Foster Kids Face Worse Mental and Physical Health Challenges, Study Finds

Children in foster care in the United States experience serious mental and physical health conditions at a much higher rate than those in the general population, a new study published in the journal Pediatrics found. Anxiety, behavioral problems, depression and attention challenges are all much more prevalent among foster kids, as well as asthma, obesity and hearing and vision impairments.

Kristin Turney, a co-author of the report and associate professor of sociology at the University of California, Irvine, noted that the study is the first to make this kind of comparison.

"No previous research has considered how the mental and physical well-being of children who have spent time in foster care compares to that of children in the general population," she said in a press release.

How large are the disparities in mental and physical health between these groups? The press release notes that it varies, but the gulfs are vast. Compared with other children, kids in the foster system are:

•Seven times as likely to experience depression
•Six times as likely to exhibit behavioral problems
•Five times as likely to feel anxiety
•Three times as likely to have attention deficit disorder, hearing impairments and vision issues
•Twice as likely to suffer from learning disabilities, developmental delays, asthma, obesity and speech problems

"This work makes an important contribution to the research community by showing for the first time that foster care children are in considerably worse health than other children," said Turney. "Our findings also present serious implications for pediatricians by suggesting that foster care placement is a risk factor for health problems in childhood."

To conduct the study, Turney and her co-author, Christopher Wildeman, a professor of policy analysis and management at Cornell University, examined data collected by the 2011-2012 National Survey of Children's Health. Only 1.3 percent of the more than 900,000 youths included in the survey were in the foster system. Turney and Wildeman compared this subset to the rest of the group using various statistical controls.

So what should we conclude from this research?

"Children in foster care are a highly disadvantaged and vulnerable group, indicating that great interventions must be targeted at these children in order to diminish these health disparities," Wildeman told Patch.

These results are not particularly surprising, because children who have safe and protective home lives are much less likely to end up in the foster system. But the research is necessary to get a clear picture of the challenges foster kids face and thus how we might work to relieve the burdens these children face.

Wildeman noted that the scale of risk faced by foster kids for mental and physical health conditions is unlikely to be caused primarily by the foster system itself.

"A large body of research purports to have great insight into what causes these disparities, but it remains unclear what the core drivers are, and future research must seek to solve this puzzle," he said. "It seems likely that prior experiences of child maltreatment, coupled with a host of other risk factors for poor health are the core drivers. "

Based on these findings, is there anything society can do to ameliorate the conditions foster children face?

Wildeman continued: "There is one policy prescription that is clear: Design interventions to improve the health of children in foster care and that focus not solely on their current living situation but also on a host of other risk factors that they face for poor health."

Additional research released this week from Columbia University Mailman School of Public Health points to another hurdle for relieving the inequalities surrounding the foster system. Renée Wilson-Simmons, a co-author of the report and assistant professor of health policy and management at the school, points out that people who age out of the foster system are frequently falling through gaps left by state implementation of the Affordable Care Act (known as Obamacare).

The problem here is that the law requires adults who aged out of the foster system at age 18 to be guaranteed health coverage by Medicaid until the age of 26. However, according to the report, only 13 states provide coverage to all such individuals, including those who turned 18 in another state. Other states have tried to find wiggle room in the wording of the law to avoid this obligation.

"Some states have been trailblazers in promoting the health of children while they're in foster care," Wilson-Simmons said in a press release. "However, several states are undoing that good work once young people leave the system, just because they aged out in another state."

"No child who's seeking an education, pursuing a job opportunity, or attempting to start the next phase of life in a different state should lose health coverage," she added. "But many former foster youth are being forced to do just that."

Given the initial disparities in health between children in the foster system and others, this report shows how the disadvantages may persist into adult life.

Read the full Pediatrics study>>

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