Download This Paper
Preprints with The Lancet is part of SSRN´s First Look, a place where journals identify content of interest prior to publication. Authors have opted in at submission to The Lancet family of journals to post their preprints on Preprints with The Lancet. The usual SSRN checks and a Lancet-specific check for appropriateness and transparency have been applied. Preprints available here are not Lancet publications or necessarily under review with a Lancet journal. These preprints are early stage research papers that have not been peer-reviewed. The findings should not be used for clinical or public health decision making and should not be presented to a lay audience without highlighting that they are preliminary and have not been peer-reviewed. For more information on this collaboration, see the comments published in The Lancet about the trial period, and our decision to make this a permanent offering, or visit The Lancet´s FAQ page, and for any feedback please contact preprints@lancet.com.
Child Poverty and Children Entering Care: A Natural Experiment Using Longitudinal Area-Level Data in England, 2015-2020
30 Pages Posted: 22 Dec 2021
More...Abstract
Background: Children in care face adverse health outcomes through the life-course, relative to their peers. In England, over the past decade, the stark rise in their number has coincided with rising child poverty, a key risk factor for children entering care. Our aim in this study was to assess the contribution of recent trends in child poverty to trends in care entry.
Methods: In this longitudinal ecological study of 147 local authorities between 2015 and 2020, we linked data from the Department for Work and Pensions and HM Revenue & Customs on the proportion of children under 16 living in families with income less than 60% median income, with Department for Education data on rates of children under 16 entering care. Using within-between regression models, and controlling for employment trends, we estimated the contribution of changing child poverty rates to changing care entry rates within areas.
Findings: Between 2015 and 2020 and controlling for employment rates, a 1% increase in child poverty was associated with 5 additional children entering care per 100,000 (95% CI 2–8). We estimate that, over the study period, 8.1% (5.0%–11.3%) of care entries were linked to rising child poverty, equivalent to 10,356 (95% CI 6,443–14,579) additional children.
Interpretation: This study offers evidence that rising child poverty rates are contributing to an increase in children entering care. Children’s exposure to poverty creates and compounds adversity, driving poor health and social outcomes in later life. National anti-poverty policies are key to tackling adverse trends in care entry in England.
Funding: DB, BB and DT-R are funded by the National Institute for Health Research (NIHR) School for Public Health Research (SPHR), Grant Reference Number PD-SPH-2015. DS and GM are funded by the NIHR Public Health Policy Research Unit (PR-PRU-1217-20901). DS is additionally funded by the Swedish Research Council (FORTE) (Grant No. 2020-00274). SW is funded by a Wellcome Trust Society and Ethics Research Fellowship (200335/Z/15/Z). DT-R is also funded by the Medical Research Council (MRC) on a Clinician Scientist Fellowship (MR/P008577/1). BB is also supported by the National Institute for Health Research Applied Research Collaboration North West Coast (ARC NWC). The views expressed in this publication are those of the authors and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care, MRC or Wellcome Trust. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or the writing of the report.
Declaration of Interest: None to declare.
Keywords: Public health, Child welfare, Out-of-home care, socioeconomic conditions
Suggested Citation: Suggested Citation