Health Needs of Homeless Children

Abstract

Families with children represent more than one third of the homeless population nationally and more than 50% of the homeless population in many cities. Lack of a permanent dwelling deprives children of the most basic necessities for proper growth and development. Homeless children have unique risks that compromise their health status. Pediatricians are encouraged to be aware of this growing population of children and include them in their service and advocacy efforts. BACKGROUND A homeless person is defined by the National Governors Association as "an undomiciled person who is unable to secure permanent and stable housing without special assistance." The US General Accounting Office defines homeless individuals as those persons who lack resources and community ties necessary to provide for their own adequate shelter. Estimates of the number of people who lacked access to conventional dwelling or residence in 1987 range from 350,000 to more than 3 million.1 Although there is disagreement concerning the exact number of homeless persons, there is consensus that the numbers are large and continuing to increase.2 The average increase from 1986 to 1987 in the number of people needing shelter was 20%, and one quarter of this need could not be met with existing emergency shelters. (US Conference of Mayors, unpublished data, December 1987). Several societal problems contribute to the increasing rate of homelessness among American families, including lack of affordable housing; decrease in availability of rent subsidies; unemployment, especially among those who have held only marginal jobs; personal crises such as divorce and domestic violence; cutbacks in public welfare programs; substance abuse; and deinstitutionalization of the mentally ill.