A youth who has spent time homeless after leaving the foster care system has much poorer access to health care compared to youth who had had stable housing situations, according to an article in Archives of Pediatrics & Adolescent Medicine (JAMA/Archives), October issue.
Of the 550,000 who are in the American foster care system, about 20,000 are released (emancipated) due to age, explain the writers. “These youth are at high risk of homelessness and have poor health outcomes, including high rates of drug and alcohol use, unplanned pregnancies and poor mental health outcomes. Approximately 40 percent of homeless adults aged 18 to 20 years were in the foster care system as youth.”
Margot B. Kushel, M.D., University of California, San Francisco, and San Francisco General Hospital, and team interviewed 749 youth in 2002-2003, they were aged 17-18. The interviews took place in Illinois, Wisconsin and Iowa. A follow-up interview was conducted one year later with 643 youth. In both interviews they were asked about their access to health care, housing, sociodemographics, physical health status, and mental health status.
45.7% of the interviewees were still in the foster care system at the second interview, the rest had been released. Of those who had been released, 14.2% had been homeless, 39.4% had precarious housing situations – they had either moved at least three times or were spending more than half their income on rent.
The authors wrote “We found high rates of poor access to health care among all emancipated youth, with an experience of homelessness being associated with significantly higher odds of being uninsured and of having unmet need for health care. While approximately 30 percent of young adults in the general population report an episode of being uninsured over the course of the past year, we found that more than half of emancipated participants were uninsured, with rates ranging from 46.5 percent of the stably housed to 76.6 percent of the participants with an experience of homelessness. More than one-fifth (22 percent) of emancipated participants reported unmet need for medical care (14.5 percent of stably housed youth, up to 40.8 percent of those with homelessness) compared with approximately 12 percent of young adults in the general population.”
Generally, 12.1% of them had fair to poor health status (instead of good or excellent), with no substantial differences based on housing status, compared to under 4% of adults in a similar age-range.
The authors concluded “Recently emancipated foster youth are at high risk for poor housing and poor health care access, which are associated with one another. Strategies to improve health outcomes among emancipated youth should address both their lack of health insurance and their risk of housing instability and homelessness.”
Arch Pediatr Adolesc Med. 2007;161(10):986-993
Written by: Christian Nordqvist