Meeting the Needs of Unstably Housed Youth in Rural Communities
Housing is a key social determinant of health. In Minnesota, almost 10% of adolescents report experiencing housing instability, including having run away or facing some form of homelessness, either with family or unaccompanied. Unstably housed youth are known to be at high risk for poor health outcomes. Although similar percentages of youth living in rural and urban areas experience housing instability, most research regarding the needs of unstably housed youth focuses on youth in cities.
To shed light on the health needs of unstably housed youth across geographic locations, University of Minnesota Adolescent Medicine Fellow, Dr. Janna Gewirtz O’Brien, teamed up with PRC researchers, Drs. Amy Gower and Annie-Laurie McRee, on an analysis of survey data from Minnesota middle and high school students. This analysis compared health among several groups of unstably housed youth living in cities, towns, suburbs and rural areas.
In this analysis of more than 10,000 Minnesota 8th, 9th and 11th graders who had run away or experienced homelessness, the team found that unstably housed youth across geographic locations faced similar burdens of health risk. The researchers examined five indicators of adolescent health including self-reported poor health, depressive symptoms, having attempted suicide in the past year, having two or more sexual partners, and e-cigarette use in the past month. Across all of these indicators, unstably housed youth in rural areas faired similarly to those in other geographic locations. The study also affirmed differences between different groups of unstably housed youth, specifically showing that runaway and unaccompanied youth had greater health risks than youth who were homeless with an adult family member.
These findings were published in the December issue of the Journal of Adolescent Health and have important implications for the PRC’s Core Research Project.
The Core Project focuses on enhancing the quality of preventive services for youth living in rural areas. “As we think together about what optimal adolescent health services look like in rural areas, these findings highlight that we need to think broadly about how to support this historically marginalized population of young people” says McRee.
Gewirtz O’Brien remarks, “Our health systems need to be ready and able to meet the unique needs of unstably housed youth. This diverse population is all too often left out of conversations about quality adolescent health services, and, as such, we often miss opportunities to intervene. “
Unfortunately, the vast majority of services to improve health and provide much-needed support for unstably housed youth are concentrated in cities. The team’s prior work has shown that unstably housed youth are, in fact, connected with preventive care and services at similar rates to their stably housed peers. Thus, primary care practices in rural communities may be well-positioned to effectively meet the needs of this population in the context of routine adolescent care. For example, Gewirtz O’Brien notes that “clinicians can assess youth housing status, address the unique health needs of unstably-housed youth, and connect them with vital resources.”