BARBARA CHAIYACHATI MD, PhD Yale University School of Medicine Cohort Three Fellow

Increased Mortality Among Children in Foster Care Interview with:
Barbara Chaiyachati, MD PhD
SafePlace: The Center for Child Protection and Health
Division of General Pediatrics
The Children’s Hospital of Philadelphia,
Center for Pediatric Clinical Effectiveness
University of Pennsylvania
Philadelphia, Pennsylvania What is the background for this study? What are the main findings?

Response: Children in foster care have high rates of medical problems including chronic diseases. There is less known about the differences in mortality for children in foster care.

Looking at national data from 2003 to 2016, this study finds that children (ages 1 to 18) in foster care have higher mortality compared to children in the general population and that the difference in mortality has increased over time. What should readers take away from your report?

Response: Children in foster care are a very vulnerable population. We cannot conclude that foster care is the cause of the increased mortality. Therefore, we should consider other factors that may be impacting this difference in mortality, including the experiences of children prior to foster care and children’s health status when they enter foster care. What recommendations do you have for future research as a result of this work?

Response: I see two critical next steps:

1) Gaining additional information about what are the causes of mortality in foster care and how those causes may be different from children in the general population; and
2) Working with policymakers to develop evidence-based interventions that address the disparity in mortality among youth in foster care.

We also did not assess mortality for children in foster care who are less than one years old; a next study may look specifically at this age group. Is there anything else you would like to add? 

Response: In the context of today, while children have not been shown to be at high risk for severe complications from COVID-19, we do believe that vulnerable populations may be particularly impacted by this pandemic in a variety of ways. In many jurisdictions across the nation, dependency court status hearings for children in foster care, in-person visits with biological parents, and even in-person supervision visits with foster care agency staff have been suspended because of COVID-19. Thus, this already vulnerable population of children is facing even greater challenges and isolation that we need to ensure we’re addressing.

We have no disclosures.  


Chaiyachati BH, Wood JN, Mitra N, Chaiyachati KH. All-Cause Mortality Among Children in the US Foster Care System, 2003-2016. JAMA Pediatr. Published online April 20, 2020. doi:10.1001/jamapediatrics.2020.0715

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Apr 21, 2020 @ 10:52 am




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