title: Health outcomes in young adults from foster care and economically diverse backgrounds.
abstract: OBJECTIVE
  Foster youth have high rates of health problems in childhood. Little work has been done to determine whether they are similarly vulnerable to increased health problems once they transition to adulthood. We sought to prospectively evaluate the risk of cardiovascular risk factors and other chronic conditions among young adults formerly in foster care (FC) and young adults from economically insecure (EI) and economically secure (ES) backgrounds in the general population.
  
  
  METHODS
  We used data from the Midwest Evaluation of the Adult Functioning of Former Foster Youth (FC group; N = 596) and an age-matched sample from the National Longitudinal Study of Adolescent Health (EI and ES groups; N = 456 and 1461, respectively). After controlling for covariates, we performed multivariate regressions to evaluate health outcomes and care access by group at 2 time points (baseline at late adolescence, follow-up at 25-26 years).
  
  
  RESULTS
  Data revealed a consistent pattern of graduated increase in odds of most health outcomes, progressing from ES to EI to FC groups. Health care access indicators were more variable; the FC group was most likely to report having Medicaid or no insurance but was least likely to report not getting needed care in the past year.
  
  
  CONCLUSIONS
  Former foster youth appear to have a higher risk of multiple chronic health conditions, beyond that which is associated with economic insecurity. Findings may be relevant to policymakers and practitioners considering the implementation of extended insurance and foster care programs and interventions to reduce health disparities in young adulthood.
authors.affiliation: Center for Child Health Behavior and Development, Seattle Children's Hospital & Research Institute, Seattle, Washington; Division of Adolescent Medicine, Department of Pediatrics, and kym.ahrens@seattlechildrens.org.
authors.forename: Kym R
authors.initials: KR
authors.lastname: Ahrens
authors.affiliation: Center for Child Health Behavior and Development, Seattle Children's Hospital & Research Institute, Seattle, Washington; Division of Child and Adolescent Psychiatry, University of Washington School of Medicine, Seattle, Washington; and.
authors.forename: Michelle M
authors.initials: MM
authors.lastname: Garrison
authors.affiliation: School of Social Service Administration, University of Chicago, Chicago, Illinois.
authors.forename: Mark E
authors.initials: ME
authors.lastname: Courtney
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D002908:Chronic Disease / Q000453:epidemiology* / Q000517:prevention & control; D015331:Cohort Studies; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005581:Foster Home Care / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data; D054625:Healthcare Disparities / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008484:Medicaid / Q000706:statistics & numerical data; D017057:Medically Uninsured / Q000706:statistics & numerical data; D009307:National Academy of Sciences, U.S.; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States; D055815:Young Adult
keywords: cardiovascular disease; foster youth; health care disparities; young adult