The Unmet Health Needs of East Asian High School Students: Are Homestay Students at Risk?

Objectives: Most "homestay" high school students come to Canada from East Asian countries such as China, Korea and Japan to attend school while living with another family. Our objectives were to examine: 1) the characteristics of homestay youth compared to immigrant and Canadian-born East Asian youth and 2) whether their health risk behaviours are similar to immigrant or Canadian-born East Asian youth. Methods: We used the 2003 British Columbia Adolescent Health Survey to examine characteristics of East Asian youth and their health risk behaviours, including sexual behaviours, substance abuse, abuse history, and health status. Homestay students were those not born or raised in Canada and not living with their parent(s) or in foster care. Multivariate models tested for the independent association of student group, controlling for age. Results: Homestay students (weighted n=3,085) were older, on average, than immigrant or Canadian-born youth and spoke a language other than English at home (p<0.001). Multivariate analyses showed that homestay students were more likely to engage in sexual behaviours than other youth and over 4 times more likely to have used cocaine. Female homestay students were 3 times more likely to be a victim of sexual abuse and were also 3 times more likely to use a substance prior to sex. Conclusion: Homestay students remain a forgotten and extremely vulnerable group of youth, in part because they have special living arrangements. No one is currently held accountable for their health or safety. In the absence of health policy about homestay students, public health officials and providers have a central role in ensuring the former's health is not threatened.