Runaway Youth: Caring for the Nation's Largest Segment of Missing Children

Trafficking in the child and adolescent: Application of SAFETY and CARE for a global crisis of exploitation

Human trafficking in the child and adolescent is a global public health crisis that can be divided into sex trafficking, labor trafficking and organ trafficking. This discussion considers basic terminology in this area, sociodemographic information on these victims, negative effects or repercussions from such egregious actions forced on the victims, issues of screening for healthcare providers based on specific risk factors/indicators, and information regarding screening tools as well as management principles for healthcare professionals. These trafficked persons are seen in varied practice settings such as primary care offices, emergency departments, street medicine operations, and others. Clinicians can approach these victims with targeted training that encourages these pediatric persons to feel safe in healthcare settings, empowering them to help with healing (i.e., trauma-informed care). It is important that those involved in the care of trafficked victims understand the rights of these persons who are essentially hostages that need rescuing, and thus, employ a rights-based approach in dealing with these vulnerable children and youth. Culturally-sensitive concepts of prevention are considered as well to reduce this illegal, inhumane exploitation of our children and adolescents ubiquitously existing throughout the United States and the world. Indeed, there is much that clinicians and society can do to help these unfortunate minors who often feel hopeless and trapped in chaotic circumstances.

Verified Human Trafficking Allegations Among Single and Dual System-Involved Children: Predicting Initial and Repeat Victimization

There is a dearth of research examining repeat human trafficking victimization among children involved with the child welfare system (i.e., single system involvement) and children involved with both the child welfare and juvenile justice systems (i.e., dual system involvement). This study uses longitudinal statewide linked administrative data from the Florida Department of Children and Families (DCF) and Florida Department of Juvenile Justice (DJJ) to investigate both initial and subsequent verified human trafficking allegations among single and dual system-involved children. We conducted logistic regression models to identify youth characteristics, prior DCF experiences, and prior DJJ experiences that predict initial and subsequent trafficking victimization. We also conducted survival analysis to identify time until human trafficking victimization and revictimization. Prior maltreatment, placement history, missing child events, referral without adjudication, community supervision, and residential facility placement predict initial trafficking victimization. These same indicators predict revictimization, except for prior placement history, residential facility commitment, prior physical abuse and prior sexual abuse. Approximately 1 in 5 child victims experience trafficking revictimization; the median time between initial and subsequent revictimization is about 6 months. This research has implications for policy and practice among system-involved children at greatest risk for human trafficking revictimization.

COVID-19 vaccine attitudes among youth experiencing homelessness: a qualitative analysis with opportunities for action

Youth experiencing homelessness (YEH) are uniquely vulnerable to COVID-19 infection, yet are often excluded from response planning during the COVID-19 pandemic and other public health crises. As part of a larger community- and youth-engaged project through a national network of Prevention Research Centers, our qualitative study sought to describe youth perspectives that influence COVID-19 vaccine confidence and uptake, and identify youth-driven strategies to guide public health efforts to improve vaccine confidence and access. We conducted focus groups with youth experiencing homelessness (n = 20) and semi-structured interviews with staff members (n = 10) at youth-serving agencies to solicit youth perspectives about COVID-19 vaccination. Focus groups and interviews were recorded, transcribed, and analyzed using thematic qualitative analysis. In partnership with youth and cross-sector partners, we distilled eight salient themes that influenced COVID-19 vaccine uptake and confidence among YEH: 1. historical harms and mistrust of systems, 2. access to reliable health information, 3. prioritization of basic needs, 4. personal health influence, 5. barriers to healthcare, 6. fear and uncertainty of the vaccines, 7. sense of bodily autonomy, and 8. community influence. We also identified three youth-driven opportunities to increase COVID-19 vaccination among this population: emphasizing autonomy, leveraging trusted sources of information, and improving vaccine access.Our study elucidates perspectives of YEH on COVID-19 vaccination, and identifies several opportunities to improve youth vaccine confidence and access. It also underscores the importance of centering youth voice in response planning during current and future public health crises.

Examining missingness among children in out-of-home care placement in Nebraska

BACKGROUND

Little is known regarding the prevalence and context of missingness (i.e., being reported as a missing person) among children in out-of-home (OOH) care.

OBJECTIVE

The present research examines the relationship between missingness and OOH care placements as well as predictors and case contexts of children missing from OOH care.

METHODS

Point-in-time count data of reported missing persons in Nebraska and administrative records on children's OOH placements are used. Bivariate significance tests examine group differences; case contexts are explored through content analysis of OOH case reviews.

RESULTS

About 30 % of Nebraska's missing children are in OOH care. Bivariate tests show that children missing from OOH care are older and are more likely to be Black and less likely to have their race listed as "unknown" than children missing from their families of origin. Children in OOH who are missing are also more likely to be in group care, on probation, and have greater placement instability compared to children in OOH care who are not missing. Case contexts of missingness include unmet substance use and mental health challenges, experiences with violence and victimization, and few bonds to school.

CONCLUSIONS

Screening and interventions for high-need children in OOH care and their caregivers are necessary to prevent children from going missing from placements.

Risk Behaviors and Experiences Among Youth Experiencing Homelessness-Youth Risk Behavior Survey, 23 U.S. States and 11 Local School Districts, 2019

Youth experiencing homelessness experience violence victimization, substance use, suicide risk, and sexual risk disproportionately, compared with their stably housed peers. Yet few large-scale assessments of these differences among high school students exist. The youth risk behavior survey (YRBS) is conducted biennially among local, state, and nationally representative samples of U.S. high school students in grades 9-12. In 2019, 23 states and 11 local school districts included a measure for housing status on their YRBS questionnaire. The prevalence of homelessness was assessed among states and local sites, and relationships between housing status and violence victimization, substance use, suicide risk, and sexual risk behaviors were evaluated using logistic regression. Compared with stably housed students, students experiencing homelessness were twice as likely to report misuse of prescription pain medicine, three times as likely to be threatened or injured with a weapon at school, and three times as likely to report attempting suicide. These findings indicate a need for intervention efforts to increase support, resources, and services for homeless youth.

Runaway History and Past 30-Day Opioid Misuse in Justice-Involved Adolescents

This study used a sample from the Florida Department of Juvenile Justice (n= 79,960) to analyze the association between runaway history and past 30-day opioid misuse (OM) among justice involved adolescents. Past 30-day OM was confirmed using a urine analysis. Adolescents who were runaways in their lifetime were twice as likely to misuse opioids, and those who were runaways at the time of arrest were three times as likely to be opioid misusers compared to adolescents who never ran away or been kicked out of a home. These findings emphasize a need for resources that focus on developing strong attachment bonds.

Variation in Health Among Unstably Housed Youth From Cities, Suburbs, Towns, and Rural Areas

PURPOSE

Youth face similar rates of homelessness across rural and urban areas, yet little is known about how the health of unstably housed youth varies by location. We assessed differences in health by location (city, suburb, town, and rural) and housing status among youth facing a range of unstable housing experiences.

METHODS

This secondary data analysis from 8th, 9th, and 11th graders completing the 2019 Minnesota Student Survey examined youth who had experienced housing instability in the prior year (n = 10,757), including running away (48%) or experiencing homelessness (staying in shelter, couch-surfing, or rough sleeping) with (42%) or without (10%) an adult family member. We conducted multifactor analysis of variance to assess differences by location (urban, suburban, town, and rural) and housing experience for each of five health indicators: suboptimal health, depressive symptoms, suicide attempts, ≥2 sexual partners, and e-cigarette use.

RESULTS

In main effects models, all health indicators varied based on housing status; suboptimal health, ≥2 sexual partners, and e-cigarette use also varied by location. Interaction models showed that unaccompanied homeless youth in suburbs reported poorer health compared with those in cities. Compared with suburbs, youth in towns were more likely to report ≥2 sexual partners (19.9%, 24.1%) and e-cigarette use (39.5%, 43.3%).

CONCLUSIONS

Our findings suggest that unstably housed youth face a similar burden of poor health across locations, with only subtle differences in health indicators, yet most research focuses on urban youth. Future research is needed to identify how to best meet the health needs of unstably housed youth across locations.

The Prevalence and Correlates of Labor and Sex Trafficking in a Community Sample of Youth Experiencing Homelessness in Metro-Atlanta

Research suggests that runaway and homeless youth (RHY) in the United States are vulnerable to sex and labor trafficking. In this paper, we report and analyze estimates of sex and labor trafficking collected as part of the Atlanta Youth Count 2018, a community-based field survey of RHY between the ages of 14 and 25 in the metro-Atlanta area. A total of 564 participants were recruited and completed a survey that included questions about their backgrounds as well as the Human Trafficking Screening Tool (HTST). We found that 39.9% experienced some form of trafficking while homeless. While 15.6% of the youth reported commercial sexual exploitation while homeless, coerced labor (29.3%) or fraud (25.2%) were even more common experiences. Women, transgender, and gender nonconforming youth, as well young people who had prior system involvement and those who had been homeless for more than a year were the most likely to report having been trafficked. The significance of these findings for research and policy on RHY and trafficking are discussed.

Helping and supporting hospitalized youth experiencing homelessness: An American perspective

Despite many similarities, there are key differences in the ability of providers in the United States to assist homeless youth compared to their colleagues in the United Kingdom. However, legislation, and strategies to identify and advocate for youth experiencing homelessness can lead to improved health outcomes and other psychosocial improvements for youth. This article highlights, compares and contrasts the systems with a goal of greater understanding and opportunities to assist youth experiencing homelessness in either country.