Inability to access addiction treatment and risk of HIV infection among injection drug users. JAIDS Journal of Acquired Immune Deficiency Syndromes 36 (2): 750–754.

    Article  Google Scholar 

  • World Health Organization (WHO). (2015) Adolescent responsive health systems. World Health Organization, http://www.who.int/maternal_child_adolescent/topics/adolescence/health_services/en/, accessed 20 December 2014.

  • Darke, S. (1998) Self-report among injecting drug users: A review. Drug and Alcohol Dependence 51 (3): 253–263.

    Article  Google Scholar 

  • Brener, N.D., Billy, J.O.G. and Grady, W.R. (2003) Assessment of factors affecting the validity of self-reported health-risk behavior among adolescents: Evidence from the scientific literature. Journal of Adolescent Health 33 (6): 436–457.

    Article  Google Scholar 

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The authors learned which groups of youth in British Columbia, Canada have the greatest difficulty getting access to health and social services and suggest opportunities to improve the situation.

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Barker, B., Kerr, T., Nguyen, P. et al. Barriers to health and social services for street-involved youth in a Canadian setting. J Public Health Pol 36, 350–363 (2015). https://doi.org/10.1057/jphp.2015.8

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  • DOI: https://doi.org/10.1057/jphp.2015.8

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