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Out-of-Home Care and Educational Outcomes: Prevalence, Patterns and Consequences
Stockholm University, Faculty of Social Sciences, Department of Sociology.ORCID iD: 0000-0002-5008-5554
2020 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis is to examine educational stratification in the context of out-of-home care (OHC; foster family care, residential care) and to place one of society’s most vulnerable groups in the fields of social stratification and family complexity research. About 5% of the Swedish population experience OHC during childhood or adolescence. OHC is not only a matter of protecting children and youth; it is also intended to improve future opportunities and compensate for adverse childhood factors. However, a vast body of international research, including Swedish studies, shows that a substantial proportion of young people from OHC have poor school performance and low educational attainment as adults. Furthermore, this is strongly associated with their high risk of other adverse outcomes in life. To date there are no signs of improvement in this regard, and the disadvantage of having a low education is increasing in today’s knowledge-based society.

Many previous OHC studies have relied on small, local samples, and longitudinal data are often lacking. In this respect, Swedish researchers are well positioned to contribute to the field through research based on our high-quality population registers. The main data source in this thesis – the Child Welfare Intervention Register – covers half a century of OHC data. Based on these data, an overview of OHC prevalence in Sweden and patterns of educational outcomes are presented in the introductory chapter. The thesis further consists of five individual studies investigating different aspects of the transition through the educational system to adult life among children and youth from OHC. Two of the five studies focus on children who spent most of their childhood in OHC and for whom society has assumed a long-term commitment of parental responsibilities.

The descriptive data show that patterns of poor educational outcomes in the OHC population have remained stable as long as they can be followed in the registers. Study I shows that youth who exited long-term care were disadvantaged as compared to youth without OHC experience, both in terms of educational attainment and regarding the strong association between poor school performance and other adverse outcomes in young adulthood. Up to 55% of their excess risks of later psychosocial problems were statistically attributable to dismal school performance. Study II shows that 54% of clients in substance-misuse treatment in the 1980s had been in OHC, half before their teen years and half as teenagers. In this group, OHC was associated with excess mortality during the 30-year follow-up from exit from treatment, with statistical significance mainly for females who had entered OHC before their teens. School failure was more common in the OHC population than for misuse clients without OHC experience, and was strongly associated with the excess mortality of females. Two Nordic comparative studies (Studies III and IV) show that the OHC population had a substantially higher risk of not completing upper-secondary education across countries, and that poor performance in primary school inflicted a greater risk in OHC youth of being NEET in young adulthood than for their peers without OHC experience. Study V shows that the intergenerational transmission of education was weak and inconsistent in the foster care setting, and that living in a highly educated foster family did not have a robust positive effect on foster children’s educational outcomes.

Place, publisher, year, edition, pages
Stockholm: Department of Sociology, Stockholm University , 2020. , p. 104
Series
Dissertation series / Stockholm University Demography Unit, ISSN 1404-2304 ; 20
Keywords [en]
out-of-home care, foster care, foster parents, school performance, educational outcomes, intergenerational transmission, Sweden, Nordic countries
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Sociological Demography
Identifiers
URN: urn:nbn:se:su:diva-180704ISBN: 978-91-7911-090-1 (print)ISBN: 978-91-7911-091-8 (electronic)OAI: oai:DiVA.org:su-180704DiVA, id: diva2:1421617
Public defence
2020-05-30, hörsal 3, hus B, Universitetsvägen 10 B, digitally via Zoom, see meeting address at www.sociology.su.se, Stockholm, 13:00 (English)
Opponent
Supervisors
Available from: 2020-05-06 Created: 2020-04-03 Last updated: 2020-05-26Bibliographically approved
List of papers
1. School performance in primary school and psychosocial problems in young adulthood among care leavers from long term foster care
Open this publication in new window or tab >>School performance in primary school and psychosocial problems in young adulthood among care leavers from long term foster care
2011 (English)In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 33, no 12, p. 2489-2494Article in journal (Refereed) Published
Abstract [en]

We used data from Swedish national registers for ten entire birth year cohorts (1972–1981) to examine psychosocial outcomes in young adulthood for youth that left long term foster care after age 17, comparing them with majority population peers, national adoptees and peers who had received in-home interventions before age 13. The population was followed in the registers from age 16 to 2005. Data were analyzed in Cox regression models.

Youth who left long term foster care had six-to eleven fold sex and birth year adjusted excess risks for suicide attempts, substance abuse and serious criminality from age 20, and for public welfare dependency at age 25. Overrisks were considerably lower for the in-home intervention group and the national adoptees. Adjusting results for poor school performance in the final year in primary school (ages 15–16) reduced overrisks by 38–52% for care leavers from long term foster care.

Irrespective of issues of causality, poor school performance seems to be a major risk factor for future psychosocial problems among youth who age out of long term foster care. The results suggest that promoting foster children's school performance should be given high priority by agencies.

Keywords
Cohort study, Longitudinal, Out-of-home care, Foster care, School performance, Education
National Category
Social Work
Research subject
Sociological Demography
Identifiers
urn:nbn:se:su:diva-61825 (URN)10.1016/j.childyouth.2011.08.024 (DOI)000298122800012 ()
Available from: 2011-08-31 Created: 2011-08-31 Last updated: 2020-04-17Bibliographically approved
2. The relationbetween out-of-home care, early school failure, and prematuremortality: A 30-year follow-up of people treated for substancemisuse in Sweden
Open this publication in new window or tab >>The relationbetween out-of-home care, early school failure, and prematuremortality: A 30-year follow-up of people treated for substancemisuse in Sweden
2020 (English)In: Nordic Social Work Research, ISSN 2156-857X, E-ISSN 2156-8588Article in journal (Refereed) Published
Abstract [en]

Evidence from Swedish and international studies show that a high proportionof children from out-of-home care (OHC) have poor school performanceand that this is strongly associated with their substantial risk ofadverse development in future life. However, risk factors for poor schoolperformance and adverse development are difficult to disentangle sincethey are often interrelated and enforce each other over the life course.This study examines premature mortality in relation to early school failure(drop-out from compulsory school) and OHC experience in childhood(0–17 years of age) among clients who were in treatment for substancemisuse in the early 1980s (N = 1,036). The analyses were based on recordlinkages between interview data collected during treatment and nationalregister data covering approximately 30 years of follow-up, from exit fromtreatment until 2013. Our results showed that 54 per cent had beenplaced in OHC as children, half before their teens and half as teenagers.The OHC population had a higher prevalence of school failure comparedwith clients who had not been exposed to childhood OHC. OHC wasassociated with an excess mortality, although this was only significantfor females who had entered OHC before their teens. Adjusting results forschool failure reduced their excess mortality by half, and additional lifecourse factors associated with mortality among people with substancemisuse adjusted for most of the remaining excess mortality. School failurewas strongly associated with the excess mortality of females, but not withthe excess mortality of males.

Keywords
Mortality; out-of-home care; foster care; substance misuse; school failure
National Category
Social Work Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:su:diva-181247 (URN)10.1080/2156857X.2020.1749119. (DOI)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00980
Available from: 2020-04-29 Created: 2020-04-29 Last updated: 2020-04-30Bibliographically approved
3. Early school leaving by children in out-of-home care: A comparative study of three Nordic countries
Open this publication in new window or tab >>Early school leaving by children in out-of-home care: A comparative study of three Nordic countries
Show others...
2018 (English)In: Children and youth services review, ISSN 0190-7409, E-ISSN 1873-7765, Vol. 93, p. 186-195Article in journal (Refereed) Published
Abstract [en]

Previous studies have reported that children and adolescents who have been placed in out-of-home care for the protection of their safety and welfare face considerably high risks for early school leaving. Our study adds to the literature by comparing the association between children's exposure to placement in care and lack of secondary education (i.e. post-compulsory education after age 16) across three Nordic countries: Denmark, Finland, and Sweden. We use data from national registers for children born in 1987, following them until age 23. The datasets for Denmark (N = 55,995, of whom 3056 are in care), Finland (N = 58,855, of whom 1884 are in care), and Sweden (N = 100,152, of whom 3209 are in care) cover the entire birth cohort. To estimate and compare country-specific risks, we calculate average marginal effects from binary logistic regression and adjust the effects for birth mother's socio-economic and health-related background. As expected, the results show that in each country, children placed in care had a significantly higher risk for early school leaving. After adjusting for maternal background, young adults who experienced out-of-home care were 24 to 39 percentage points more likely than their peers never in care to have not completed secondary education. Those placed in care for the first time at teenage were the most likely to have low attainment. In Finland and Sweden, children in care had a similar excess risk for early school leaving, whereas in Denmark the risk was higher. We discuss these results and recommend developing effective interventions to improve the educational attainment of children in care. The difference between Denmark and the other two requires further investigation.

Keywords
Child welfare, Out-of-home care, Educational attainment, Cohort study, Comparative study
National Category
Sociology
Research subject
Sociological Demography
Identifiers
urn:nbn:se:su:diva-161008 (URN)10.1016/j.childyouth.2018.06.007 (DOI)000445990000023 ()
Available from: 2018-10-15 Created: 2018-10-15 Last updated: 2020-04-17Bibliographically approved
4. Long-term NEET among young adults with experience of out-of-home care: A comparative study of three Nordic countries
Open this publication in new window or tab >>Long-term NEET among young adults with experience of out-of-home care: A comparative study of three Nordic countries
Show others...
(English)Manuscript (preprint) (Other academic)
Keywords
NEET, employment, education, school-to-work transition, child welfare, out-of-home care, comparative study, Nordic countries.
National Category
Social Work Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:su:diva-181257 (URN)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-01657
Note

This study compares the risk of long-term NEET (Not in Employment, Education or Training) among young adults with out-of-home care (OHC) experience across Denmark, Finland, and Sweden, using register data for an entire cohort of domestic born in 1987. The Nordic countries share many features, but there are differences in the provision of after-care support and in the linkage between the educational system and the labour market. The results show that about one-fourth in Denmark and Sweden, and about one-third in Finland, of young adults with OHC experience were NEET. The high prevalence of poor school performance in the OHC population was associated with their excess risk of NEET, and the findings suggest that the current measures aimed at improving young adults’ school-to-work transition are not sufficient for youth from OHC. Implications for research, policy and practice are discussed.

Available from: 2020-04-29 Created: 2020-04-29 Last updated: 2020-04-30Bibliographically approved
5. Educational outcomes of children from long-term foster care: Does foster parents’ educational attainment matter?
Open this publication in new window or tab >>Educational outcomes of children from long-term foster care: Does foster parents’ educational attainment matter?
2019 (English)In: Developmental Child Welfare, ISSN 2516-1032, Vol. 1, no 4, p. 344-359Article in journal (Refereed) Published
Abstract [en]

Parental education is a robust predictor of children’s educational outcomes in general population studies, yet little is known about the intergenerational transmission of educational outcomes in alternative family settings such as children growing up in foster care. Using Swedish longitudinal register data on 2,167 children with experience of long-term foster care, this study explores the hypothesized mediating role of foster parents’ educational attainment on foster children’s educational outcomes, here conceptualized as having poor school performance at age 15 and only primary education at age 26. Results from gender-stratified regression analyses suggest that there was an association between foster parental educational attainment and foster children’s educational outcomes but that the educational transmission was weak and inconsistent and differed somewhat between males and females. For males, lower educational attainment in foster parents was associated with poor school performance but was not associated with educational attainment at age 26. The reverse pattern was found among females: the educational gradient was inconsistent for poor school performance but appeared in educational attainment. The results indicate that supported interventions for improving foster children’s educational achievements are needed, even when placements are relatively stable and foster parents have a long formal education.

Keywords
Educational attainment, foster parents, out-of-home care, parental education, school performance
National Category
Social Work
Research subject
Sociological Demography
Identifiers
urn:nbn:se:su:diva-176959 (URN)10.1177/2516103219892274 (DOI)
Available from: 2019-12-11 Created: 2019-12-11 Last updated: 2020-04-17Bibliographically approved

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