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Ruth M. Parker, MD; Leslie A. Rescorla, PhD; Jonathan A. Finkelstein, MD; Nathaniel Barnes, MD; John H. Holmes, MS; Paul D. Stolley, MD, MPH

Am J Dis Child. 1991;145(5):520-526.

Abstract
• 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. Schoolaged 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.

(AJDC. 1991;145:520-526)

Author Affiliations
From the Department of Medicine, Emory University School of Medicine, Atlanta, Ga (Dr Parker); the Department of Human Development, Bryn Mawr (Pa) College (Dr Rescorla); the Department of Pediatrics, Children's Hospital, Boston, Mass (Dr Finkelstein); the Department of Urology, Duke University Medical Center, Durham, NC (Dr Barnes); and the Clinical Epidemiology Unit, Section of General Internal Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia (Mr Holmes and Dr Stolley).

Footnotes
Accepted for publication January 30, 1991.

Reprint requests to Emory University School of Medicine, Department of Medicine, 69 Butler St SE, Atlanta, GA30345 (Dr Parker).

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