Related Experiment Videos
Assessing the health status of children entering foster care
R Chernoff1, T Combs-Orme, C Risley-Curtiss
1Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD.
Insights
Children entering foster care exhibit widespread health issues, including vision, hearing, and developmental problems. Immediate medical, dental, and mental health interventions are crucial for this vulnerable population.
Area of Science:
- Pediatric Health
- Public Health
- Child Welfare
Background:
- Existing research on foster child health is often cross-sectional, overemphasizing long-term cases.
- This study addresses the underrepresentation of short-term foster care children in health research.
Purpose of the Study:
- To assess the health status of children upon entering foster care.
- To identify the prevalence of various health conditions in this population.
Main Methods:
- A cohort of children entering foster care underwent comprehensive health examinations.
- Data was collected over a 2-year period in a mid-sized city.
Main Results:
- Over 90% had at least one system abnormality; 25% failed vision, 15% failed hearing screenings.
- Significant mental health concerns noted: 75% family history of substance abuse/mental illness, 15% suicidal ideation (age >3).
- Developmental delays (23% for age <5) and high referral rates for medical (over 50%), dental (over 50% for age >3), and mental health services (over 50% for age >3) were observed.
Conclusions:
- Children entering foster care present with a high prevalence and wide spectrum of health needs.
- Improved healthcare delivery models are essential for children in the foster care system.
Objective:
Most research on health problems of children in foster care has been cross-sectional, resulting in overselection of children who have been in care long-term and underrepresentation of children who are in care for a short time.
Methodology:
This paper reports on the health of a large cohort of children who had complete health examinations at the time of entry into foster care in a middle-size city during a 2-year period.
Results:
Results indicate that > 90% of the children had an abnormality in at least one body system, 25% failed the vision screen, and 15% failed the hearing screen. The children were also lighter and shorter than the norm. Mental health screening revealed that 75% had a family history of mental illness or drug or alcohol abuse. Of children older than 3 years of age, 15% admitted to or were suspect for suicidal ideation and 7% for homicidal ideation. Of the children younger than 5 years of age, 23% had abnormal or suspect results on developmental screening examinations. At the time of entry into foster care, 12% of the children required an antibiotic. More than half needed urgent or nonurgent referrals for medical services and, for children > 3 years of age, more than half needed urgent or nonurgent referrals for dental and mental health services. Just 12% of the children required only routine follow-up care.
Conclusions:
The high prevalence and broad range of health needs of children at the time they enter foster care necessitate the design and implementation of better models of health care delivery for children in foster care.