Report reveals high mortality risk among homeless youth in San Francisco

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Homeless youth in San Francisco experience a mortality rate more than 10 times greater than the state’s general youth population, according to a report published Thursday by researchers from UC Berkeley, UCSF and the San Francisco Department of Public Health.

The report — co-authored by Colette Auerswald, campus associate professor of community health and human development in the School of Public Health — concluded that homeless individuals are at a higher risk of mortality, with a majority of deaths in the individuals studied resulting from suicide or causes related to drugs or alcohol.

“We accept a level of suffering among (homeless youth) that is intolerable,” Auerswald said. “They have a human right to a safe place to live, to food, to education.”

A nonrandom sample of 218 homeless youth was recruited from outdoor places such as parks or street corners rather than shelters. The recruitment method allows the findings to reflect the risk of mortality for youths in a street setting rather than those who have already gained access to services, according to the report.

From 2004-10, 11 of the original 218 homeless youths died.

The direct impact homelessness has on one’s mental and physical well-being often goes unacknowledged, and the report should be viewed as a call to action to prevent youth homelessness, said executive director of Larkin Street Youth Services Sherilyn Adams.

It is especially common for youths to become homeless because of a traumatic precipitating event, such as domestic abuse, according to Adams. The suffering caused by this trauma is exacerbated when they enter into a highly unstable situation, such as homelessness, she added.

Many homeless youths also come from foster care, from which individuals must exit once they turn 18, whether they have found a stable home or not, according to campus professor at the School of Social Welfare Steven Segal, who spent several years of his own childhood in a children’s institution.

According to the report, half of the reported deaths in the study occurred outside California. Women who are homeless youth have a higher standardized mortality rate than their male counterparts, Auerswald said. The standardized mortality ratio is a ratio of the number of deaths observed in the sample to the number of deaths researchers would have expected had the cohort not been homeless.

“Young women have different social environment on the street,” Auerswald said. “Young women are often in extremely exploitative relationships on the street.”

Auerswald said she became interested in working with homeless youth because there is an especially large expectation for good health among youth. Therefore, high mortality or illness among youths would most likely result directly from a poor environment.

Current governmental efforts focus more on eradicating homelessness among veterans than among youths, according to Auerswald, but she expects policy to increasingly emphasize youth and family homelessness.

Although homelessness among youths is often assumed to be a matter of choice, according to executive director of Youth Engagement, Advocacy and Housing Jaclyn Grant, research and Grant’s experience working with homeless youth have shown that this isn’t usually the case.

“On an individual level, it’s powerful for people to take time to talk to people experiencing homelessness — to hear their life stories (and) how they got there,” said Tomas Leon, campus graduate student in the School of Public Health and co-president of the Homeless Ministry, a campus organization. “I think that generates empathy.”

Contact Anna Dell’Amico at [email protected] and follow her on Twitter at @adellamico_dc.

Clarification(s):
A previous version of this article may have implied that women who are homeless youth have a higher absolute risk of mortality than their male counterparts. In fact, they have a higher standardized mortality ratio than their male counterparts.