According to a new study from the journal Pediatrics, adults who were raised in the foster-care system are more likely to have chronic-health problems than those not from foster backgrounds, even after controlling for economic security.
It has long been recognized that foster kids have high rates of health problems as children, but this study is the first to ask what happens when those kids reach adulthood. It considered cardiovascular risk factors and other chronic problems, and it compared three groups of young adults: those formerly in foster care, those from the general public with economically insecure backgrounds, and those from the general public with economically secure backgrounds. The results were graduated among the three groups, from foster care, to economic insecurity, to economic security.
In the paper, the authors explain why their findings are not surprising:
Foster youth are often exposed to poverty and many other adverse childhood experiences including abuse, neglect, domestic violence, and parental substance use, and many undergo frequent placement and school changes while in foster care. Several theories exist regarding the effects of chronic and early exposures to adversity, all of which suggest that the more stressors to which one is exposed, the higher the likelihood of a chronic physical or mental health condition later in life.
However, because these theories regarding adversity haven't yet been adequately investigated, this study has important implications. Scientific evidence could influence policy-makers to address this problem, perhaps by continuing Medicaid access for former foster kids or granting it to those far below the poverty line, or by offering continued support from the foster-care system into young adulthood. Provisions for the first two changes were made in the Affordable Care Act, and the federal government does offer incentives for states to continue foster care until age 21, but due to technicalities and state-level laws, these benefits are not widely accessible.
The authors also offer a discussion on how the quality of medical care impacts foster youth:
Our access indicators suggest that former foster youth do not perceive a lack of needed medical care during young adulthood; previous analyses reveal that foster youth also perceive similar or higher rates of access to medical care compared with general population youth while they are still in care. However, it is important to note that access to “needed care” does not equate to access to high-quality, evidence-based care.... there is little reason to believe these problems improve as foster youth become young adults facing homelessness, unemployment, and other issues known to affect quality of health care.
Policies and programs may need to be tailored to the unique life experiences of foster youth to have maximal effect, for example, including individualized strategies to promote the formation of trusting relationships with health care and allied providers. Support to maintain these relationships across placement changes may also be beneficial.
The work was conducted by researchers from Seattle Children’s Hospital & Research Institute, the University of Washington School of Medicine, and the University of Chicago's School of Social Service Administration.
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