Project Title:

Looked after children grown up: a scoping study of the Scottish and Northern Ireland Longitudinal Census data

Project Number:

2019_005

Researchers:

Dr Rebecca Lacey (UCL)
Prof Amanda Sacker (UCL)

Start Date:

01/10/19

Summary:

This scoping study will examine whether we can extend our previous work on the long-term outcomes of looked after children in England and Wales to Scotland and Northern Ireland.

Our aims for this scoping study are:

1. To identify in census years 1991 and 2001, children who were living in residential care, as a biological or adopted child in a parental household, as a child in a relative household, or as an unrelated member of an individual household;

2. To estimate statistical power for future analyses;

3. To assess data quality issues;

4. To investigate the feasibility of linkage to other administrative data such as health and social care records. If this study is feasible we plan to write a larger grant application to undertake research into the long-term outcomes of looked after children.

More specifically in future work we plan to:

a) assess the role of mental and physical health as predictors as well as outcomes of experiencing out-of-home care (selection versus causation effects);

b) investigate the health and employment transitions of care leavers in Scotland and NI;

c) compare experiences in the adult years across the UK (assessing variations in patterns of adjustment, mobility and experiences of ‘successful’ vs. less ‘successful’ transitions);

d) develop a comparative study, collaborating with Finland and Sweden, who both have similarly linked administrative data, enabling a comparison and evaluation of different approaches in states’ support to care leavers in different countries.

Nearly 96,500 children in the UK live in out-of-home care. While there is some evidence on their experiences in the education system, their health and first economic activities, there is little information about their lives after leaving local authority care. More generally, research on health and quality of life is not readily available concerning people on the margins. Consequently, there is a lack of robust empirical knowledge about care-leavers, a hard-to-survey population who are under-represented in mainstream population surveys. The limited research on longer-term outcomes reinforces the message of poorer outcomes for looked-after children; a study of looked-after children using the ONS LS[1], prospectively followed up children in residential care from 1971 to 2001. Cared-for children were 3 times more likely to have died than the comparison sample of children living in private households, mainly from accidents, violence, injury and poisoning. Those surviving to 2001 were more often living in rented accommodation than their peers and still more likely to have no qualifications and less likely to be employed, although many were permanently sick or disabled. Looked-after women over 40 years of age also had more children. We are currently extending this work, using the ONS LS, to examine health and social functioning up to 40 years after an experience of care. We are not only following up children who were in residential care but also those cared for in other out-of-home situations such as with a relative or unrelated adult. To date we have found that it is not only those in residential care that are at risk for adverse outcomes; the health and mortality risk for those cared-for in private households is also raised, albeit at lower levels[2]. The proposed project will lay the foundations for a proposal to extend the work to Scotland. Although the ONS-LS has many advantages over prior work (such as the representativeness of the sample and follow-ups over an extended period), it still has limitations which a study using the SLS has the potential to address. Specifically, the ONS-LS only includes a limited range of morbidity measures; no measures of psychiatric health problems; no measures of health in childhood; inability to identify if children are informally fostered, under a Care Order or in voluntary care arrangements; and a lack of information on the duration and number of placements. Using census data linked to other routine administrative records can potentially provide new and important insights regarding the lives of care-leavers, their health, achievements, contributions to society and the associated costs for society.

References:

1 Meltzer H, Guinea-Martin D, Millard B, Blackwell L. A thirty-year prospective study of children in residential care in the 1970s. Scottish J Resid Child Care 2008; 7.https://www.celcis.org/files/6814/8475/3535/2008_Vol_07_1_Meltzer_Guinea-Martin_Millard_Blackwell_thirty-year_perspective.pdf (accessed 1 Oct2019).
2 Murray E, Lacey R, Sacker A. P21 The health of adults who had been in care up to 40 years earlier: are there differences by type of care? findings from the ONS longitudinal study. In: Poster presentations. BMJ Publishing Group Ltd, 2018, p A70.2-A71.

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