Health Concerns of Children in Foster Care
Meeting the Health Care Needs of Youth in the Chihld Welfare System
Mar 25, 2009
“Over 76,000 children and youth are in foster care in Canada, and their numbers are increasing annually,” says the Child Welfare League of Canada in a 2008 report entitled “Children in care in Canada: A summary of current issues and trends with recommendations for future research.”
Children and youth in foster care have higher than average medical, emotional, developmental and educational needs. These special needs are often chronic, under-recognized and neglected. There are many barriers to health care including lack of or inadequate medical records, lack of consistent care or follow-up due to temporary placements, and difficulty accessing services.
Foster care is the provision of care and supervision by a family other than a biological parent or guardian, and is approved and arranged by a child welfare authority. At times it is a temporary placement with the goal of family reunification after relevant support services such as parenting skills training, counselling, respite care, daycare, life skills training or specialized treatment programs have been accessed (Child Welfare League of Canada).
Child welfare services operate under provincial and territorial jurisdictions. Each jurisdiction has its own legislation, definitions, policies and services. The exception to this is the federal responsibility for children with First Nations status.
“Approximately 40% of foster children are Aboriginal (up to 68% in Manitoba), and 6% of Aboriginal children are in care,” says Statistics Canada in a 1993 Aboriginal Peoples Survey entitled “Language, Tradition, Health, Lifestyle and Social Issues.”
Possible Medical Problems of Children Entering Foster Care
Children entering into foster care are often in poor health not only because of risk factors such as poverty, prenatal exposure to drugs or alcohol, or parental mental illness, but also due to inadequate medical supervision before coming into care. Some common issues that arise on admission to foster care include:
- Anxiety
- Asthma
- Attachment disorders
- Compulsive water drinking (polydipsia)
- Depression
- Developmental delay
- Emotional or behavioral problems
- Failure to thrive
- Enuresis
- Excess appetite (hyperphagia)
- Genetic and birth defect syndromes
- HIV infection
- Inadequate immunization
- Long bone and rib fractures
- Poor dental hygiene or multiple caries
- Poorly controlled chronic illness
- Prenatal exposure to cocaine, alcohol, narcotics
- Sexually transmitted diseases
- Shaken baby syndrome
- Sleep disorders
The 2003 Canadian incidence study of reported child abuse and neglect found that in 34% of substantiated maltreatment investigations, there was at least one physical, emotional or cognitive health problem. Fifteen per cent of investigated children had a learning disability, 10% had developmental delays, 3% had a substance abuse-related birth defect and 2% had a physical disability.
The study also reported that 40% of investigated children had at least one behavioural functioning issue, with 13% of cases having poor school attendance, attention-deficit hyperactivity disorder (ADHD) or negative peer involvement.
“45% to 92% of children entering foster care have at least one identifiable health problem, with highest rates for respiratory, growth, dermatological and hematological disorders,” says the American Academy of Pediatrics in a 2004 article entitled “Fostering Health: Health Care for Children and Adolescents in Foster Care.” Higher rates of educational problems are reported including learning disabilities, intellectual disabilities and academic failure were also noted.
Children and youth entering into foster care are a high-risk, special needs population with many barriers to optimum health care. The trauma of separation from their families and placement in the foster care system often compound these conditions.
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