STREET KIDS 11 TIMES AS LIKELY TO DIE, STUDY FINDS

Canada's street youth often romanticize themselves as "adventurers" and
people "living life on their own terms" but, in reality, these youngsters
face a higher death rate than anyone expected, researchers have found.

Of 1,013 Montreal street youth who were followed for nearly three years on
average, 26 died -- a death rate more than 11 times that of youth in the
general population.

Thirteen died by suicide, eight by drug overdose and two from an
unintentional injury, such as an accident. There was one death each from
hepatitis A and heart disease. In one case, the cause of death is unknown.

Five of the youth died before reaching age 20.

Risks for dying on the street included being HIV-infected, being recently
homeless, daily alcohol or injection drug use in the previous month, and
gender: Male street youth are nearly three times more likely than females
to die on the street.

Overall, the death rates shocked even the researchers, who warn street
youth urgently need to become a public health priority in Canada.

"We were not expecting that at all," says Nancy Haley, a pediatrician with
the Montreal Regional Public Health department and co-author of the study,
published in today's issue of the Journal of the American Medical
Association. "Even more unsettling, they are dying of things we could do
something about."

An estimated 67,000 youth aged 18 and under are reported as missing in
Canada. Ninety-five per cent are runaways, according to the Missing
Children Society of Canada. Many are repeat and long-term runners.

An accompanying editorial in today's journal calls the Montreal study stark
evidence "of the vulnerability of street youth that belies their bravado.

"Living without a regular place to stay; squatting in blighted housing and
abandoned buildings; camping in doorways, parks, overpasses, or wooded
areas" and spending lives begging for spare change make street life
dangerous, violent and unpredictable, writes Dr. Sue Ellen Abdalian, of
Tulane University Health Sciences Center in New Orleans.

Some end up severely depressed and use drugs to self-medicate. Others turn
to prostitution, break-and-enters and drug running in exchange for food,
clothing or a place to stay.

In the Montreal study, street youth aged 14 to 25 were recruited from
drop-in centres, shelters and outreach vans from January 1995 to September
2000. Two-thirds were boys, most reported having used cannabis, cocaine,
crack or other drugs and one-quarter had been involved in "survival sex" --
performing sexual favours in exchange for food, shelter, gifts or drugs,
but not necessarily money.

Youth were interviewed face-to-face every six months and followed until age
30 or until they were no longer "street-involved." The team originally
wanted to determine rates and risk factors for HIV infection and injection
drug use. But when they began having trouble retracing some of the youth,
the team started contacting the coroner's office.

"Some of these kids were drinking in elementary school and started
multi-drug use early on. Many have serious family and mental health
problems. And we didn't pick it up early enough," Dr. Haley said.

For youths on the streets of Montreal, the result of the study isn't
surprising.

"It's a struggle," said Tom, 24, as he panhandled for beer money. "You
spend most of your time getting high, and when you're not, all you think
about is finding money to buy drugs," he said, sporting black eyes and a
bruised lip after he was jumped by five other street kids the night before.

Eighteen-year-old Jonathan, who has been on the streets for almost a year,
explained that you can't trust anyone on the streets. "There's no one you
can depend on," he said. "Sure, you make friends, but they're not your real
friends and will stab you in the back if it can help them."