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Case-control study of the health of those looked after by local authorities
J Williams1, S Jackson, A Maddocks
1School of Postgraduate Studies in Medical & Health Care, University of Wales Swansea, Singleton Park, Swansea SA2 8PP, UK. john.williams@pgms.wales.nhs.uk
Insights
Children in local authority care face significant health disparities, particularly in emotional and behavioral health, compared to peers at home. This highlights critical gaps in healthcare provision and health promotion for vulnerable youth.
Area of Science:
- Child Health
- Public Health
- Social Determinants of Health
Background:
- Children in local authority care represent a vulnerable population with unique health needs.
- Understanding their health status is crucial for effective intervention and policy development.
Purpose of the Study:
- To evaluate the health needs of school-aged children in local authority care.
- To assess the adequacy of healthcare provision for this group.
Main Methods:
- A comparative study involving 142 children in local authority care and 119 matched controls.
- Assessment of routine healthcare, physical, emotional, and behavioral health, and health promotion.
Main Results:
- Children in care had higher rates of GP changes, incomplete immunizations, and inadequate dental care.
- They exhibited more anxieties, interpersonal difficulties, bedwetting, smoking, illegal drug use, and police involvement.
- Despite these issues, they reported less overall physical ill health and had more recent hearing/eye tests.
Conclusions:
- Children in care for over six months experience worse overall healthcare, especially in emotional/behavioral domains and health promotion.
- Physical health issues were not as pronounced as anticipated, contrasting with some previous research.
Aims:
To assess the health needs and provision of health care to school age children in local authority care.
Methods:
A total of 142 children aged 5 to 16 in local authority care, and 119 controls matched by age and sex were studied. Main outcome measures were routine health care, physical, emotional, and behavioural health, health threatening and antisocial behaviour, and health promotion.
Results:
Compared with children at home, those looked after by local authorities were significantly more likely to: experience changes in general practitioner; have incomplete immunisations; receive inadequate dental care; suffer from anxieties and difficulties in interpersonal relationships; wet the bed; smoke; use illegal drugs; and have been cautioned by police or charged with a criminal offence. They also tend to receive less health education. They were significantly more likely to have had a recent hearing or eye sight test, and reported significantly less physical ill health overall.
Conclusions:
The overall health care of children who have been established in care for more than six months is significantly worse than for those living in their own homes, particularly with regard to emotional and behavioural health, and health promotion. In contrast to uncontrolled observational studies we have not found evidence of problems with the physical health of these children.