In most cases, poverty is the main reason children and teens worldwide end up homeless or living on the streets, according to a new review of past research.
About 40 percent of youths reported poverty as the main reason they were homeless, according to the report in JAMA Pediatrics. Family conflict and abuse were also among the most commonly reported reasons for living on the streets.
The findings should make policymakers "think hard about what they can do about these issues," said senior author Paula Braitstein, who is affiliated with the University of Toronto and based in Kenya.
The researchers say societies often classify homeless youths as juvenile delinquents, which results in exclusion, criminalization and oppression.
Until now there had been no large reviews of data on why youths end up on the streets, they write.
Braitstein and her colleagues used data collected from 49 studies with a total of 13,559 participants from 24 countries, including 21 developing countries. No one was older than 24.
Thirty-nine percent of participants cited poverty as their reason for homelessness. About 32 percent reported family conflict as their reason for being on the streets, and about 26 percent cited abuse.
When the researchers examined countries by economic status, poverty was the main reason for youth homelessness in developing countries and family conflict was the main reason in developed countries.
While delinquency is often blamed for youth homelessness, only 10 percent of participants said that was what caused them to be homeless. It was the least-cited reason.
And even that 10 percent figure might be an overestimate, because youth are more inclined to report behavioral problems than abuse as a reason for living on the streets, said Dr. Colette Auerswald, of University of California Berkeley-University of California San Francisco Joint Medical Program.
"We need to focus on having an appropriate safety net for kids who do fall through the cracks because of poverty or abuse," said Auerswald, who co-wrote an editorial accompanying the new study.
"The kinds of solutions that these children, adolescents and young adults need are not adult solutions," she said. "Tailoring them for a mini-me or smaller size . . . doesn't work."
Instead, she would like to see homeless youth served in programs offering university-style housing, where they would be looked after, fed and not threatened with eviction.
Braitstein told Reuters Health that governments need to take responsibility for the care of their children.
A lot of children "end up turning to the streets because they have nowhere else to go," she said.