title: Health status and type of out-of-home placement: informal kinship care in an investigated sample.
abstract: OBJECTIVE
  To assess the sociodemographic, health, and mental health of children in different types of out-of-home placements after investigation by child welfare agencies; to determine whether there are systematic differences in the children and their caregivers by type of out-of-home placements; and to provide the first description of these characteristics in a nationally representative sample for children in informal kinship care after child welfare involvement.
  
  
  METHODS
  Using data from the National Survey of Child and Adolescent Well-being (NSCAW II), we compared children (0-17.5 years) in formal nonkinship foster care, formal kinship foster care, and informal kinship care shortly after a child welfare investigation. All analyses were weighted to reflect the sampling design.
  
  
  RESULTS
  Children in informal kinship care are at comparable risk of having chronic health conditions and poorer health but are less likely to receive school-based services. All children in kinship care (formal and informal) are less likely to be reported to have mental health problems and are more likely to live with older caregivers whose educational level is low and whose health is reportedly poorer.
  
  
  CONCLUSIONS
  Although children in kinship care have health problems similar to children in nonkinship foster care, they are likely to live in families with fewer economic and educational resources. This mismatch between need and access has implications for the long-term well-being of the children who are living in informal kinship arrangements without system-level support of formal foster care.
authors.affiliation: Albert Einstein College of Medicine/Children's Hospital at Montefiore, New York, NY. Electronic address: ruth.stein@einstein.yu.edu.
authors.forename: Ruth E K
authors.initials: RE
authors.lastname: Stein
authors.affiliation: School of Social Work, University of Southern California, Los Angeles, Calif; Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, Calif.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Hurlburt
authors.affiliation: Palo Alto Medical Foundation, Palo Alto, Calif; Case Western Reserve University School of Medicine, Cleveland, Ohio.
authors.forename: Amy M
authors.initials: AM
authors.lastname: Heneghan
authors.affiliation: Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, Calif.
authors.forename: Jinjin
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, Calif.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Rolls-Reutz
authors.affiliation: Child and Adolescent Services Research Center, Rady Children's Hospital, San Diego, Calif.
authors.forename: John
authors.initials: J
authors.lastname: Landsverk
authors.affiliation: Department of Child and Adolescent Psychiatry, New York University School of Medicine, New York, NY.
authors.forename: Sarah
authors.initials: S
authors.lastname: McCue Horwitz
mesh_terms: D000293:Adolescent; D002648:Child; D002669:Child Welfare; D002675:Child, Preschool; D005190:Family; D005260:Female; D005581:Foster Home Care / Q000379:methods*; D006305:Health Status Indicators; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States
keywords: foster children; health; insurance; kinship care; mental health