The worlds of homeless white and African American youth in San Francisco, California: A cultural epidemiological comparison

https://doi.org/10.1016/j.socscimed.2008.12.030Get rights and content

Abstract

Research to date has given little attention to differences in the experience of youth homelessness by ethnicity. This article provides a comparative descriptive analysis of the effect of differences and similarities in paths to homelessness, self-perception, and survival strategies on health behaviors and consequent health outcomes of African American and white homeless youth in San Francisco, USA. We conducted participant observation and ethnographic interviews with 54 youth primarily recruited from street venues. Hypotheses generated from the ethnographic data were validated in between-group analyses using concurrent epidemiological data collected from a sample of 205 youth. Our samples of unstably housed African American and white youth, though sharing common histories of family dysfunction, differed in both the ethnographic accounts and epidemiological analyses in their experiences of family, access to housing, street survival strategies, self-presentation, health behaviors and service utilization. Our sample of white youth generally identified with the term “homeless,” engaged in survival activities associated with such a label, and accessed the services intended to address the needs of homeless youth. In contrast, our sample of African American youth generally did not perceive themselves as “homeless,” a stigmatized term, and were thus less likely to utilize, or be accessed by, relevant services.

Section snippets

Background

Homeless youth have attracted the attention of investigators because of their location at the intersection of research on HIV, drug use, poverty and health. Homeless youth are more likely than non-homeless youth to engage in behaviors that put them at risk of adverse health outcomes, including survival sex (exchanging sex for drugs, money, shelter or protection) (Clements et al., 1997, Ennett et al., 1999), substance abuse (Greene, Ennett, & Ringwalt, 1997), and exposure to violence (Kipke,

Background on study sampling methods

Sampling marginalized populations is compromised by the inability to recruit a statistically representative sample. With notable exceptions (Kipke, O'Connor, Palmer, & MacKenzie, 1995), investigators studying homeless youth have primarily studied convenience samples recruited from service providers. This is a significant limitation since studies suggest that highest-risk youth are recruited on the streets rather than in clinics, shelters, or drop-in centers (Auerswald et al., 2007, Ennett

Two distinct groups of youth—qualitative data

During the course of venue assessment, we observed that there were two distinct groups of homeless youth.

One group was composed of predominantly white youth who spent their days and nights either in downtown San Francisco or in and around the largest city park. Though several reported growing up nearby, most had traveled from other parts of California or the United States.

The second group of youth was composed of African American youth recruited in downtown San Francisco. These youth fit the

Discussion

Our mixed-method, comparative study of the experience of African American and white homeless youth in San Francisco illustrates that homeless youth are not all the same. The accounts of African American youth highlight the role of poverty, absent economic opportunities in their communities of origin, and failed institutional interventions on the path to hustling on the street for money and shelter. Many of their communities of origin have suffered from structural transformations in the Bay Area

References (37)

  • I. Binswanger et al.

    Release from prison – a high risk of death for former inmates

    New England Journal of Medicine

    (2007)
  • P. Bourgois et al.

    Reinterpreting ethnic patterns among white and African American men who inject heroin: a social science of medicine approach

    PLOS Medicine

    (2006)
  • P. Bourgois et al.

    The everyday violence of hepatitis C among young women who inject drugs in San Francisco

    Human Organization

    (2004)
  • California Family Code (Section...
  • C.J. De Rosa et al.

    HIV risk behavior and HIV testing: a comparison of rates and associated factors among homeless and runaway adolescents in two cities

    AIDS Education and Prevention

    (2001)
  • J.M. Greene et al.

    Substance use among runaway and homeless youth in three national samples

    American Journal of Public Health

    (1997)
  • M. Kipke et al.

    Street youth in Los Angeles: profile of a group at high risk for human Immunodeficiency virus infection

    Archives of Pediatrics and Adolescent Medicine

    (1995)
  • A. Kral et al.

    HIV seroprevalence among street-recruited injection drug and crack cocaine users in 16 U.S. municipalities

    American Journal of Public Health

    (1998)
  • Cited by (0)

    The research described in this paper was conducted with support from the National Institute of Child Health and Development (K-23, HD 0149003), the University of California at San Francisco Research Evaluation and Allocation Committee and Committee on Research (PI: C. Auerswald) and the Health Resources and Services Administration Title IV/Ryan White Funds (Larkin Street Youth Services). We thank the project coordinator, Eiko Sugano, and our research staff who recruited and interviewed youth for the epidemiological study, including Mirriam Rafiq, Eddie Cruz, Brooke Lober, Rondia Crawford, Jennifer Hecht, and Renol Ratchford. We thank Philippe Bourgois, Matthew Kramer and Mary Ott for their editorial suggestions. We are most grateful to our subjects without whose participation this endeavor would not have been possible.

    View full text