Westfall Matthew Y, Padmanabhan Pranav, Wang Jianing, Nall Samantha K, Stella Sarah A, Kushel Margot, Belcher Christian, Davis Lanae, Versen Elysia, LeBeouf Whitney, Barocas Joshua A
Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado.
Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts.
Pediatrics. 2025 Feb 1;155(2). doi: 10.1542/peds.2024-067965.
Homelessness is a public health crisis in the United States, yet homelessness prevalence, especially among children and youth, is not well understood. In this study, we use an indirect estimation method known as multiple systems estimation to further evaluate prevalence of youth experiencing homelessness in Denver, Colorado.
We performed a multiple systems estimation ("capture-recapture") analysis to estimate annual homelessness among youth aged 14 to 17 years in the city and county of Denver, Colorado from 2017 to 2021. We used 3 citywide datasets linked at the individual level and stratified by year, as follows: (1) Denver-Metro Homeless Management Information System, (2) Denver Public Schools McKinney-Vento data, and (3) Colorado's Statewide Automated Child Welfare Information System TRAILS. We identified "known" youth experiencing homelessness from the 3 datasets and developed log-linear models with calculated 95% CIs to estimate the unknown population. We combined these counts to estimate the total youth homeless population and stratified counts by race, ethnicity, and gender.
The known count of youth experiencing homelessness increased from 840 in 2017 to 1040 in 2021. We estimated the total number of youth experiencing homelessness increased from 2880 (95% CI, 2199-3290) in 2017 to 7084 (95% CI, 2826-9046) in 2021. This corresponds with an increase from 10.4% to 25.1% in the total prevalence of youth experiencing homelessness in Denver. We found 74.9% to 83.1% of youth experiencing homelessness were Black/African American or Hispanic.
The scope of youth homelessness increased notably and may be far greater than previously understood. Using multiple systems estimation may improve homelessness prevalence estimates and facilitate more effective resource allocation and service delivery.
