May 26, 2006

Certain Foster Children at Greatest Health Risk

By Amy Norton

NEW YORK -- Foster children are known to have a much higher-than-average rate of chronic health problems, but new research suggests that the youngest children are among those at greatest risk.

Using data from a national study of 727 U.S. foster children, researchers found that children younger than 2 and those placed in relatively small households were particularly likely to have chronic medical conditions such as asthma, allergies or repeat ear infections.

On the other hand, Hispanic caregivers reported fewer child health problems compared with foster parents of other ethnicities.

The reasons for these associations are not completely clear, but the findings offer some direction as to which foster children have the greatest healthcare needs, according to Dr. Sandra H. Jee of the University of Rochester School of Medicine and Dentistry in Rochester, New York.

In an interview, Jee explained that foster children younger than 2 may have more health problems due to factors such as preterm birth and prenatal exposure to drugs or alcohol.

The finding on small family size, according to Jee, likely reflects the fact that children with greater health needs may be intentionally placed in smaller households.

In general, Jee said, most foster children are probably coming into the system already suffering from various physical and mental health problems.

She and her colleagues report their findings in the Journal of Health Care for the Poor and Underserved.

Studies on the state and local level have estimated that anywhere from 44 percent to 82 percent of U.S. children in foster care have a chronic health problem. Along with physical illnesses like asthma and allergies, many children also have mental health conditions such as depression, anxiety and behavioral disorders.

"Ideally," Jee said, "we would like all primary care providers to understand that all kids in foster care should get special attention."

But, she added, her team's findings point to certain children who may be especially vulnerable to health problems.

Overall, 30 percent of the children in the study had at least one chronic medical condition, according to caregivers' reports. But among children younger than 2, the rate was 40 percent.

Similarly, one-third of children in households with fewer than four people had a chronic health condition, versus 20 percent in larger families.

On the other hand, Hispanic children were less likely to have a health problem than either white or black children, and Hispanic caregivers were least likely to say their foster child had a medical condition.

Jee said this is an "interesting" finding that deserves further study. It's possible, she speculated, that Hispanic families have strong social support that translates into better health for their foster children.

SOURCE: Journal of Health Care for the Poor and Underserved, May 2006.