Health Literacy and Former Foster Care Youth: The Role of the State

Background/Purpose:

Health literacy (HL) has been defined as the ability to access, process, and understand basic health information in order to make important health decisions. While the majority of HL research has focused on adults and individuals with specific illnesses, much less attention has been centered on youth - particularly at-risk adolescent populations such as those in foster care.  Youth who have grown up in the foster system face significant challenges that put them at a higher risk of having limited HL (e.g., frequent placement changes, incomplete health records, and significant educational deficits), which is associated with poor health outcomes, frequent visits to the hospital, increased health care expenses, and decreased use of prevention services. The limited studies on HL and foster care youth that have been conducted show that upwards of 65% of youth in foster care settings are at risk of limited HL. Therefore, the purpose of this study was to identify states that provide HL training to youth in foster care, and examine the content of the training materials provided. 

Methods:  The research team contacted each state’s Department of Family and Child Services (or equivalent). Using a semi-structured script, researchers inquired about and requested curriculum and materials that youth receive before aging out of foster care - specifically those relating to health and HL. The training materials that were provided were then analyzed and coded by the research team to identify themes within the data.

Findings:  The findings of this study showed a lack of statewide curricula used for youth aging out of foster care.  Many states contracted with outside organizations to implement aging-out programs, while others operated on a county-by-county basis.  For the states that did have a statewide curriculum, limited emphasis was placed on HL. Much of the material provided focused on sexual health, healthy eating, and mental health, while very limited space (if any) was dedicated to understanding health insurance, accessing health care, and the importance of preventative care. 

Implications:

As we seek to ensure healthy development for all youth, the nearly 500,000 children served annually in out-of-home placements must be a top priority as they face some of the greatest health challenges among all youth in the US. The results of this study demonstrate the need for evidence-based HL education programs for youth aging out of foster care. Such programs would greatly benefit our foster care youth by preparing them to manage their own health needs in order to decrease preventable illnesses, reduce visits to the hospital, reduce health care costs, and enhance their overall quality of life.