Foster Children at Most Risk for Chronic Health Problems

Newswise — The first national sampling of children in the welfare system identified those in foster care most at risk for chronic health problems — children under the age of two and those living in small families. Latino caregivers were least likely to report their child as having a chronic condition.

The authors of the study in the latest issue of the Journal of Health Care for the Poor and Underserved urged health care providers to invest additional time and energy in caring for these youngsters, in light of their complex needs.

"Nearly 600,000 children in the United States are in foster care, which is an increase of nearly 90 percent over the past two decades," said lead author Sandra Jee, M.D.

Using data from a joint survey by the U.S. Department of Health and Human Services and the Administration on Children, Youth, and Families, the researchers analyzed interviews and assessments on a sample of 727 children who had been in foster care for about one year.

Jee, an assistant professor of pediatrics at the University of Rochester School of Medicine, said that the sickest children with multiple complex health problems may be placed with smaller families purposely. These parents would require more sophisticated levels of training in caring for these children.

Children under age two may be more likely to have chronic conditions because many were exposed to drugs or alcohol before birth, Jee said. They may have been premature and have experienced chronic lung disease, leading to asthma and other lung conditions. Asthma and assorted respiratory problems affected 45 percent of children in this study who were identified as having a chronic condition.

"By definition, nearly 100 percent of young children [in foster care] are exposed to abuse and neglect," Jee said, "so in addition to physical problems, many suffer from considerable mental health problems as well."

Heidi M. Feldman, M.D., a professor at the University of Pittsburgh School of Medicine not involved in the study, said children in foster care "should have an electronic record, since they move so frequently. They should all be evaluated for early intervention or special education, because of the high rates of developmental disorders and emotional problems."

According to Jee, some of the findings of this study were unexpected, such as Latino families being less likely to report having children with chronic health problems. She suggested the possibility that some protective factors associated with the strong social support in Latino families may have secondary positive effects on health.

"Are these children in Latino families really healthier, or is there a difference in how these families perceive health? We don't know. It will be interesting to find out," Jee said.

Jee SH, et al. Factors associated with chronic conditions among children in foster care. Journal of Health Care for the Poor and Underserved 17(2), 2006.