Denver saw an increase in youth homelessness from 10% to 25% between 2017 and 2021, according to our study recently published in the peer-reviewed journal “Pediatrics.”
We are two physicians whose clinical work and research focuses on the social causes of health and disease. In particular, we’ve seen firsthand how housing instability influences health outcomes.
Homelessness takes many forms, including living on the street or in a car, motel or shelter, or staying temporarily with friends or family. This last scenario is known as “doubling up.”
Our findings suggest that 1 in 4 Denver youth age 14 to 17 experienced some form of homelessness in 2021, and that the number of youth experiencing homelessness in Denver is many times greater than what traditional methods find.
In our study, we used three data sources in what’s known as a multiple systems estimation approach. This approach has been used to count other difficult-to-measure groups of people, including those with substance use disorders or COVID-19. Rarely has it been applied to homelessness.
Our study relied on data from the public school system, Colorado child protective services and the Metro Denver Homeless Initiative.
We combined these datasets to avoid overlap between individuals and counted unique youth present in the data. We then used statistical modeling techniques to estimate those who are “unknown” – meaning not identified in the data. Together, these combined known counts and “unknown” estimates can give a more complete size of the total population.
Among our findings, we noted that 75% to 83% of youth experiencing homelessness in Denver identified as Black/African American or Hispanic.
Why it matters
Homelessness is associated with myriad negative health outcomes. Among youth, the rate of death is 10 times higher for those experiencing homelessness compared with housed youth.
To count people experiencing homelessness, states and homelessness service providers most often rely on point-in-time counts. In a point-in-time count, local service providers interview and record people experiencing homelessness on one night in January of each year. Typically, only people who are living on the streets or in shelters are counted.
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Point-in-time counts are crucial for policy decisions around homelessness because they help local, state and national organizations and governments allocate resources.
However, point-in-time counts may miss people living in motels, doubling up, those who experience homelessness at other times of the year beyond January, and others. Consequently, many experts and researchers recognize that these counts give incomplete data.
Young people are especially undercounted because they frequently experience homelessness as doubling up. For example, the national point-in-time count from 2019-2020 identified 106,364 school-age children experiencing homelessness in the United States. However, estimates from the public schools suggest the actual number was closer to 1.3 million.
Service providers and governments need new methods to count those experiencing homelessness. From Denver to Washington D.C., they cannot appropriately make decisions or adequately fund evidence-based interventions using incomplete numbers. We believe our methods can be an important piece of the toolbox to improve estimates and better inform policy.
What’s next
Even according to traditional point-in-time counts, homelessness continues to rise significantly across Colorado and nationally. Our results suggest many more youth, and likely persons from all walks of life, are experiencing homelessness than previously known.
Our team is working to use this methodology at the state level in Colorado. We plan to expand our counts to include adults in order to improve estimates among racial and ethnic minorities, LGBTQ+ people and other at-risk communities.
At the same time, our results demonstrate that multiple systems estimation can be an important tool in Colorado and nationally. Our team is optimistic that other researchers, service providers and governments will begin to use this method in their localities.
We hope that with a better understanding of the scope of homelessness, legislators and service providers can implement more effective policies to address this hidden crisis.
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