摘要：Objectives. We estimated the incidence of homelessness during the transition to adulthood and identified the risk and protective factors that predict homelessness during this transition. Methods. Using data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth, a longitudinal study of youths aging out of foster care in 3 Midwestern states, and a bounds approach, we estimated the cumulative percentage of youths who become homeless during the transition to adulthood. We also estimated a discrete time hazard model that predicted first reported episode of homelessness. Results. Youths aging out of foster care are at high risk for becoming homeless during the transition to adulthood. Between 31% and 46% of our study participants had been homeless at least once by age 26 years. Running away while in foster care, greater placement instability, being male, having a history of physical abuse, engaging in more delinquent behaviors, and having symptoms of a mental health disorder were associated with an increase in the relative risk of becoming homeless. Conclusions. Policy and practice changes are needed to reduce the risk that youths in foster care will become homeless after aging out. Among the populations at greatest risk for becoming homeless are the 25 000 to 30 000 youths who age out of foster care each year when they turn 18 or, in some states, 21. 1 Unlike many of their peers who continue to live with or receive financial assistance from their parents, these youths often struggle just to keep themselves housed. 2,3 A review of research published between 1990 and 2011 has suggested that between 11% and 36% of the youths who age out of foster care become homeless during the transition to adulthood. 4–6 By comparison, approximately 4% of the nationally representative sample of youths aged 18 to 26 years who participated in the third wave of the National Longitudinal Study of Adolescent Health reported ever being homeless. 7 Youths who become homeless after aging out of foster care appear to experience many of the same problems as other homeless youths and young adults, 8–12 including high rates of mental health disorders, a high risk of physical or sexual victimization, and a lack of access to health care services. 5,6,13 Although researchers have compared youths who became homeless after aging out of foster care with youths who aged out but did not become homeless, not much is known about which youths are at greatest risk of becoming homeless after aging out because these studies used a cross-sectional design. 5,6 To our knowledge, only 1 study of homelessness among youths aging out of foster care used longitudinal data to identify risk and protective factors. Dworsky and Courtney 14 analyzed data collected from youths transitioning out of foster care in 3 Midwestern states. All other things being equal, the odds of becoming homeless by age 19 years were higher for those who (1) had run away more than once while in foster care, (2) were placed in a group care setting at baseline, (3) had been physically abused before entering foster care, (4) had engaged in more delinquent behaviors, and (5) did not feel very close to a biological parent or grandparent. We built on Dworsky and Courtney’s14 analysis and asked what the predictors of becoming homeless would be when (1) the observation period was extended to age 26 years, (2) event history techniques were used to measure relative risk, and (3) the sample included youths who were still in foster care when the data Dworsky and Courtney analyzed were collected. This third condition is important because 69% of the study participants did not exit foster care until sometime between their 20th and 21st birthdays.
