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This group are also known as the “invisible homeless”. Relatively homeless youth live in unsafe, inadequate or insecure housing, including a hotel or motel room rented by the month, or stay temporarily with friends or relatives (called ‘couch surfing’). Absolutely homeless youth live outdoors, in abandoned buildings or use emergency shelters or hostels. The two classifications used by the United Nations compare the “absolutely homeless” with the “relatively homeless”. Examples of common and often overlapping terms are: ‘situational runaway’, ‘runaway’, ‘throwaway’, ‘systems youth crasher’, ‘curbsider’, ‘missing child’ and ‘homeless’ youth. Some terms describe how youth make their way to the street others describe current housing status. Researchers have developed different categories for study and classification purposes. While elevated risk profiles are associated with street involvement, street youth studies have revealed a diverse spectrum of characteristics and lifestyles. The youth who is not necessarily ‘homeless’ but who is exposed to and experiencing the physical, mental, emotional and social risks of street culture is the focus of this statement. The term ‘street-involved youth’ is quite broad, accounting for both varying degrees of homelessness and a wide range of at-risk behaviours. The literature was limited to English-language articles, with the majority originating in Canada and the United States. MethodsĪ MEDLINE search was conducted for the period between 1950 and November 2012, using the terms “street youth” and “homeless youth” combined with “health care, health behaviour or health”, “health resources/health services”, “oral health”, “delivery of health care”, “adolescent health services” and “preventive health services”. Recommendations are made toward diminishing the negative impact of risk factors on youth heath, safety and well-being. The intention of the present statement is to help paediatricians, family physicians and other health care providers recognize and reduce the multiple risks – physical, mental, emotional and social – of being homeless or street-involved. Inadequate health care, education and advocacy for homeless and street-involved youth (SIY) who present in various health care settings every day in Canada is one of this country’s great unmet needs. Key Words: Health problems Homelessness SIY Street Youth
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Principles of care, including accessibility, confidentiality and harm reduction, and strategies to target and engage this population lead to recommendations for improving services, outcomes, advocacy and increased governmental support. Common physical and mental health problems are considered, along with legal and ethical issues that may affect care. The present statement describes the types and scale of homelessness in Canada, and reviews reasons why youth turn to the street, risks of the ‘street economy’ and barriers to health care.
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Health care providers who see homeless or street-involved youth can help to reduce the impact of many risk factors – physical, mental, emotional and social – pertaining to street culture. April S Elliott Canadian Paediatric Society, Adolescent Health Committee