A Meta-Regression of Racial Disparities in Wellbeing Outcomes during and after Foster Care

Background and Purpose:

Children in foster care face heightened risk of adverse psychosocial and economic outcomes compared with children in the general population. Yet, the effects of foster care as an intervention are heterogeneous, as children’s experiences before, during, and after foster care are variable. Heterogeneity in the outcomes of foster care by race and ethnicity are of particular interest, given that Black and Indigenous youth experience foster care at higher rates than other racial and ethnic groups and group differences in foster care settings, duration spent in care, and exits to permanency through reunification, adoption, and guardianship.

Methods:

This meta-regression explores racial disparities in education, employment, mental health and behavioral outcomes during and after foster care. A systematic search of PsycINFO, ERIC, and Academic Search Complete using a series of search term combinations for studies published between January 2000 and June 2021 found 70 articles and 350 effect sizes that provided outcomes of US-based out-of-home care by race/ethnicity. All analyses used random effects meta-regression with robust variance estimation for each outcome domain by specific racial group comparison: Black vs non-Black, Black vs. White, Hispanic vs non-Hispanic, and Hispanic vs White. Effect sizes for other racial group comparisons were coded, but there were not enough effect sizes for further analyses. Moderator analyses were conducted for select study level features for Black vs non-Black and Hispanic vs non-Hispanic FCIPs in select outcome domains.

Results:

Findings reveal that Black foster care impacted persons (FCIPs) have 20% lower odds (95% CI: .68-.93) of achieving employment or substantial financial earnings and have 18% lower odds (95% CI: .68-1.00) of mental health concerns compared to White FCIPs. Hispanic FCIPs have 10% lower odds (95% CI: .84-.97) of achieving stable housing compared to non-Hispanic FCIPs. Moderator analyses revealed certain study features (i.e. publication type, timing of the study, location of the study, and placement status of the participants) have a significant impact on the gap between Black and non-Black and Hispanic and non-Hispanic FCIPs. For example, studies that collected baseline data after 2002 reported lower odds of mental health concerns for Black vs Non-Black former foster youth than studies that started baseline data collection before 2002.

Conclusions and Implications

The findings of this study illustrate numerous gaps in the literature, both in the types of samples and racial groups studied, and in the information provided in published studies regarding varying foster care experiences. Nevertheless, this meta-analysis found significant differences by race on several outcomes, and that certain study level features moderate these differences. Overall, the findings of this study provide important implications for racial disparities in foster care outcomes, as well as highlight important gaps and missing information from published studies.