Children in care are more likely to die before age 18 compared with the general population of the same age, conclude researchers from Finland in this week's BMJ. The results indicate the need for continuing attention to be paid to the transition period from foster care to independence.
The study analysed deaths among all children in Finland who were taken into care between 1991 and 1997. During the study period 106 individuals (32 females and 74 males) died. In both sexes, this represents a higher death rate than would have been expected in the general population and in the most socially disadvantaged groups in Finland.
Substance misuse, accidents, and suicide accounted for the higher death rate in this group. Deaths related to alcohol and drug misuse also occurred at a higher rate than expected. Deaths from illness can be attributed to an increase in acute and chronic health conditions and developmental delays among children in foster care, add the authors.
The child protection system does not cause the deaths, but it fails to protect adolescents from self endangering behaviour both within the system and during adaptation to independent living, say the authors. Continuing attention needs to be paid to the transition period from foster care to independence, they conclude.
Mirjam Kalland, Researcher, Save the Children, Helsinki, Finland