Associations between individual-level characteristics and exposure to physically violent behavior among young people experiencing homelessness: A meta-analysis
Introduction
There are important opportunities to reduce homelessness among young people and the health and social problems associated with experiencing homelessness through risk factor reduction approaches. Young people experiencing homelessness are a marginalized and vulnerable population group. Many of these young people have experienced violence and abuse within their family of origin (Bearsley-Smith, Bond, Littlefield, & Thomas, 2008). These harms have negative consequences for young people's sense of safety, skills for emotional regulation, feelings of self-control, and the development of safe interpersonal relationships (Goodman, Saxe, & Harvey, 1991; Hamilton, Poza, & Washington, 2011). For young people experiencing homelessness, trauma (“threats to life or bodily integrity, or a close personal encounter with violence and death”; Herman, 1992, p. 33) faced prior to transitioning into homelessness and while living through homelessness, poses risk for many detrimental health and social behaviors (Goodman et al., 1991). Homeless young people are at substantial risk of exposure to violence, both as perpetrators and as victims (Baron, Forde, & Kennedy, 2007; Baron & Hartnagel, 1998; Heerde, Hemphill, & Scholes-Balog, 2014; Heerde, Hemphill, & Scott, 2016; Kipke, Simon, Montgomery, Unger, & Iversen, 1997). Rates of perpetrating assault among homeless young people have been estimated as ranging between 10 and 45% (Heerde et al., 2014; Kipke et al., 1997). The perpetration of violent and non-violent offences by young people experiencing homelessness increases risk for their contact with law enforcement and the criminal justice system (Greenberg & Rosenheck, 2008).
Young people who experience homelessness are highly vulnerable to being victimized from both homeless and non-homeless persons; rates of having been physically assaulted range from 27% to 37% (Heerde et al., 2014; Kipke et al., 1997). Prior research has investigated risk and protective factors across various spheres of influence (e.g. family, peers) in association with homeless young people's exposure to violence, both as perpetrators and as victims (Heerde & Hemphill, 2018; Heerde & Hemphill, 2017; MacLean, Paradise, & Cauce, 1999; McCarthy, Hagan, & Martin, 2002). However, little research has investigated the role of characteristics of homeless young people (herein referred to as individual-level risk and protective factors). Where such research has been conducted, a small number of factors have been examined in relation to outcomes such as substance use (Thompson, 2004), risky sexual behavior (Tevendale, Lightfoot, & Slocum, 2009), or mental health concerns (Rew, Taylor-Seehafer, Thomas, & Yockey, 2001). One approach to understanding if risk and protective factors have common influences in relation to violence exposure is to adopt a meta-analytic approach that statistically appraises results from extant studies. This study presents a meta-analysis exploring associations between characteristics of homeless young people (individual-level risk and protective factors) and exposure to physically violent behavior both as perpetrators and as victims.
Homelessness continues to be a significant social and economic problem internationally. Approximately 550,000 unaccompanied children and young people experience homelessness each year in the United States (National Alliance to End Homelessness, 2018). In 2016, almost 19% of the 35,000 homeless persons on any given night in Canada were young people (Gaetz, Dej, Richter, & Redman, 2016). The annual cost of homelessness to the Canadian economy in 2013 was estimated to be over $7 billion (Canadian Observatory on Homelessness, 2016). In the USA, over $5 billion was allocated to homelessness services in 2016 (including specialist youth homelessness services; United States Interagency Council on Homelessness, 2016). In line with the studies retained for analysis, the definition of homelessness utilized in this study is informed by those used in Canada (Canadian Homelessness Research Network, 2012) and the USA (National Coalition for the Homeless, 2011). Homeless persons include those who have no suitable and permanent occupancy at a residence and who may be unsheltered (living directly on the streets or other spaces not intended for habitation) or residing in emergency shelters or temporary accommodation.
Definitions of violent behavior are consistent in recognizing both perpetration and victimization. The World Health Organization's (2014) definition of violence informs this study. Perpetration of physically violent behavior is defined as the physical handling or threat of harm performed by an individual(s) against another person without their consent. These behaviors may include intentional and unwanted physical contact (e.g. hitting, punching, mugging and robbery, use of weapons against another person), threats to use intentional and unwanted force or physical contact (e.g. threats to harm using weapons, threatening gestures), and accosting another person in an aggressive or threatening manner. Physical violence victimization is defined as the physical handling or threat of physical harm experienced by an individual at the hands of another person(s). Victimization may include being assaulted, being threatened with harm with or without the use of weapons and being mugged or robbed. Herein, unless otherwise specified, exposure to physical violence includes both perpetration and victimization. Vulnerability to and fear of violence, as well as witnessing violence, are also forms of exposure to physically violent behavior. Fear/risk of violence exposure is defined as an individual's vulnerability to physical handling or threat of physical harm experienced at the hands of another person(s). Witnessing violence and/or victimization is defined as having seen another person(s) being physically handled or threatened with physical harm.
Few studies have comprehensively examined risk factors (that increase the probability of experiencing health and social problems) and protective factors (that decrease, mediate or moderate the effect of risk factors; Catalano & Hawkins, 1996) for exposure to physically violent behavior among young people experiencing homelessness (Heerde & Hemphill, 2018; Heerde & Hemphill, 2017; van den Bree et al., 2009). Rather, existing research has investigated risk factors associated with the transition to homelessness (Hamilton et al., 2011). There is emerging evidence that risk factors at the family-level (e.g. experience of childhood abuse) and within the peer group (e.g. engaging with deviant peers) are associated with increased risk for exposure to physical violence among homeless young people. Similar family-level and peer group risk factors, as well as individual-level risk factors (e.g. substance use, involvement in crime), have been posited as increasing risk for each of sexual victimization, engagement in sexual risk behavior, and engagement in survival sex (the exchange of sexual practices for money, food, shelter or another commodity) among young people experiencing homelessness (Heerde & Hemphill, 2017; Tyler & Johnson, 2006). Other individual-level factors such as support received within the family and peer group have shown some protective effects against exposure to physical violence; however, the influence of other protective factors, including those at the individual-level remains understudied (Heerde & Hemphill, 2018). It is plausible that exposure to physically violent behavior among young people experiencing homelessness occurs within attempts to preserve personal safety, and results from perceptions that the perpetration of violence and being physically victimized are ‘normative’ street behaviors and experiences (Baron & Hartnagel, 1998; Kipke et al., 1997).
Using a meta-analytic approach, this study seeks to quantify associations between individual-level risk and protective factors and exposure to physically violent behavior among young people experiencing homelessness. Understandings gained through the conduct of this study are critical to informing prevention and early intervention approaches designed to improve the health and social behaviors of homeless young people. This meta-analysis examines the research question: Are individual-level risk and protective factors associated with exposure to physically violent behavior, both as perpetrators and as victims, among young people experiencing homelessness?
Section snippets
Systematic literature search
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement informed the conduct of this systematic review and meta-analysis (Moher, Liberati, Tetzlaff, Altman, & Group, 2009). Systematic searches were conducted across seventeen psychology, health, medicine, social science, and criminology databases. In performing the search, database-specific controlled subject vocabulary (i.e. subject headings) and/or keywords in the title and abstract were used to ensure
Study characteristics
Across the 26 studies included in the meta-analysis 426 effect sizes were examined. The meta-analysis examined 8842 participants, ranging from 13 to 26 years of age (refer Table 1). Most studies were conducted in the USA, with five studies (19%) conducted in Canada (Baron, 2011; Baron et al., 2007; Baron & Hartnagel, 1998; Martin et al., 2009; McCarthy et al., 2002). Twenty-seven percent of studies used a longitudinal study design. Participants were commonly recruited using strategies employed
Discussion
Young people experiencing homelessness are a marginalized sub-group of homeless persons. These young people report experiencing trauma and abuse within their family of origin (Bearsley-Smith et al., 2008), as well as exposure to violence both as perpetrators and as victims while homeless (Baron et al., 2007; Baron & Hartnagel, 1998; Heerde & Hemphill, 2014; Heerde et al., 2014; McCarthy & Hagan, 1991; Whitbeck et al., 2001). Together, these forms of family- and street-based trauma have
Conclusion
Experiencing homelessness creates substantial strain and distress in the lives of young people. This study presented a comprehensive meta-analysis of individual-level risk and protective factors in association with exposure to physically violent behavior among young people experiencing homelessness. Findings suggested homeless experiences, mental health problems, substance use and sexual behavior were associated with exposure to physically violent behavior. A possible reciprocal association
Funding sources
The work of Dr Heerde is supported by funding provided through a Research Fellowship from the Westpac Scholars Trust. Early conceptualizations of this article were supported through a Murdoch Children's Research Institute Population Health Theme Funding Grant. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies. The funding agencies did not have any involvement in the analysis and interpretation of data, the
Conflict of interest
The authors declare no conflict of interest.
References1 (86)
- et al.
Trauma and homelessness in youth: Psychopathology and intervention
Clinical Psychology Review
(2017) - et al.
Health and health needs of homeless and runaway youth: A position paper of the Society for Adolescent Medicine
Journal of Adolescent Health
(1992) - et al.
Victimization, psychological distress and subsequent offending among youth
Children and Youth Services Review
(2011) - et al.
A systematic review of associations between perpetration of physically violent behaviors and property offenses, victimization and use of substances among homeless youth
Children and Youth Services Review
(2014) - et al.
‘Fighting’for survival: A systematic review of physically violent behavior perpetrated and experienced by homeless young people
Aggression and Violent Behavior
(2014) - et al.
Homeless youth and their exposure to and involvement in violence while living on the streets
Journal of Adolescent Health
(1997) - et al.
Direct protective and buffering protective factors in the development of youth violence
American Journal of Preventive Medicine
(2012) - et al.
Countervailing social network influences on problem behaviors among homeless youth
Journal of Adolescence
(2008) The file drawer problem and tolerance for null results
Psychological Bulletin
(1979)- et al.
A longitudinal population-based study of factors in adolescence predicting homelessness in young adulthood
Journal of Adolescent Health
(2009)
Correlates of psychological functioning of homeless youth in Accra, Ghana: A cross-sectional study
International Journal of Mental Health Systems
Use of the program explication method to explore the benefits of a service for homeless and marginalized young people
Public Health Nursing
Street youths' fear of violent crime
Deviant Behavior
Disputatiousness, aggressiveness
and victimization among street youths. Youth Violence and Juvenile Justice
Street youth and criminal violence
Journal of Research in Crime and Delinquency
The psychosocial profile of adolescent risk of homelesssness
European Child & Adolescent Psychiatry
Multiple victimizations before and after leaving home associated with PTSD, depression, and substance use disorder among homeless youth
Child Maltreatment
Capacity for survival: Exploring strengths of homeless street youth
Child and Youth Care Forum
Confidence intervals in comprehensive meta-analysis
Cost analysis of homelessness
A theory of antisocial behavior
Risk factors for long-term homelessness: Findings from a longitudinal study of first-time homeless single adults
American Journal of Public Health
Mental disorders, comorbidity, and postrunaway arrests among homeless and runaway adolescents
Journal of Research on Adolescence
Onset of conduct disorder, use of delinquent subsistence strategies, and street victimization among homeless and runaway adolescents in the Midwest
Journal of Interpersonal Violence
Demarginalizing the intersection of race and sex: A black feminist critique of antidiscrimination doctrine
feminist theory and antiracist politics. University of Chicago Legal Forum
Common risk and protective factors in successful prevention programs
American Journal of Orthopsychiatry
Serving our youth: Findings from a national survey of services providers working with lesbian, gay, bisexual and transgender youth who are homeless or at risk of becoming homeless
Advantages and disadvantages of the meta-analysis approach
Journal of Hypertension
The state of homelessness in Canada 2016 (1772210013)
Homelessness as psychological trauma: Broadening perspectives
American Psychologist
Jail incarceration, homelessness, and mental health: A national study
Psychiatric Services
Predictors of youth violence. U.S
Exploration of associations between family and peer risk and protective factors and exposure to physically violent behavior among homeless youth: A meta-analysis
Psychology of Violence
Is substance use associated with perpetration and victimization of physically violent behavior and property offences among homeless youth? A systematic review of international studies
Child & Youth Care Forum
Sexual risk behaviors, sexual offenses, and sexual victimization among homeless youth a systematic review of associations with substance use
Trauma, Violence, & Abuse
The role of risk and protective factors in the modification of risk for sexual victimization, sexual risk behaviors, and survival sex among homeless youth: A meta-analysis
Journal of Investigative Psychology and Offender Profiling
Associations between leaving out-of-home care and post-transition youth homelessness: A review
Developing Practice: The Child, Youth and Family Work Journal
“There's no one there to protect you”: Exploring and understanding violent behaviours and victimisation among homeless youth
“The longer you spend homeless the more damaged you become...”: An introduction to the study of exposure to physical violence among young people experiencing homelessness
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Asterisks (*) in the reference list indicate studies included in the meta-analysis.