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An Opportunity for Intervention
CHORI Scientists Discover Link between Foster Care in Childhood and Emotional and Physical Problems in Adulthood

March, 2012 – A new study published in the March issue of the American Journal of Public Health, CHORI Associate Research Scientist Cheryl Zlotnick, RN, DrPH and her colleagues report that adults with histories of being in the foster care system have higher rates of mental and physical health concerns than adults who have no history of foster care.

"Whether the cause is events that precede foster care or the experience of foster care itself, what this tells is that there is a need for very vigilant physical and emotional health care services," says Dr. Zlotnick.

“What this tells is that there is a need for very vigilant physical and emotional health care services.”



An expert in studies on the immediate effects of poverty and those services most beneficial to children who live in transient or impoverished care such as foster care or homeless shelters, Dr. Zlotnick undertook the current study to answer the questions as to whether or not these kinds of situations had longer term impacts beyond childhood.

"We wanted to see if children and youth who had experience being in foster care, which includes the experiences that may have led to their being in foster care, had measureable impacts later in their adulthood," says Dr. Zlotnick.

Utilizing a plethora of data from the State of California's 2003-2005 California Health Interview Survey, Dr. Zlotnick and her colleagues compared for the first time the prevalence rates of mental and physical health problems of adults with and without a history of foster care in the United States. The results of the study indicated that there were indeed long-term effects associated with foster care, with adults who had a history of childhood foster care having more than twice the odds of receiving Social Security Disability Insurance.

“We found that having experienced foster care was associated with emotional and physical problems in adulthood.”
"We found that having experienced foster care was associated with emotional and physical problems in adulthood that impaired the ability of such individuals to work for a year or more," says Dr. Zlotnick. "This suggests that the events surrounding foster care are associated with a health-related impact throughout the lifespan, and could be considered what we call a sentinel event."

The idea behind a sentinel event is that a single event in a person's life, or even in utero, can have lifelong health-related effects, such as increased rates of morbidity or early mortality.
"This idea is quite obvious if the event is something that caused a disability or involves the onset of a chronic disease," says Dr. Zlotnick. "For situations like that, we expect lifelong consequences. It's much less obvious if it has to do with trauma, such as experiencing abuse, witnessing violence, or evening experiences poverty and homelessness."

Current studies like this one, however, are demonstrating that emotional experiences also have lifelong health-related effects. While the latest study can't pinpoint whether the events that preceded and triggered the foster care or the experience of foster care itself create the longer term impacts, knowing there are longer term consequences for this population of children provides an opportunity for intervention now.

"Since foster care in the United States falls under government purview, it provides us a critical opportunity to consider potential ways of alleviating some of these effects," says Dr. Zlotnick.

“First and foremost, we need to be following children who have entered the foster care system, and continue providing them needed services even after they have left the child welfare/foster care system.”

About a half a million children are in foster care in the United States at any given time, with Texas, New York and California having the greatest number of children in the system.

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Sunday, July 29, 2012 12:43 PM

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