Out-of-home care in childhood and biomedical risk factors in middle-age: National birth cohort study.

Abstract

Abstract

Objective: To examine if a history of having been in out-of-home care is embodied such that it has a measurable impact on human physiology.

Methods: We used data from the National Child Development Study in which exposure to public care was prospectively gathered on three occasions up to age 16. Responding study members also participated in a social survey at age 42 and a clinical survey at age 44/45 when cardiovascular, inflammatory, neuroendocrine, and respiratory risk markers for mortality were collected, nineteen of which were included as endpoints in the present analyses.

Results: Of the 8012 participants in the biomedical survey, 4% (N=322) had been in care at some point in childhood and/or adolescence. We found the expected marked differences in the early life characteristics of poverty, health, and disability in children with experience of public care relative to their unexposed counterparts. After controlling for these confounding factors, however, care in childhood was essentially unrelated to biomarkers in middle-age. We also found no consistent links between biomarkers and duration, timing, or type of care.

Conclusions: Our results suggest that the biomarkers captured in the present study are unlikely to mediate the link between public care in childhood and later chronic disease or mortality. Processes involving mental health, socioeconomic position, and health behaviours would seem to be a potential alternative pathway warranting investigation.