Children in foster care are more likely to have chronic conditions if they are young and live in a small family, not because they are poor, less educated or African American, as has been hypothesised.
A University of Rochester study in this month’s Journal of Health Care for the Poor and Underserved is the first to assess health status of foster care children in a nationally representative sample.Overall, about 30 percent of the children were reported by their caregivers as having chronic conditions such as asthma, cerebral palsy, failure to thrive, obesity and severe allergies. More than 40 percent of children younger than 2 had chronic conditions, and more than one-third of families with three or fewer members had a foster child with at least one chronic condition. An interesting twist: the group least likely to report chronic conditions was Hispanic or Latino families.”It makes sense that children less than 2 years old in foster care are more likely to have these health issues because they often come into the system with pre-existing conditions such as prematurity or prenatal exposure to drugs or alcohol,” said lead author Sandra Jee, M.D., M.P.H., Assistant Professor of Paediatrics at Golisano Children’s Hospital at Strong. “And small families may be more likely to take in foster children who have health issues than larger families who have more to juggle. They may also be less likely to take in more children when they already have their hands full with one special-needs child.”The likelihood of a child having a chronic condition did not differ significantly by the caregiver’s gender, age, marital status, employment status, educational level or income or whether the child was reunited with the biological family. The data for the study came from the National Survey of Child and Adolescent Well-Being survey conducted by the U.S. Department of Health and Human Services and the Administration on Children, Youth and Families, which included children investigated for abuse and neglect in 1999 and 2000.Rochester has a national model for caring for children in foster care in its Foster Care Paediatrics clinic, run by Moira Szilagyi, M.D., Ph.D., an Associate Professor of Paediatrics at Golisano Children’s Hospital at Strong. The clinic relies on partnerships among the Monroe County Health Department, Strong Behavioral Health and Fostering Futures, the Paediatric Practice at Strong, Community Health Nursing at Strong, Mt. Hope Family Centre and the Kirch Developmental Centre at Strong. Once placed in foster care, children are seen by the clinic, even through changes in local foster care placement.”Health providers serve as a resource for children, foster families, caseworkers, family court and others involved in the lives of children in foster care,” Szilagyi said. “Having a dedicated health resource improves the health of children, increases stability in foster care homes, supports foster families and improves communication among child welfare, family court and health professionals.”(Source: Health Care for the Poor and Underserved: University of Rochester Medical Centre: May 2006).