NEW YORK (Reuters Health) - After leaving foster care, many children end up homeless, without adequate access to health care, warn researchers in a report published this week in the Archives of Pediatrics and Adolescent Medicine.
“It makes no sense,” write Dr. Peter J. Pecora and Tiffany Washington of Casey Family Programs, Seattle, in a commentary, “to spend tens of thousands of dollars to care for young people during childhood, only to ignore their developmental needs and abandon them as young adults.”
Each year, about 20,000 of the 550,000 children in the U.S. foster care system are released from the system due to age, Dr. Margot B. Kushel, of the University of California, San Francisco and colleagues note in their report.
These youths have high rates of drug and alcohol use, unplanned pregnancies, and mental health problems, they point out, and are at risk of becoming homeless. It’s estimated that about 40 percent of homeless adults between 18 to 20 years old spent their childhood in the foster care system.
Between 2002 and 2003, Kushel and colleagues interviewed 749 young adults ages 17 or 18 still in the foster care system in Illinois, Wisconsin or Iowa. Through follow-up interviews conducted with 643 of these kids one year later, they found that 45.7 percent were still in foster care, while the remaining teens had left the system.
A little more than 14 percent of youth who had left the foster care system had experienced homelessness. Roughly 39 percent had unstable housing arrangements, meaning that since leaving foster care they had moved three or more times or had spent more than half of their income on rent.
Moreover, the team found “high rates” of poor access to health care among all emancipated youth and experiencing homelessness significantly increased the odds of being uninsured and having unmet health care needs.
Kushel’s team found that more than half of emancipated foster care youth were uninsured. The rates ranged from about 46 percent of the stably housed ex-foster care youth to 77 percent of those who experienced homelessness. By comparison, roughly 30 percent of young adults in the general population report an episode of being uninsured.
Overall, 22 percent of emancipated foster youth reported an unmet need for medical care, with up to 41 percent of those with homelessness having unmet health care needs, compared with 12 percent of young adults in the general population. Overall 12 percent of emancipated youth had fair or poor health status.
Kushel and colleagues conclude that “strategies to improve health outcomes among emancipated youth should address both their lack of health insurance and their risk of housing instability and homelessness.”
SOURCE: Archives of Pediatrics and Adolescent Medicine, October 2007.