MRC/CSO Social and Public Health Sciences Unit

The UK government considers it our moral, social and economic duty to give everyone the opportunity to flourish, live longer lives, and benefit from rises in living standards and wellbeing. The Scottish Government has promised that all children, including those in care, will be listened to, have a right to safe, loving relationships, and can access a supporting system to help them and their families in times of difficulty. Both of these commitments include the rights of care experienced children and young people – those who have been ‘looked after’ by the state (in kinship, foster or residential care, or living at home under a supervision order) – to have the same chances as everyone else to live healthy, safe, and happy lives.

Unfortunately, evidence across UK shows that care experienced children and young people have higher rates of ill health and mortality compared to children and young people who have not been in care. The CHiCS project aims to improve the health of care experienced children and reduce health inequalities in early life and young adulthood. We do this by linking children’s social care and health records collected by public services, such as the NHS and local authorities. Health outcomes of care experienced children are compared to children who have not been in care across the life course, from birth, early childhood (before entering care) and during care placements up to early adulthood, after leaving care. This will tell us whether inequalities in health are already present at birth and if they increase or decrease during and after leaving care.

We also investigate differences in health service use, such as in completing childhood vaccinations, missing doctors’ appointments, emergency admissions and length of stay in hospital. Our aim is to determine if care experienced people are less likely to engage in preventive health care and adhere to treatment, both of which lead to worse health and higher health service use in later life.

Poor health and health inequalities are not an inevitability, and our research aims to provide a foundation for the delivery of better outcomes for care experienced children. Our work will highlight which services are needed and when, for example by identifying the specific pre-existing health conditions that affect entering care and identifying health risks that arise after young people leave care. Public services, including health, education, justice, and social care, can use this knowledge to support families who have children with conditions associated with higher risk of entering social care and help keep them together. Similarly, aftercare services can focus on preventing young people from developing health problems that are common among care leavers.

This work was supported by the Economic and Social Research Council. The data linkage and access to the National Safe Haven was facilitated by the Urban Big Data Centre and the Scottish Centre for Administrative Data Research.