title: Foster care, residential care and public care placement patterns are associated with adult life trajectories: population-based cohort study.
abstract: OBJECTIVE
  Childhood experiences of public care may be associated with adult psychosocial outcomes. This study aimed to evaluate the associations of four public care exposures: type of placement, length of placement, age at admission to care and number of placements, as well as the reasons for admission to public care with emotional and behavioural traits at age 30 years.
  
  
  METHODS
  Participants included 10,895 respondents at the age 30 survey of the 1970 British Cohort Study (BCS70) who were not adopted and whose care history was known. Analyses were adjusted for individual, parental and family characteristics in childhood.
  
  
  RESULTS
  Cohort members with a public care experience presented lower childhood family socio-economic status compared with those in the no public care group. After adjusting for confounding, exposure to both foster and residential care, longer placements and multiple placements were associated with more extensive adult emotional and behavioural difficulties. Specifically, residential care was associated with increased risk of adult criminal convictions (OR = 3.09, 95% CI: 2.10-4.55) and depression (1.81, 1.23-2.68). Multiple placements were associated with low self-efficacy in adulthood (OR = 3.57, 95% CI: 2.29, 5.56). Admission to care after the age of 10 was associated with increased adult criminal convictions (OR = 6.03, 95% CI: 3.34-10.90) and smoking (OR = 3.32, 95% CI: 1.97-5.58).
  
  
  CONCLUSIONS
  Adult outcomes of childhood public care reflect differences in children's experience of public care. Older age at admission, multiple care placements and residential care may be associated with worse outcomes.
authors: Division of Primary Care and Public Health Sciences, King's College London, Capital House, 42 Weston St, London, SE1 3QD, UK. alexandru.dregan@kcl.ac.uk
authors: A
authors: A
authors: Dregan
authors: M C
authors: MC
authors: Gulliford
mesh_terms: D000328:Adult; D000367:Age Factors; D001519:Behavior; D015331:Cohort Studies; D003415:Crime / Q000523:psychology; D003482:Custodial Care / Q000523:psychology* / Q000706:statistics & numerical data; D004644:Emotions; D005191:Family Characteristics; D005260:Female; D005581:Foster Home Care / Q000523:psychology* / Q000706:statistics & numerical data; D006304:Health Status; D006801:Humans; D011159:Population Surveillance; D012307:Risk Factors; D020377:Self Efficacy; D012737:Sex Factors; D012907:Smoking; D012959:Socioeconomic Factors; D006113:United Kingdom