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Show Medical Care for Street Youth in Salt Lake City: Project Update Amy Williams, Ben-David Barr, M.S.W., Cynthia B. Snider, M.P.H., & Crispin Abbott Abstract: A clinic designed to treat homeless street youth was opened in Salt Lake City in the spring of 1996. The data compiled after two years of operation indicates that 132 youths were seen with a total of 534 service encounters. Approximately 44% of the clients were women and the average age of the youths seen was 19.1 years, with ages ranging from 12 to 25 years. Provider sensitivity and willingness to serve patients without appointments and without judgement have encouraged youth who might not normally seek out treatment to come to the clinic. The youth have demonstrated that they can be compliant with treatment and will return to the clinic for follow-up. The consistent use of Open Door Clinic is indicative that homeless youth in the community are in need of alternate forms of health care. Collaboration of public and private organizations allows a difficult-to-reach population to be served in an effective manner. Background Between 1997 and 1998, Utah was the sixth fastest growing state in the United States (U.S Census Bureau, 1998). The rapid population growth of the last ten years has led to an increased number of urban problems, including a lack of low cost housing, increased poverty, and increased homelessness (Utah's Health, 1998). Between 1986-1996, the population of Utah grew 20.4%, from 1.7 million to 2.0 million (Utah's Health, 1998), while the number of individuals who were homeless grew 226.7%, from 628 to 2,051 (Community Development Division, 1996). A 1992 study estimated that there were 150 homeless adolescents on the streets of Salt Lake City at any given time (Marriott & Erickson, 1992). With a current population of over 1.2 million, the number of homeless individuals in the Salt Lake Metropolitan Area is estimated at 3,600 people on any given day (Wasatch Homeless Healthcare, 1997). Community agencies responding to homelessness in Salt Lake City are constantly being challenged to meet the needs of this growing population. In 1996, 4th Street Clinic (a Healthcare for Homeless program serving adults and families) established an outreach youth clinic to address the health care needs of homeless adolescents after 4th Street staff noticed very few homeless youth accessing clinic services. The youth clinic was initially housed at the Homeless Youth Resource Center, a daytime drop-in site for homeless youth, located in downtown Salt Lake City. After the teens became familiar with the providers and began to access care on a regular basis, the clinic was moved one block east to the Salt Lake City-County Health Department's City Clinic. The new clinic, named the Open Door Clinic, provides improved medical facilities, allowing expanded patient services and improved quality of care. The mostly volunteer clinic staff includes physicians, physician assistants, residents, physician assistant students, medical assistants, registered nurses, pharmacists, front desk staff, AmeriCorps volunteers, and substance abuse counselors. In addition, local religious groups, restaurants, and schools provide weekly meals for the clinic patients. Methods After the first two years of operation (January 1997-January 1999), the charts of all individuals seen at the clinic were reviewed. Information was collected on demographics (age, gender, ethnicity), substance abuse history, laboratory tests performed, medications given, and diagnoses. The diagnostic categories used were as follows: gynecological (amenorrhea, cervicitis, etc.); sexually transmitted infections (chlamydia, gonococcus, etc.); dermatological (eczema, rash, lice, etc.); gastrointestinal (ulcers, reflux disease, etc.); HEENT (teeth, etc.); respiratory (asthma, sore throat, etc.); trauma (lacerations, bruising, etc.); musculoskeletal (joints, bones, etc.); psychiatric (insomnia, depression, etc.); and other. 29 |