CDC Data Show Higher Health Risks for High School Students Experiencing Homelessness

On April 28th, 2023, the Centers for Disease Control (CDC) released data from the 2021 Youth Risk Behavior Survey (YRBS), which monitors health-related behaviors among students in grades 9–12 enrolled in U.S. public and private schools.

For the first time, the nationally representative 2021 Youth Risk Behavior Survey included an item assessing “housing stability,” or nighttime residence on its standard questionnaire. This question mirrors the McKinney-Vento Act’s education definition of homelessness, and includes youth staying with others because they had to leave their home or their parents or guardians could not afford housing, as well as those in shelters, hotels/motels, and unsheltered situations.

Previously, SchoolHouse Connection had collaborated with the CDC’s Division of Adolescent and School Health to make homelessness questions part of the optional questionnaire in 2017 and 2019. For 2021, the CDC–in response to advocacy coordinated by SchoolHouse Connection– made homelessness questions part of the 2021 standard high school questionnaire for all states. This makes the YRBS the largest source of data on the extent of homelessness among high school students, and the serious health risk factors that youth experiencing homelessness face.

Compared with students who were stably housed, students experiencing homelessness were more likely to engage in risky sexual behaviors, substance use, and suicide ideation and attempts, and to experience violence. These findings highlight the urgent need to proactively identify students experiencing homelessness; ensure their access and stability in school as required by federal law; and closely examine and revise school-based health and mental health efforts to ensure that students experiencing homelessness are prioritized and can access support.We summarize the major 2021 YRBS findings below.

1. During 2021, at least 2.7% of U.S. high school students experienced homelessness (referred to as “unstable housing” in the CDC report).

The YRBS includes the following responses as “unstable housing.” These responses are intentionally aligned with the McKinney-Vento Act’s education definition of homelessness.

Of these responses, sleeping in the home of others was the frequent response (1.7% of high school students), followed by shelter/emergency housing (0.3%); not having a usual place to sleep (0.3%), motel/hotel (0.2%); or car, park, campground, or other public place (0.2%).

It is important to note that these data very likely underestimate of high school homelessness for the following reasons:

  • Only students who were present on the day(s) of data collection are represented in the YRBS data. Students experiencing homelessness have high rates of chronic absence, and may not have been present on the day the survey was administered. Moreover, in 2021, the YRBS surveys were conducted during the COVID-19 pandemic. Federal education data shows a significant decrease in the number of enrolled homeless students during the pandemic, with evidence that virtual learning and other pandemic-related disruptions caused school disengagement among students experiencing homelessness.
  • YRBS specifically asks about “unstable housing” (homelessness) in the past 30 days, and therefore underestimates the prevalence of “unstable housing” (homelessness) among high school students over the course of the entire year.
  • Students who slept “somewhere else” in the past 30 days were categorized as experiencing stable housing, although it is possible that students who experienced homelessness also may have selected this option.

2. High school students experiencing homelessness are at much higher risk of experiencing violence.

Youth experiencing homelessness have little control over where they stay. They may trade sex for a place to stay, or may find themselves staying in crowded situations with people they don’t know. As a result of these precarious living situations, they are at high risk of physical and sexual violence. The 2021 YRBS data found that prevalence of sexual and physical dating violence and sexual violence by anyone in the past year was two to nearly four times higher among students experiencing homelessness compared to stably housed students.

3. High school students experiencing homelessness face much higher risk of suicide.

The 2021 YRBS survey found that students who experienced homelessness were nearly twice as likely to have seriously considered suicide or made a suicide plan during the past year, and more than three times as likely to have attempted suicide during the past year.

For adolescents, homelessness means hunger, instability, and extreme emotional stress. It often means victimization, trafficking, and separation from family and other support networks, whether due to family rejection or the family’s inability to find shelter together. The isolation and stress of the pandemic has compounded the underlying trauma and mental health issues that accompany homelessness.

Yet for many students experiencing homelessness, school is often their sole mental health services provider, and their only opportunity to receive the caring, individualized attention from trusted adults that they need. School and community-based mental health initiatives must ensure that instability and homelessness are specifically acknowledged and addressed in efforts to reach and serve students, including close collaboration with school district homeless liaisons.

4. Native Hawaiian or other Pacific Islander, American Indian or Alaska Native, and Black youths were more likely to experience homelessness.

According to the YRBS data, certain racial and ethnic groups are overrepresented among high school students experiencing homelessness and more likely to experience homelessness than white youth.

While show over-representation among Hispanic/Latino students, who make up the largest group of students identified by schools as homeless (39%), YRBS data did not find elevated risk among these students.

5. Lesbian, gay, bisexual, and questioning or other youths were more likely to experience homelessness compared with their heterosexual peers.

The prevalence of homelessness was approximately two times higher among students who identify as LGBQ+ compared with heterosexual students. 

Among these groups, the prevalence of homelessness was 2.0% among heterosexual students, 4.7% among lesbian or gay students, 4.2% among bisexual students, 4.0% among questioning students, and 2.6% among students who describe their sexual identity in some other way.

It is important to note that the 2021 national YRBS did not include a question assessing gender identity; therefore, it does not have data specifically on students who identify as transgender. However, some states do include this question. In 2019, for example, the YRBS state survey results contained enough data to report about students who identify as transgender, revealing that, in 27 states, transgender students are 9.22 times more likely to experience homelessness than their peers.