Abstract
Objectives
To examine differences in health risks, health outcomes and health services use of Calgary street-involved youth by level of street involvement to inform services planning.
Method
355 street-involved youth (61% male, 26% Aboriginal) completed surveys at a variety of outdoor and agency locations: 46% currently lived on the street, 33% had lived on the street in the past, and 20% were street-involved but had not lived on the street. Odds Ratios (OR) adjusted for sex, ethnocultural group, and age group were calculated for each health/health risk and health service factor by level of street involvement.
Results
With the exception of condom use, significant health and health risk outcome differences were seen by level of street involvement. Use of hospitals and walk-in clinics did not differ significantly by level of street involvement; however, youth living on the street were less likely (OR 0.2) than those who had not lived on the street to use a physician during office hours, and those who had lived on the street were more likely (OR 10.1) to use mobile clinics, services that are targeted to street-involved people.
Conclusion
Street-involved youth who had not lived on the street showed better health/health risk outcomes than those who currently or had lived on the street, and health services use showed some differences by level of street involvement. Public health and other service providers need to be cognizant of their role in providing prevention, safety or stabilization services for youth at different stages of street life.
Key words: Street youth, health risks, health services utilization, community-based research
Résumé
Objectifs
Examiner les écarts dans les risques sanitaires, les résultats cliniques et l’utilisation des services de santé par les jeunes de la rue de Calgary selon leur niveau d’itinérance, afin d’étayer la planification des services.
Méthode
Trois cent cinquante-cinq jeunes de la rue (de sexe masculin à 61 %, autochtones à 26 %) ont répondu à un sondage à divers endroits à l’extérieur et à l’intérieur d’organismes: 46 % vivaient actuellement dans la rue, 33 % y avaient déjà vécu, et 20 % n’y avaient pas vécu, mais fréquentaient le milieu. Nous avons calculé des rapports de cotes (RC) rajustés selon le sexe, le groupe ethnoculturel et le groupe d’âge pour chaque facteur de santé/de risque sanitaire et de service de santé selon le niveau d’itinérance des jeunes.
Résultats
À l’exception du port du condom, nous avons observé des écarts significatifs dans les résultats de santé et les risques sanitaires selon le niveau d’itinérance. La fréquentation des hôpitaux et des cliniques sans rendez-vous ne différait pas significativement selon le niveau d’itinérance, mais les jeunes vivant dans la rue étaient moins susceptibles (RC 0,2) que ceux qui n’avaient pas vécu dans la rue de consulter un médecin pendant les heures de bureau, et ceux qui avaient déjà vécu dans la rue étaient plus susceptibles (RC 10,1) de fréquenter les unités sanitaires mobiles (un service qui cible les personnes de la rue).
Conclusion
Les jeunes qui n’avaient pas vécu dans la rue affichaient de meilleurs résultats sur le plan de la santé et des risques sanitaires que ceux qui vivaient actuellement ou qui avaient déjà vécu dans la rue, et l’utilisation des services de santé variait quelque peu selon le niveau d’itinérance. Les intervenants en santé publique et autres fournisseurs de services doivent être conscients de leur rôle lorsqu’ils offrent des services de prévention, de sécurité ou de stabilisation aux jeunes à différents stades d’itinérance.
Mots clés: jeunes de la rue, risques sanitaires, utilisation des services de santé, recherche en milieu communautaire
Footnotes
Acknowledgements: This study was supported by an operating grant from the Canadian Institutes of Health Research (CIHR) (CBR68751) and an establishment grant from the Alberta Heritage Foundation for Medical Research (AHFMR). C. Worthington is a CIHR New Investigator and an AHFMR Population Health Investigator. We thank the many youth who participated in the study, Calgary youth and health agency staff on the research team for their contributions to the study, and the street outreach workers who acted as research assistants. Particular thanks go to the Project Coordinator, Dawn Dittmann, and to AIDS Calgary Awareness Association, the lead community agency partner on this study. Thanks also go to Nedra Huffey, Eric Berndt, and San Patten, all of whom acted as research partners over the course of the study, and to M.C. Auld who reviewed the statistical analyses.
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