The health of shelter-based foster youth

There is a lack of information on the health needs of foster care adolescents in emergency shelters or group homes. The purpose of this study was to conduct an assessment of access to health care among shelter-based foster care adolescents in Baltimore, Maryland. The health passports of all the foster care youth staying at two emergency shelters had data extracted to a standardized chart audit tool. In addition, semistructured interviews were conducted with 15 of the adolescents and five shelter staff. Of the 84 passports, only nine (10.7%) had documented up-to-date immunizations, and only one (1.2%) had documented purified protein derivative (PPD) application and reading. A total of 11 (13.1%) met the criteria for significant delay in recommended follow-up to care. Major themes of the interviews revealed that shelter staff and youth were unaware of specific health care recommendations, or were unable to obtain needed health care due to insurance problems or prolonged waiting for appointment times. The results of this health passport audit indicate that shelter-based foster care youth suffer from worse access to health care than do comparable nonshelter-based foster care youth from the same city. Specific public health nursing recommendations are made for improving health supervision for these vulnerable youth.