Adult health and social outcomes of children who have been in public care: population-based study

Abstract

Objective: To examine adult socioeconomic, educational, social, and health outcomes of being in public care in childhood.

Methods: The 1970 British birth cohort was followed up at 5 (N = 13135), 10 (14875), 16 (11622), and 30 years (11261). Cases were defined as those ever in statutory or voluntary public care at 5, 10, and 16 years. Self-reported adult outcomes were occupation, educational achievement, general health, psychological morbidity, history of homelessness, school exclusion, and convictions.

Results: A total of 343 (3.6%) of 9557 had been in public care <17 years. Nonwhite children were more likely to have been in care (odds ratio [OR]: 3.3; 95% confidence interval [CI]: 2.1-5.4). Controlling for socioeconomic status, men with a history of public care were less likely to attain high social class (OR: 0.6; 95% CI: 0.4-0.9) and more likely to have been homeless (OR: 2.0; 95% CI: 1.1-3.8), have a conviction (OR: 2.3; 95% CI: 1.5-3.4), have psychological morbidity (OR: 1.8; 95% CI: 1.1-3.0), and be in poor general health (OR: 1.6; 95% CI: 1.1-2.6). Similar associations were found in women. Men but not women with a history of care were more likely to be unemployed (OR: 2.6; 95% CI: 1.4-5.0) and less likely to attain a higher degree (OR: 0.4; 95% CI: 0.2-0.7). Nonwhite ethnicity was associated with poorer adult outcomes of being in care.

Conclusions: Public care in childhood is associated with adverse adult socioeconomic, educational, legal, and health outcomes in excess of that associated with childhood or adult disadvantage.