New study: how does local authority care affect the health and education of vulnerable children?

Doctor Sara Long provides an overview of a complex, yet exciting study funded by the 
Economic and Social Research Council (ESRC),
which commenced in October 2019.

Previous and current research shows that children who are looked after have poorer educational outcomes in terms of number of GCSEs, university attendance and school behaviour. These children are also more likely to have mental health diagnoses, and poorer overall health and well-being compared to the general population. Some research suggests that certain aspects of care, for example, being in long-term care, lead to better health and education outcomes compared to children who are in short-term care or who experience lots of placements. Outside of the care experience, research shows that adverse experiences, such as physical abuse; living in a household where adults have mental illnesses; substance misuse problems and other social issues can also have a major impact on health and education outcomes. 

We are faced with a complex issue: are ‘pre-care’ experiences,
or aspects of care itself, related to poorer health
and educational outcomes?’

Adverse experiences in childhood are likely to come before care entry or intervention from social services (albeit some will come after), and so it becomes difficult to disentangle the extent to which care itself; pre-care experiences; or a combination of both,  contribute to poor outcomes. We are faced with a complex issue: are ‘pre-care’ experiences (e.g. physical abuse, substance misuse within the household), or aspects of care itself (eg number and duration of placements), related to poorer health and education outcomes?

Adverse experiences are not just experienced by those in care, or in receipt of intervention from social services – children not known to social services may also experience these problems at home. This study will therefore explore the picture around four groups: Children looked after (CLA); children known to social services but not looked after (NLA); children not known to social services but who have experienced adversity;
and the general population. 

To answer our questions, we are using data linkage, via the Secure Anonymised Information Linkage (SAIL) databank. We will link routinely collected social services data, GP data, and data from the National Pupil Database.  

The study will explore how the association between some Adverse Childhood Experiences (ACE) and negative health and education outcomes is influenced by contact with social services.’ 

The study covers all children in Wales born between 1990 and 2018, and aims to understand some of the health and educational outcomes (at GCSE) of children who are known to social services, including those who are, or have been, in local authority care. In addition, the study will explore how the association between some Adverse Childhood Experiences (ACEs; including living with adults with mental health issues and/or substance misuse issues, child physical victimisation and living in a single adult household as an indicator for parental separation), and negative health and education outcomes is influenced by contact with social services. 

A multidisciplinary study, this work brings together academics from DECIPHer, CASCADE, WISERD and Division of Population Medicine in Cardiff University, as well as academics from the National Centre for Population Health and Wellbeing Research (NCPHWR) in Swansea University, and non-academic organisations such as Welsh Government and local government. Hence, as well as bringing together several Cardiff University research centres, who will be shortly co-located within the universities new SPARK building, it connects three major new Health and Care Research Wales infrastructure investments (DECIPHer, CASCADE and NCPHWR). 

This research will aid decision making in policy in terms of what would work best for different children who are known to social services. It will end in September 2022; look out for updates here on the DECIPHer blog and my Twitter page.

Doctor Sara Long is a Research Associate in the School of Social Sciences.
She works across a range of interdisciplinary projects
aiming to improve health, wellbeing and education outcomes.
Follow her on Twitter: @DrSaraLong

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