Study Location: Los Angeles, California, USA
Type of Paper: Original Article; Medical Chart Review
Purpose: To assess health-related problems across placement type and to examine the associations of placement type, demographic, and child variables with health-related problems.
- Physical growth: standard anthropometry [height and weight]. Z scores were calculated were calculated using CDC 2000 as a reference.
- Previous research in children in foster care has reported underweight as a primary medical concern. However, given the increase in overweight/ obesity in the U. S. , this study emphasized that these findings may be outdated and may not reflect the current weight status of children living in foster care.
Participants: 449 children under the age of 6 years old who were seen at a U. S. clinic (Los Angeles, CA) that only serves children receiving child welfare services. Children were living in one of three types of placement: 58% were in unrelated foster care, 29% were in kin foster care, and 13% were with birth parents.
Methods: Retrospective medical chart review of children entering the child welfare system. Approximately half of the children were seen within 30 days of entering the child welfare system, and 75% were seen within one year of entry.
Nutrition Results (Physical Growth):
- More children were overweight/obese than were underweight. Overweight/obese was defined as being above the 85th percentile for BMI in children over 2 years old or above the 85th percentile for weight for length in children less than 2 years old. Underweight was defined as below the 5th percentile for BMI or weight for length depending on age:
- Overweight/obese: 28% of all children. 22% of children under 2 years old.
- Children over 2 years old were 1. 73 times more likely to be overweight/obese than younger children.
- Overweight/obesity was also more common in Hispanic children and children living with non-English speaking caregivers.
- Underweight: 7% of all children. 8% of children under 2 years old.
- Failure to thrive: 6% of all children
Conclusions & Clinical Implications: More children in the child welfare system in the U. S. are overweight than underweight. 28% were overweight/obese, and 7% were underweight. Children over the age of 2 years were almost two times more likely to be overweight/obese than children under the age of 2 years. The prevalence of overweight/obesity in children living in foster care in this study was higher than the prevalence in the U. S. for children of similar ages [based on the National Health and Nutrition Examination Survey (NHANES) between 2003 and 2006].
Limitations of the Nutritional Results: The authors discuss that it is not known whether the prevalence of overweight/obesity is associated with being in the child welfare system or with poverty. The prevalence of obesity in 2-5 year olds in this study was similar to the prevalence of obesity in low-income children reported in a national survey.
Reference: Schneiderman JU, Leslie LK, Arnold-Clark JS, McDaniel D, Xie B. Pediatric health assessments of young children in child welfare by placement type. Child Abuse & Neglect. 2011; 35 (1): 29-39. http://www.ncbi.nlm.nih.gov/pubmed/21316106