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Health Status of Children in Foster Care The Experience of the Center for the Vulnerable Child

Neal Halfon, MD, MPH; Ana Mendonca, MPH; Gale Berkowitz, DrPH
Arch Pediatr Adolesc Med. 1995;149(4):386-392. doi:10.1001/archpedi.1995.02170160040006.
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Objectives:  To describe the health status and to illustrate the usefulness of an enhanced primary care model for children in foster care.

Design:  Cross-sectional analysis of a clinical cohort via chart review.

Setting:  Foster Care Program of the Center for the Vulnerable Child at the Children's Hospital, Oakland, Calif.

Subjects:  Two hundred thirteen children in foster care assessed between August 1988 and June 1991.

Interventions:  None.

Methods:  A multidisciplinary assessment protocol was used to collect health and social histories and to conduct developmental, emotional, and behavioral assessments and medical examinations. Cross-tabulations were used to compare distributions of conditions and characteristics of the population, including the reasons for, timing of, and number of placements.

Results:  The population was largely African-American (83.4%), with a mean age of approximately 3 years. At least 78% of children came from homes where drug use was a primary reason for placement. A history of maternal drug use was present in 94% of infants. The number of placements ranged from one to eight (mean, 2.0). Placement changes were common. Over 20% of children had growth abnormalities, 30% had neurologic abnormalities, and 16% had asthma. Fewer than 20% of children had no medical conditions, while 28.8% had three or more conditions. Over 80% of children had developmental, emotional, or behavioral problems. Emotional, relational, and behavioral problems were more common in children first placed after 2 years of age and in those with a greater number of placements (χ2=12.6, P<.05).

Conclusion:  This comprehensive assessment of children in foster care revealed higher rates of chronic multiple medical and mental health problems than previously reported.(Arch Pediatr Adolesc Med. 1995;149:386-392)


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