PEDIATRICS Vol. 115 No. 4 April 2005, pp. 894-899 (doi:10.1542/peds.2004-1311)
Adult Health and Social Outcomes of Children Who Have Been in Public Care: Population-Based Study
From the Department of Paediatrics and Child Health, Royal Free and University College Medical School, Royal Free Campus, Royal Free Hospital, London, United Kingdom
Objective. To examine adult socioeconomic, educational, social, and health outcomes of being in public care in childhood.
Methods. The 1970 British birth cohort was followed up at 5 (N = 13135), 10 (14875), 16 (11622), and 30 years (11261). Cases were defined as those ever in statutory or voluntary public care at 5, 10, and 16 years. Self-reported adult outcomes were occupation, educational achievement, general health, psychological morbidity, history of homelessness, school exclusion, and convictions.
Results. A total of 343 (3.6%) of 9557 had been in public care <17 years. Nonwhite children were more likely to have been in care (odds ratio [OR]: 3.3; 95% confidence interval [CI]: 2.1–5.4). Controlling for socioeconomic status, men with a history of public care were less likely to attain high social class (OR: 0.6; 95% CI: 0.4–0.9) and more likely to have been homeless (OR: 2.0; 95% CI: 1.1–3.8), have a conviction (OR: 2.3; 95% CI: 1.5–3.4), have psychological morbidity (OR: 1.8; 95% CI: 1.1–3.0), and be in poor general health (OR: 1.6; 95% CI: 1.1–2.6). Similar associations were found in women. Men but not women with a history of care were more likely to be unemployed (OR: 2.6; 95% CI: 1.4–5.0) and less likely to attain a higher degree (OR: 0.4; 95% CI: 0.2–0.7). Nonwhite ethnicity was associated with poorer adult outcomes of being in care.
Conclusions. Public care in childhood is associated with adverse adult socioeconomic, educational, legal, and health outcomes in excess of that associated with childhood or adult disadvantage.
Key Words: foster care • population health • psychiatric disorders • public health • public policy
Abbreviations: BCS70, 1970 British Birth Cohort Study • OR, odds ratio • CI, confidence interval
Accepted Aug 2, 2004.
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