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Risk, Protection, Provision and Policy pp 309–343Cite as

Mobile Homeless Youth, Health Disparities, and Access to Care: Using Mobile Phones and Geospatial Technologies to Document Geographies of Risk and Pathways to Care

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Part of the book series: Geographies of Children and Young People ((GCYP,volume 12))

Abstract

As many as five million adolescents in the USA experience homelessness each year. Despite disproportionate health risks and higher prevalence of injuries and other serious health problems, many have persistent unmet need for healthcare services. Living “under-the-radar” and “off-the-grid,” homeless youth often mistrust providers and are lost to follow-up. While some homeless youth are highly mobile, little is known about the character of their mobility or its impact on health trajectories. The federally funded Youth Trek study overcame challenges of conducting longitudinal research by partnering with homeless youth as research collaborators. Using smartphones, ongoing communication was maintained for up to two years. As Youth Trek participants navigated San Francisco and traversed the continental USA, they created individualized, mixed-media, electronic travelogues: designing personalized captioned maps; contributing geographical information to sketch out their travel routes; uploading documentary photos; and describing their travel experiences through geo-narratives recorded during biweekly telephone interviews. Their travelogues documented anxieties, risks, and protections experienced in different environments including squats, trains, encampments, and institutional settings. As health problems emerged, young people documented their efforts to care for themselves and others. They identified sanctuary spaces and described specific barriers and facilitators to care, like VET SOS, a mobile veterinary van that links youth to healthcare services. Youth Trek travel routes evidenced patterns of return, as young people came back to clinics where they had received respectful and effective treatment. For two homeless young women seeking to terminate unexpected pregnancies, place mattered since access to reproductive health services varied by state.

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Acknowledgements

Gratitude goes Youth Trek project participants, your energy, enthusiasm, and original contributions are applauded. Thanks to Ms. Mary Howe, Director, Homeless Youth Alliance.

Work on this project was funded by the National Institutes of Health (Grant Number UL1RR024131) and was carried out by P.I. Amy Donovan Blondell, Ph.D. at the University of California, San Francisco (UCSF). Research was initially undertaken at the UCSF Institute for Health and Aging, with the support of Co-Directors Wendy Max, Ph.D. and Pat Fox, Ph.D., and Analyst, Ms. Christie Chu. Research continued at Philip R. Lee Institute for Health Policy Studies at UCSF, with unflagging support from Director, Claire Brindis, Dr.PH, and administrator, Mr. Patrick Henderson. Throughout, co-author Marjorie J. Robertson, Ph.D. offered ongoing mentorship. Co-authors Andrea Papanastassiou and Sarah Jane Bradley, raised important questions and re-crafted text and Drs. Judith Barker and Lynn Rew, Sara Daniel MPH, Hannah Whitley offered valuable feedback on early drafts. Jo Boyden, Ph.D., Oxford University Department of International Development, provided an intellectual home during the final writing stage.

For developing geospatial methods, credit goes to Nicolas Sheon, Ph.D. For geographic consulting thanks go to Mr. Dan Swick and also Mr. Kevin Koy, MA the Geospatial Innovation Facility, U.C., Berkeley, and Director, Maggi Kelley, Ph.D.

The Youth Trek study thanks Jean Scandlyn, Ph.D., for conceptual work that came to fruition in this study, and E. Cristin O’Keeffe, J.D., for valuable foundational work and insight. For tireless editing and continuous support thanks go to William Blondell Donovan M.D. S.M.Hyg. and Patricia Ann Donovan M.S., Ph.D.

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Authors and Affiliations

  1. Oxford Department of International Development, University of Oxford, Queen Elizabeth House, 3 Mansfield Road, OX1 3TB, Oxford, Oxfordshire, UK

    Amy Donovan Blondell

  2. Public Health Institute, Alcohol Research Group, Emeryville, CA, USA

    Marjorie J. Robertson

  3. University of California, San Francisco Philip R. Lee Institute for Health Policy Studies, San Francisco, CA, USA

    Claire D. Brindis

  4. San Francisco, CA, USA

    Andrea Anastasia Papanastassiou & Sarah J. Bradley

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  1. Amy Donovan Blondell
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  2. Marjorie J. Robertson
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  3. Claire D. Brindis
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  4. Andrea Anastasia Papanastassiou
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  5. Sarah J. Bradley
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Correspondence to Amy Donovan Blondell .

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Editors and Affiliations

  1. Department of Geography, University of Otago, Dunedin, New Zealand

    Claire Freeman

  2. School of Physical, Environmental and Ma, University of New South Wales Canberra, Canberra BC, Australia

    Paul Tranter

  3. Department of Geography, National University of Singapore, Singapore, Singapore

    Tracey Skelton

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Blondell, A.D., Robertson, M.J., Brindis, C.D., Papanastassiou, A.A., Bradley, S.J. (2017). Mobile Homeless Youth, Health Disparities, and Access to Care: Using Mobile Phones and Geospatial Technologies to Document Geographies of Risk and Pathways to Care. In: Freeman, C., Tranter, P., Skelton, T. (eds) Risk, Protection, Provision and Policy. Geographies of Children and Young People, vol 12. Springer, Singapore. https://doi.org/10.1007/978-981-287-035-3_27

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