Christopher L. Ringwalt

Pregnancy among three national samples of runaway and homeless youth

PURPOSE To compare estimates of the prevalence of pregnancy among runaway and homeless youth between the ages of 14 and 17 years in various settings with each other and with youth in the general population. METHODS Comparisons used three surveys of youth: (a) the first nationally representative survey of runaway and homeless youth residing in federally and nonfederally funded shelters, (b) a multicity survey of street youth, and (c) a nationally representative household survey of youth with and without recent runaway and homeless experiences. RESULTS Youth living on the streets had the highest lifetime rates of pregnancy (48%), followed by youth residing in shelters (33%) and household youth (<10%). CONCLUSIONS Shelter and street youth were at much greater risk of having ever been pregnant than were youth in households, regardless of whether they had recent runaway or homeless experiences. Such youth need comprehensive services, including pregnancy prevention, family planning, and prenatal and parenting services.

Homeless and runaway youths’ access to health care

PURPOSE To describe use of health services and self-reported access to regular and emergency care by homeless adolescents and street youth. METHODS Interviewer-administered surveys addressed use of health services, availability of sources of care for emergencies, and types of care sources used. An abbreviated version of the questionnaire used for youth in shelters was used for street youth. A nationally representative sample of 640 sheltered youth and a purposive sample of 600 street youth aged 12-21 years were interviewed. All data were collected in 1992. RESULTS Half of street youth and 36% of sheltered youth did not have a regular source of health care (p < or =.05). One-fourth of street youth and 18% of sheltered youth also reported serious health problems within the past year (p < or =.05). Street youth were more likely than sheltered youth to have used emergency treatment (36% vs. 29%; p < or =.05) and alcohol- or drug-related emergency treatment (25% vs. 13%; p < or =.05). Sheltered youth with a regular source of care were more likely to use nonemergency sites than those without a source of primary care (46% vs. 20%; p < or =.001). Few sheltered or street youth perceived shelter clinics, clinics for runaway youth, or free youth clinics to be available to meet their emergency care needs. CONCLUSIONS Significant numbers of homeless youth did not have a regular source of health care. Those who had a regular source of care were more likely to have continuity between routine and emergency care. Integration of health services with other agencies serving youth in shelters or on the street may improve access to care for those without a routine source of care and provide better continuity for these high-risk youth.

Youth and familial substance use's association with suicide attempts among runaway and homeless youth

This study examined how youth suicide attempts are associated with youth and familial substance use among two samples of runaway and homeless youth (RHY): (a) a nationally representative sample of RHY residing in shelters, and (b) a multicity, purposive sample of RHY found on the street. Data were collected using personal interviews from 640 shelter youth and 600 street youth in 1992. Logistic regression analyses revealed that, after controlling for key demographic characteristics, youth who had used substances (particularly sedatives, hallucinogens, and inhalants) were much more likely than those who had not used substances to have ever attempted suicide. In addition, after controlling for their own substance use, youth with family members who had used substances were twice as likely as those without such family members to have ever attempted suicide. This study suggests the importance of developing and focusing suicide prevention.