Critical Review of “Homelessness and Health in Adolescents” The research article “Homelessness and Health in Adolescents” brings attention to the problem of homeless youth in Canada and attempts to connect the challenges they experience to lessons for health care and governmental policy. Specifically, the authors set out to understand how adolescents experience homelessness and how gender is factor in that experience, homeless adolescent’s perceptions of health and healthcare accessibility, and how Canadian policy influences these perceptions and experiences. Although the purpose of the research is concisely described within the “Purpose of Study and Research Question” section of the article, I found it difficult to grasp the particular subject they were leading up to in the previous sections. When discussing “Background and Significance”, the authors touch the surface on a number of points regarding gender, homelessness, and healthcare, but they fail to describe any in depth significance why those certain points are important, or how they are related to this research study. I also found it peculiar that the authors cited only one source in this section on a point that is described as being “well documented”, such as the problem of homeless adolescents having a variety of health care concerns. The literature review of this article is well organized into subcategories and the majority of it is written in language that can be easily understood by non-academics. The overall discussion of previous literature seems thorough, especially when considering the specific health risks of the homeless. I found it to be lacking in any comment of past literature focusing on how governmental policies shape the experiences of the homeless which is a research question posed by the authors. Despite this, the authors did address the issue of public policy and homelessness in a discussion of the current Canadian social housing programs which was supported by government statistics and the opinions of the authors.
The researchers used qualitative design in this work which involved semi structured face to face interviews conducted with a small sample of 6 female and 7 male homeless adolescents. The description of the sample utilized was clear and detailed. Acknowledgment that all study subjects were previously associated with a community organization assisting the homeless implies that this factor should be considered when interpreting the results.
The most problematic aspect of this article was that they failed to provide details of the specific questions asked of the interview participants. The authors state “the individual and group interviews followed a semi-structured format and were dialogic and interactive in nature”. Although this offers some insight into the process, it provides no way of assessing whether the questions asked were leading, or if interviewer bias affected the results. Consumers of this study are left wondering if every subject was asked the same questions, or if the process was a more organic path, with the dialogue dominated by what the subjects wanted to talk about that day. Additionally, no information is given to the reader regarding the length and locale of the interviews.
Despite a few shortcomings, I believe that this research did ultimately contribute a bit of valuable knowledge to the field of social work, healthcare, and to welfare policy makers. From the interview data, the researchers encountered five themes the adolescents relayed as major problems with their circumstances. Although most of the themes would be expected, as in females experiencing more dangers and health problems than males, the “elusiveness of the healthcare system” may be significant and new information to many working in the related fields.
I personally encounter this problem in the work I do at a county welfare office. Many people in need, not just adolescents, do not know what help is available to them and where to find it. As this research article exposes, most homeless youth do not possess knowledge of where to find services to help them, including healthcare. My guess is that this population relies heavily on each other for information through word of mouth, and this may often be the wrong information. The authors draw an implication from this theme noting that future research should focus where adolescents receive health related information. A more pragmatic implication might be to actually develop advertising techniques to reach this population. The other implications of the research that the authors discussed were fairly clear, but at times I failed to see the practicality of what they were suggesting. For example, the authors suggest that “care providers can invite homeless youth to join them in their lobbying of local governments as a way to initiate change”. I’m not suggesting that it couldn’t be done, but I think homeless adolescents are more concerned with how they are going to eat, and where they are going to sleep that night than becoming a lobbyist. Some of the final conclusions drawn by the authors may be true, but they are not supported by this actual work. For example, they state that “This study draws attention to the fundamental roles that affordable housing policies and gender play in shaping the health of homeless adolescents”. Although the adolescents’ personal experiences with various social policies is discussed, the specific role of housing policy in the health of adolescents is not delineated. Also, without knowing exactly what the housing policies are, it is difficult to draw conclusions solely based on what a few adolescents said, but it may warrant further inquiry. The technique chosen by the researchers in this work was successful at yielding valuable information to be used in policy formation and future research. Additionally, it can aid healthcare workers to be more sensitive to the needs of homeless youth and to provide them with information on available resources when they are seen in clinics or hospitals. That being said, I did not find the authors’ ideas to always be presented in the most logical and concise manner, and they did not use graphs or diagrams to aid in understanding. Lastly, I feel more detail is required to explain to the reader the specifics of the interviews so that an informed evaluation of their validity can be conducted.