Foster child health and development: implications for primary care

Children in foster care are the most vulnerable to experiencing poor health compared with any other group of children in the United States. Children enter foster care due to experiences that have been detrimental to their health and well-being, including child abuse and neglect. They have significantly higher rates of all health problems than the general population of children, including acute and chronic illnesses, growth and developmental problems, serious mental health problems, and difficulties accessing health services. Additionally, they often experience multiple foster care placement transitions, involvement in multiple systems of care (e.g., mental health, juvenile justice, special education), and aging-out of foster care at age 18 before they are developmentally ready for independent living. While management of the complex health and developmental needs of these children is challenging, nurses in primary care have the expertise and obligation to serve these vulnerable children. Priorities for clinical practice include care coordination and interdisciplinary collaboration; maintenance of adequate, up-to-date health records; vigorous follow-up; and health-targeted advocacy.