Reverse Outline of HCP Assignment What is a Reverse Outline? A reverse outline is…wait for it…an outline in reverse. You’ve already written a full draf

Reverse Outline of HCP Assignment What is a Reverse Outline? A reverse outline is…wait for it…an outline in reverse. You’ve already written a full draft of your HCP. Now, go back over that draft, and write down the main argument of your overall essay (i.e., the specific, arguable thesis from your introduction) followed by the sub-claims of each paragraph (hopefully stated clearly in the topic sentence). You’ll probably also want to include the main evidence that you use in each paragraph, possibly also listing the sources.What you should end up with is a clear map of the argument you’re making in your HCP. Ideally, this will let you see how all the sub-claims in your different paragraphs work together to back up your overall argument. If, however, you find that some paragraphs don’t really relate to your overall argument; or if you see that some paragraphs don’t stay on topic but rather wander off and deal with multiple things unrelated to the topic sentence; well, then, go back and rewrite these paragraphs, or rewrite your thesis! This Reverse Outline is an assignment that should help you produce a better, tighter overall draft. Zhou 1
Health Status of Homeless Children and Adolescents: Historical Causes of Problems
Homelessness is one of the significant social problems in the United States and the consequences
of the economic factors that are beyond the controls of the people that lose their homes or
victims of the cultural practices that exist in their households and communities. It is a problem
whose severity and implications have tremendous adverse impacts on the proper development of
young people in the early years of their lives. While the demographics of the homeless
population in the country consist of families, individual adults, and young people, San Francisco
is considered as the city of refuge for runaway homeless teenagers and families with children.
According to Jones and Willis, the city is home to an estimated 15,000 homeless children and
over 1,200 adolescents. In the Ravenswood district alone, over 37percent of its 3,076 students
are homeless, which is a problem that makes the provision of public education services highly
challenging for the school district (para 5).
Empirical evidence from the different studies that are conducted on the state of
homelessness in San Francisco revealed that teenagers have come to the city for decades to seek
shelter and protection from emotional, physical, or sexual abuse and violence from their parents,
relatives, and guardians at home. Putnam‐Hornstein, Lery, Hoonhout, and Curry stated that in the
case of the homeless families, the availability of emergency shelters and educational services for
their children was found to be the historical causes for the high number of children living on the
street of San Francisco (46). The uncertainty surrounding emergency shelters for homeless
children and young people, as well as their constant exposure to maltreatment, abuse, and
neglect, increases their potential to suffer from mental, social, and physical health problems,
which would result in impaired functioning as adults. Therefore, it is imperative to examine the
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historical causes of the issues that make young live on the street and the consequences of their
decision as input to the development of social and public health policies that would address the
The incidence of Children and Youth Homelessness in San Francisco
San Francisco is the city with the highest number of homeless children and youth in the country
and one that attracts this vulnerable population of the perception that the issues or problems that
made them to live on its streets would be resolved. In a report by Larkin Street Youth Services
on the incidence of the problem in the city, loss of employment, disagreement with a family
member or friends, and eviction are three significant issues that force people aged 12- 18 years to
live on the streets (4). The report furthers added that problems in the youth care system also
create the path to homelessness for this young people include foster care, juvenile, and mental
health among others, as well as a history of residential instability (2). In the case of the high
population of homeless children, a significant percentage come to San Francisco with their
families because of the availability of food, emergency shelters, sleeping parks, and free
educational services (Jones and Willis para 3). Although these factors are related to the economic
instability that is caused by job loss and results in loss of housing, the city is attractive to these
homeless families because of the access to the unique public educational services for homeless
Meanwhile, an examination of the composition of the population of homeless children
and youth is necessary to identify the extent of the problem and the associated social and health
challenges that are faced by this category of vulnerable members of society. According to Larkin
Street Youth Services, the estimated 3,000 homeless youths who live in the city consist of
unaccompanied children that are less than 18years old and transitional-age-youths who are aged
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between 18 and 24years. Also, 87% of this population is citizens of the United States while 60%
of the foreigners are from Latin American countries (3). An additional aspect of the
demographics of the population is the 93 percent of the children less than 18years old and 80
percent of those older but below 25years are unsheltered. It is pertinent to state that outcomes of
the survey showed that over 50% of this population has experienced at least one form of adverse
childhood experiences including maltreatment, sexual and physical abuse, neglect, and lack of
health services for their medical conditions (Brinamen, Taranta, and Johnston 283). Therefore,
the high population of homeless youths and children in San Francisco is not just a social problem
that is impacting several areas of the city’s systems but a source of mental and physical health
challenges that should be addressed.
The Health Status of Homeless Children and Youth in San Francisco
The factors that force children and adolescents to run away or be ejected from their homes are
resulting in mental and physical health issues that remain unsolved for several years thereby
resulting in their impairment of their functioning as adults. In a study conducted by Angela
Narayan and her colleagues, the high rate of childhood exposure to maltreatment and family
dysfunction is resulting in the adverse experiences that increase the probability of developing
mental illnesses in sheltered children aged 4-6years. Similarly, Brinamen and colleagues stated
that the lack of access to early childhood mental health consultation by these children is limiting
the potential of interventions that are designed to help to prevent these children from
experiencing impairment of the proper functioning in adulthood (285). In this context, the
failure of the children to receive the required interventions that would help them to overcome the
impacts of their exposure to adverse events is responsible for their poor health status, which
affects important stages of their lifespan development. Also, the prevention of access of these
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children to care services and refusal of their parents to disclose some of the medical conditions
affecting their kids is part of the factors for their poor health. Therefore, the combination of the
need to deal with the issues of survival that these homeless youths face on the streets and failure
of the child protective services to provide access to early intervention is responsible for the poor
health status of this demographic of the population.
Furthermore, the state of the health status of the homeless youths in San Francisco,
California can be examined from the high prevalence rates of substance abuse among this
population. Injection drug use is the leading form of substance abuse practices within this
population and responsible for the many physical health problems that they encounter and lack
access to treatment options. In a cohort study conducted by Parriott and Auerswald, illiteracy,
social exclusion, and age are the main factors that predict the initiation of injected drugs among
homeless youths, which was found to be responsible for the high prevalence of sexually
transmitted diseases (1965). When the implications of these findings are placed in the context of
the high rate of exploitation and victimization of unsheltered homeless youths and children in the
city, the poor health status and overall wellbeing of this population would become apparent.
Also, it is pertinent to state that part of the factors that are responsible for the high incidence and
prevalence rates of sexual transmitted infections within the unsheltered homeless youth
population is the practice of exchanging sexual favors for meals, clothing, protection, and other
basic needs for their survival. Thus, the poor health status of homeless youths in the city due to
drug and substance abuse and sexual transmitted diseases is caused by some factors that beyond
the control of these young people as the strive for their survive on the streets.
Meanwhile, the insights into the mental health status of homeless children and youths can
be analyzed from the adverse effects of the neglect and maltreatment that forced them to leave
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their families and homes. In this regard, the evidence of the problem can be identified through
the relationship between the substance abuse problem, adverse childhood experiences, and
potential psychiatric disorders. Ernika Quimby and her colleagues found from their investigation
that 32% and 33% of homeless youth in San Francisco suffer from Antisocial Personality
Disorder and anxiety disorder respectively. They further claimed that the situation is critical
when consideration is given to the fact that an estimated 84% of the sample population has
abused at least one substance in the past twelve months (186). When consideration is given to the
fact that a significant percentage of this children and adolescents are oblivious of their mental
health status because of lack of access to diagnostic and treatment services, the extent of their
healthcare needs and type of services to meet them can be identified. Hence, the review of the
level of access to health care services is essential to gain further insights into the state of the
problems affecting homeless youths and children in this city.
The current level of access to health care and services in the city by homeless youths and
children in the city is another source of information that can provide insights to the health status
of this demographic of the population. As noted in the previous section of this paper, the capacity
to provide mental health counseling for children that exposed to adverse childhood experiences
such as domestic violence and maltreatment in the child protection system is limited because of
the instability of their residence. Also, a significant percentage of the transition-age-youths that
are expected to have health insurance does not possess one due to financial issues, which is an
indicator of their inability to access care that can prevent mild illness from developing into
chronic ones (Morewitz 88). An additional dimension of the problem is the failure of the parents
of homeless infants, and young children who are residents of homeless shelters allow mental
health consultation of their children due to ignorance and fear of separation. Therefore, the health
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status of homeless children and youths in San Francisco is in an abysmal state, which increases
the imperatives for the development of comprehensive public health and social policies that deal
with them tactically and strategically.
In conclusion, the outcome of the evaluation of the factors that are responsible for the
poor health status of homeless children and youths in San Francisco affirmed the absences of the
relevant services that are needed by these demographics to take them away from the streets.
Also, the findings are a reflection of the inadequacy of the efforts by non-governmental
organizations such as the Larkin Street Youth Services to deal with the problem effectively,
especially when consideration is given to the evidence that the rise in the number of homeless
young people will continue for several decades. However, the evidence from the literature also
showed that some of the solutions that can be used to address this problem include outreach
programs for homeless youths that focus on the provision of information on the community
resources for dealing with their problems and methods for accessing them. Finally, drop-inServices and emergency housing units are additional solutions that several research studies have
shown to have greater positive impacts on the elimination of the physical problems that lead to
the mental health problems that lead to their poor health status.
Works Cited
Brinamen, Charles F., Adriana N. Taranta, and Kadija Johnston. “Expanding early childhood
mental health consultation to new venues: Serving infants and young children in domestic
violence and homeless shelters.” Infant Mental Health Journal 33.3 (2012): 283-293.
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Larkin Youth Services. “Youth homelessness in San Francisco: 2014 Report On Incidence and
Needs.” (2015): 1-16.
Morewitz, Stephen J. “Well-being and access to health care.” Runaway and Homeless Youth.
Springer International Publishing, Switzerland, 2016. 87-98.
Narayan, Angela J., et al. “Intergenerational continuity of adverse childhood experiences in
homeless families: Unpacking exposure to maltreatment versus family
dysfunction.” American Journal of Orthopsychiatry 87.1 (2017): 3.
Parriott, Andrea M., and Colette L. Auerswald. “Incidence and predictors of onset of injection
drug use in a San Francisco cohort of homeless youth.” Substance Use & Misuse 44.13
(2009): 1958-1970.
Putnam‐Hornstein, Emily, et al. “A retrospective examination of child protection involvement
among young adults accessing homelessness services.” American journal of community
psychology 60.1-2 (2017): 44-54.
Quimby, Ernika G., et al. “Psychiatric disorders and substance use in homeless youth: A
preliminary comparison of San Francisco and Chicago.” Behavioral Sciences 2.3 (2012):

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