The Health Status of Transition Age Foster Age: Early Findings from the Calyouth Study

Background  Transition age foster youth are disproportionately at risk for a number of poor health outcomes compared to their non-foster care peers (Courtney, Terao, & Bost, 2004; Havlicek, Garcia, & Smith, 2012). Adolescence is an important period of development for all youth with strong links to future adult trajectories of health and well-being (Sawyer, et al., 2012). Youth directly influence their health, as does the context in which they develop. With the option to extend foster care to age 21, states can now provide a contextual “net” of health related services to foster youth during this important developmental period. This policy change provides an opportune time to examine the health status of foster youth to improve our understanding of their health needs and importantly, to inform the services and supports they will require as they make the transition to adulthood.

Method  This study draws from self-report data from Wave 1 interviews with 16 and 17-year-old foster care youth in the CalYOUTH Study (n = 727). The data were collected using a stratified random sample design and when weighted are representative of the 16 and 17-year-old foster care population in California in 2013. Outcomes examined include: physical health, suicide, mental health, pregnancy, health care utilization, preparation for managing health needs, and satisfaction with health services and trainings. Univariate and bivariate statistics are used to describe the sample with unweighted frequencies and weighted percentages.

Results  Sixty-one percent (n=450) of respondents report having excellent/very good health. Almost 90% had a physical and dental exam in the previous year, while 10% received psychiatric hospitalization. Many participants (54%) report having received counseling and almost 1 in 5 have ever attended a substance abuse treatment program; 41% and 23% have ever thought about and ever attempted suicide respectively. Forty-two percent of youth are diagnosed with recurrent major depressive episodes, 14% have ever had a manic episode, 7% have an anxiety disorder and PTSD respectively, 5% have a conduct disorder and 7% have oppositional defiant disorder. Differences in mental health by gender indicate that females compared to males are more likely to experience major depression (p < .01), past manic episodes (p < .01), social phobia (p < .05), and PTSD (p < .01). A drug dependence or abuse problem was assessed for 11% of youth and over 25% of females (9% of males) have ever been pregnant (gotten a girl pregnant). Most youth  report feeling prepared to manage different aspects of their health and while a large proportion (87%) have received services in various health related areas, as many as 11% feel dissatisfied with that preparation.

Implications  Findings suggest a mixed view with adolescent foster care youth faring well in some dimensions of health and mental health but with significant needs in other areas. As California and other states implement extended foster care services, the health status of older foster youth may call for more tailored supports than what has been previously provided in an effort to give youth the  strongest start possible in adulthood.