Abstract
BackgroundStreet-involved youth who use illicit drugs are at high risk for health-related harms; however, the profile of youth at greatest risk of hospitalization has not been well described. We sought to characterize hospitalization among street-involved youth who use illicit drugs and identify the most frequent medical reasons for hospitalization among this population.MethodsFrom January 2005 to May 2016, data were collected from the At-Risk Youth Study (ARYS), a prospective cohort study of street-involved youth in Vancouver, Canada. Multivariable generalized estimating equation (GEE) was used to identify factors associated with hospitalization.ResultsAmong 1216 participants, 373 (30.7%) individuals reported hospitalization in the previous 6 months at some point during the study period. The top three reported medical reasons for hospital admission were the following: mental illness (37.77%), physical trauma (12.77%), and drug-related issues (12.59%). Factors significantly associated with hospitalization were the following: past diagnosis of a mental illness (adjusted odds ratio [AOR] = 1.85; 95% confidence interval [95% CI] 1.47–2.33), frequent cocaine use (AOR = 2.15; 95% CI 1.37–3.37), non-fatal overdose (AOR = 1.76; 95% CI 1.37–2.25), and homelessness (AOR = 1.40; 95% CI 1.16–1.68) (all p < 0.05).ConclusionsFindings suggest that mental illness is a key driver of hospitalization among our sample. Comprehensive approaches to mental health and substance use in addition to stable housing offer promising opportunities to decrease hospitalization among this vulnerable population.
Highlights
Street-involved youth who use illicit drugs are at high risk for health-related harms; the profile of youth at greatest risk of hospitalization has not been well described
Chang et al Harm Reduction Journal (2018) 15:14 the USA, it has been documented that acute medical conditions, mental illness, substance use, and injuries are the most common reasons for hospitalization among homeless youth [10]
Mental illness (37.77%) was the most common medical condition followed by physical trauma (12.77%) and drug-related conditions (12.59%). Based on this prospective cohort of street-involved youth who use drugs, homelessness, past diagnosis of a mental illness, frequent cocaine use, and non-fatal overdose were significantly associated with hospitalization
Summary
Street-involved youth who use illicit drugs are at high risk for health-related harms; the profile of youth at greatest risk of hospitalization has not been well described. We sought to characterize hospitalization among street-involved youth who use illicit drugs and identify the most frequent medical reasons for hospitalization among this population. Many health concerns have been identified among this population, including sexually transmitted infections, mental illnesses, intentional and unintentional injuries, and substance use [3, 4]. In. Chang et al Harm Reduction Journal (2018) 15:14 the USA, it has been documented that acute medical conditions (primarily infections), mental illness, substance use, and injuries are the most common reasons for hospitalization among homeless youth [10]. In the context of growing concerns of homelessness and its related burdens, especially overdoses, among youth in North America [12], we sought to update the knowledge of the most common medical reasons for hospital admission and characterize hospitalization among street-involved youth who use drugs. We hope the findings can inform policy makers and healthcare workers to provide more effective interventions to prevent more serious health conditions requiring hospitalization among this vulnerable population and subsequently reduce the related economic burden
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