A study by UC Berkeley researchers tracked 218 homeless young people over six years; in that time 11 died largely due to suicide or substance abuse

Young people living on the streets of San Francisco have a mortality rate that is more than 10 times higher than those who have a place to live, largely because of suicide or substance abuse, according to a study from the UC Berkeley school of public health.

“This is a phenomenon of our greater and greater acceptance of the poverty of children,” said Dr Colette “Coco” Auerswald, who led the six-year study that was published online on Thursday in the open-access journal PeerJ. “I was born in the 60s, grew up in the 70s. There were men, alcoholics, on the street in Washington DC. They were suffering. But there weren’t legions of young people on the street.”

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Auerswald and her research team studied 218 young homeless people ranging in age from 15 to 24. Two-thirds of the youths were male and one-third were female.

All had reported “unstable housing” for at least two days during the previous six months, meaning they lived outside of their homes with people who were not in their families – in cars, shelters, squats, on public transportation, in single-room occupancy hotels, or outdoors, with strangers.

Over the course of the study, 11 of them died. That’s 5% of the study group, a rate 10.6 times higher than what would be expected for a similar group matched for age, race and gender. Three of the homeless youths killed themselves. One was a homicide victim. Others were cut down by substance abuse.

The deaths, Auerswald said, were preventable.

Of the eight young men and three young women who died, two-thirds had injected drugs at some point. The study also showed that young homeless women were more likely to die than young homeless men. Their mortality rate was 16 times greater than their peers, while young men in the study died at a rate 9.4 times greater than their peers.

“Women are in a very vulnerable place socially on the streets,” Auerswald said. “And they’re often in exploitative relationships where they are dependent on people who are hurting them in order to survive.”

The most recent count in San Francisco, mandated by the federal Department of Housing and Urban Development, estimated that 1,378 youths are on the streets here at any given time. Most, however cycle in and out of homelessness.

Auerswald and her research team did not seek out young people for the study by connecting with them at drop-in centers or other programs; those homeless youths tend to be at lower risk.

Instead, they headed to Haight Street first, a popular San Francisco neighborhood for young homeless people to congregate. The researchers talked to youths there, asking about their lives and about other places where such homeless kids gather. Then they went to the new spot and asked the same questions.

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That way, they created a map of young, homeless San Francisco, she said, finding, for example “the African American youth coming to Market Street selling marijuana and escaping violence in their own communities, the survival sex in this other neighborhood, the white kids who travel”.

“We were interested in meeting youth ‘where they’re at’ on the street, not in services,” Auerswald said. “Setting foot in services is a big act of faith that a large amount of kids don’t do.”

Earlier studies both globally and in the US have shown that most young people become homeless not because they are delinquent or are there “by choice”. In the developed world, homeless youth tend to be fleeing neglect and physical or sexual abuse. In developing countries, poverty plays a bigger factor.

“We tend to blame youth and wash our hands of it, but we have a moral and legal responsibility,” she said, to reach out to homeless young people and help them get the support and services they need.

“I joke that my daughter is in a wrap-around program in New York City, with housing, vocational training, internships, education, health services,” Auerswald said. “It’s called college.

“She didn’t go into it with a tremendous amount of trauma to recover from ... The degree of support this high-functioning kid is getting is not matched by the best programs out there.”

• An earlier version of this article stated that the mortality rate of young women was 16% greater than their peers and of young men was 9.4% greater than their peers. The mortality rate respectively is 16 times and 9.4 times that of their peers.