Institute of Epidemiology & Health Care


Children in care “suffer poor health for decades”

20 July 2020

Findings from new ICLS research shows that children in care suffer poor health for decades.

Child and adult hands

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, UCL and King’s College London research finds.

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 Centre for Lifecourse Studies at UCL analysed data from 350,000 people to explore whether children not with their parents fared better or worse if they spent time in residential care compared with living in foster care, or with relatives.

Associations with poor health were highest for adults who had been looked-after in residential care as children, followed by with a non-relative, then a relative.

They 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’.

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 percent 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.

The latest study showed children who had been living in any type of care setting had worse self-rated health – an indicator of physical and mental health problems – at 10, 20 and 30 years later than those who had been living with parents.

Adults who had lived in residential care settings in childhood had a 40 percent chance of reporting poor health 10-years after being in care, rising to more than 85 percent 20- and 30-years later compared with a probability of 13 percent, rising to 21 percent for those who had lived with parents.

The chances were much lower for children living with a relative, , ranging from 21 percent to 43 percent over the 30-year follow-up.

Professor Sacker said historically, cared-for children usually went into residential or foster care, but people’s attitudes to placements have changed over time, including recognising the positive impact that staying with a family member can have – reducing the trauma of being removed from their 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.

Co-author Dr Emily Murray / Dr Rebecca Lacey  (UCL Department of Epidemiology and Public Health) highlights the need for more support for relative carers, particularly at times of crises such as the COVID pandemic:

"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".

The study was funded by Nuffield Foundation and used data gathered between 1971-2001 from the Office for National Statistics Longitudinal Study, the largest longitudinal data resource in England and Wales.