Children in care 'suffer poor health for decades'

Children and young people who grow up in care are up to four times more likely to suffer from poor health 30 years later than those who grew up with their parents, finds new research from UCL and King's College London.

The study, published in the European Journal of Public Health, shows those who were raised by someone other than their parents were more likely to report their health as poor well into adulthood.

Academics in the ESRC International Center for Lifecourse Studies at UCL analyzed data from 350,000 people to explore whether looked-after children fared better or worse if they spent time in residential care compared with living in foster care, or with relatives.

The study shows adults who grew up in any type of care setting had worse self-rated health – an indicator of physical and mental health problems—10, 20 and 30 years later than those who lived with their parents.

The team say the results highlight the need to expand mental health support beyond young adulthood and that more help is needed for relatives who care for children informally and often go "under the radar."

Adults who lived in residential care during childhood had a 40% chance of reporting poor health 10 years later. This rose to an 85% chance over the following two decades.

The chances were much lower for those who grew up with a relative, with the probability ranging from 21% to 43% over the 30-year period.

By contrast, adults who grew up with their parents only had a 13% chance of reporting poor health after 10 years, rising to 21% at the later checkpoints.

Professor Amanda Sacker (UCL Epidemiology & Public Health), who led the study, said: "More must be done to close the inequality gap between those who spend time in care and those who do not, particularly as the impact of COVID starts to be felt. We're seeing the same differences in rates of poor health among people that have survived to their 40s as people in their 20s. The effects are not wearing off—and we suspect these are more likely to be mental health problems than physical. Support is available for mental health during the transition into adulthood but there's nothing later on in life. I would like the support to last for longer. There are opportunities to turn things around—people just need a little bit of help to do this."

The team previously found that adults who spent time in care as children were 70% more likely to die prematurely than those who did not. The majority of deaths were down to unnatural causes such as self-harm, accidents or in some way related to mental illness.

Professor Sacker said historically, cared-for children usually went into residential or foster care, but people's attitudes to placements have changed over time. This includes recognizing the positive impact that staying with a family member can have, in reducing the trauma of being removed from parents and maintaining a child's sense of identity and self.

Recent evidence suggests that up to 96% of children being cared for by relatives might be being looked after informally, rather than through social services.

First author Dr. Emily Murray (UCL Epidemiology & Public Health) highlighted the need for more support for relative carers, particularly at times of crises such as the COVID pandemic.

She said: "A lot of the relatives that look after children, especially grandchildren, are not particularly well off. They are completely under the radar—they need support but often don't ask for help. Inequalities tend to increase in magnitude at times like this. Let's put in safeguards now, so that we don't keep seeing the same, or worse, inequalities for the next 10, 20 or 30 years."