ASSESSING THE HEALTH-STATUS OF CHILDREN ENTERING FOSTER-CARE

Objective. Most research on health problems of children in foster care has been cross-sectional, resulting in overselection of children who have been in care long-term and underrepresentation of children who ar e in care for a short time. Methodology. This paper reports on the hea lth of a large cohort of children who had complete health examinations at the time of entry into foster care in a middle-size city during a 2-year period. Results. Results indicate that >90% of the children had an abnormality in at least one body system, 25% failed the vision scr een, and 15% failed the hearing screen. The children were also lighter and shorter than the norm. Mental health screening revealed that 75% had a family history of mental illness or drug or alcohol abuse. Of ch ildren older than 3 years of age, 15% admitted to or were suspect for suicidal ideation and 7% for homicidal ideation. Of the children young er than 5 years of age, 23% had abnormal or suspect results on develop mental screening examinations. At the time of entry into foster care, 12% of the children required an antibiotic. More than half needed urge nt or nonurgent referrals for medical services and, for children >3 ye ars of age, more than half needed urgent or nonurgent referrals for de ntal and mental health services. Just 12% of the children required onl y routine follow-up care. Conclusions. The high prevalence and broad r ange of health needs of children at the time they enter foster care ne cessitate the design and implementation of better models of health car e delivery for children in foster care.