142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Healthcare utilization and needs of homeless youth

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 8:50 AM - 9:10 AM

Hailey Winetrobe, MPH, CHES , School of Social Work, University of Southern California, Los Angeles, CA
Harmony Rhoades, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Eric Rice, PhD , School of Social Work, University of Southern California, Los Angeles, CA
Norweeta Milburn, PhD , Department of Psychiatry and Biobehavioral Sciences, UCLA Nathanson Family Resilience Center, UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA
Introduction: Homeless youth (HY) are a vulnerable population with a host of healthcare needs.  However, much of the literature concerning HY’s healthcare service utilization and access needs is outdated.  Many factors may affect HY’s access to care, including a lack of: health insurance, identification, and knowledge of where to seek care and how to get there.  We examined rates of health insurance coverage, healthcare utilization, barriers to accessing care, and correlates of unmet need.

Methods: Between May and June 2013, all HY who were accessing services at a drop-in center in Venice, CA were asked to participate.  Seventy percent of the eligible clients completed the self-administered questionnaire (n=125).   

Results:  Most of the HY were male, heterosexual, and white, with a mean age of 21 years.  Only 30% of HY reported having health insurance within the previous 12 months.  Of those who had health insurance, 46% were on their parents’ plan and 34% had Medicaid.  Within the past year, the emergency room was the most frequently cited source of care; emergency care was the most common reason for seeking care, though preventive care was identified by 27% of participants.  Within the past year, 31% of HY had unmet healthcare needs, with financial cost identified as the main barrier.

We examined correlates of healthcare utilization and unmet healthcare needs.  A multivariable logistic regression (n=107) demonstrated that HY with health insurance were 10.8 times (p<0.05) as likely to have used healthcare in the previous year, than those who did not have insurance.  A multinomial multivariable logistic regression (n=98) showed that HY who were currently experiencing major depression were 12.4 times (p<0.01) as likely to report unmet healthcare needs, compared to no needs.  Additionally, HY who identified as Black and non-heterosexual, were 89% and 88% as likely, respectively (p<0.05), to have met healthcare needs, while HY with at least a high school education were over 10 times (p<0.05) as likely to report having met healthcare needs, compared to no needs.  Notably, there was a trend among HY with a history of exchange sex being more likely to report unmet healthcare needs.

Conclusions:  Healthcare service opportunities must be made available to HY.  To increase their comfort with receiving services, previous research identifies the importance of HY having their own time and space for healthcare services.  Future studies should investigate the impact of the Affordable Care Act on HY’s insurance coverage and healthcare service utilization.

Learning Areas:

Provision of health care to the public

Learning Objectives:
Identify barriers homeless youth may face in trying to access healthcare services Define specific behaviors or characteristics that may increase or reduce the likelihood of homeless youth accessing healthcare services

Keyword(s): Homelessness, Accessibility

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed my MPH at UCLA and have been working as a health educator and researcher with homeless youth for the past five years. My scientific interests focus on HIV risk and protective behaviors and technology use.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.