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Published on: July 10, 2017
Health-risk behaviors in young adolescents in the child welfare system
Laurel K Leslie1, Sigrid James, Amy Monn
1Center on Child and Family Outcomes, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA. lleslie@tuftsmedicalcenter.org
Purpose:
To examine rates and patterns of health-risk behavior (e.g., sexuality, depression/suicidality, substance use, delinquency) among a national probability sample of youth active to the child welfare/child protective services system. Recent federal legislation, P.L. 110-351, encourages child welfare systems, Medicaid, and pediatric experts to collaborate to ensure youth entering foster care receive comprehensive health examinations.
Methods:
Analysis of baseline caregiver, caseworker, and child interviews, and assessment data for a subsample (n = 993) of youth, aged 11-15 years, from the National Survey of Child and Adolescent Well-Being, a national probability sample of children and adolescents undergoing investigation for abuse or neglect.
Results:
Almost half of the sample (46.3%) endorsed at least one health-risk behavior. On Poisson multivariate regression modeling, factors related to higher rates of health-risk behaviors included older age, female gender, abuse history, deviant peers, limited caregiver monitoring, and poor school engagement.
Conclusion:
Given the heightened vulnerability of this population, early screening for health-risk behaviors must be prioritized. Further research should explore specific subpopulations at risk for health-risk behaviors and possible interventions to change these youths' trajectories.
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