A survey of the health of homeless children in Philadelphia shelters
R. M. Parker, L. A. Rescorla, J. A. Finkelstein, N. Barnes, J. H. Holmes and P. D. Stolley
Department of Medicine, Emory University School of Medicine, Atlanta, Ga 30345.
We conducted a random-sample survey of homeless children and their mothers
residing in Philadelphia (Pa) shelters. One hundred forty-six families were
included in the final sample, resulting in an 80% response rate. The aims
of the survey were to characterize the child's current and past health
status, to determine access to and use of medical services, and to
determine the serum erythrocyte protoporphyrin levels and tuberculin skin
test status of the children. In addition, psychological tests were
administered to both child and parent to assess developmental level and
psychological problems. Finally, detailed questions were asked concerning
the reasons for the homeless condition. The important reasons for
homelessness cited in the survey included physical abuse, substance abuse,
disagreements with landlords, and poor living conditions. The children's
health problems included a high incidence of reported accidents and
injuries, burns, and lead toxicity; the parents suffered from depression,
physical abuse, and substance abuse. School-aged children tended to have
low scores on tests of expressive vocabulary and word decoding, and
preschoolers seemed to be below age expectations in receptive vocabulary
and visual motor skills. The findings of this study suggest that homeless
children tend to score poorly on developmental and psychological tests and
tend to sustain serious burns and accidents. Policy implications of the
survey include suggestions for health screening, rehabilitation, and
education.
