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Associations of receipt of social services intervention in adolescence with educational outcomes and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales,...

Emily Lowthian Orcid Logo, Professor Graham Moore, Dr Annette Evans, Dr Rebecca Anthony , Dr Muhammad Azizur Rahman, Professor Rhian Daniel, Professor Jonathan Scourfield , Professor Chris Taylor, Professor Shantini Paranjothy, Dr Sara Long

Receipt of social services intervention in childhood, and educational outcomes and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK

Swansea University Author: Emily Lowthian Orcid Logo

Abstract

Background: Children receiving intervention from social services are at increased risk of lower educational attainment and poorer healthcare outcomes. Most research has focused on children placed ‘out-of-home’, or ‘looked after’ (CLA). Limited research has considered those at home (i.e. children on...

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Published in: Receipt of social services intervention in childhood, and educational outcomes and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
Published: BMC Public Health
URI: https://cronfa.swan.ac.uk/Record/cronfa67842
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Abstract: Background: Children receiving intervention from social services are at increased risk of lower educational attainment and poorer healthcare outcomes. Most research has focused on children placed ‘out-of-home’, or ‘looked after’ (CLA). Limited research has considered those at home (i.e. children on the child protection register (CPR) or in need but not at risk (CIN)). These children often experience Adverse Childhood Experiences (ACEs) and deprivation, which are also known to negatively impact outcomes in childhood and adulthood. The impact of social care, ACEs, and demographic characteristics can be challenging to disentangle. We examine the association between being CLA/CIN/CPR and educational and healthcare outcomes, adjusted for ACEs, and birth, school, and demographic characteristics. Methods: We linked retrospective, routinely collected administrative records from health, education, and social care via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and their household members (N=30,439) across four different groups: (1) no social care intervention; (2) children in need but not in care (CIN); (3) children on the Child Protection Register but not in care (CPR); (4) Children removed from the family home and looked after by the local authority (CLA). Primary and secondary outcome measures included educational outcomes at age 16, all cause emergency hospital admissions, and emergency hospital admissions for external causes/injuries.Results: Children in receipt of social care intervention between age 12 to 15 years were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics; conditional OR: 1·76, (95%CI) 1·25-2·48 (CLA), 2·51, 2·00-3·15 (CIN) and 4·04, 2·44-6·68 (CPR). For all-cause emergency hospital admissions, all social care groups were at greater risk compared to children in the general population (conditional HR: 1·31, 1·01-1·68 (CLA), 1·62, 1·38-1·90 (CIN), 1·51, 1·11-2·04 (CPR).Conclusions: We find children in receipt of social services at home require more in-home support to improve outcomes. Both health and educational outcomes had similar risk factors in terms of ACEs. Policymakers and practitioners should consider adoption of holistic approaches, such as health in all policies, to support children.
Keywords: Children in Need; Children in Care; Adversity; Education attainment; Public Health, Hospital admissions; Administrative data; data linkage; routinely collected data
College: Faculty of Humanities and Social Sciences
Funders: This work was funded by the Economic and Social Research Council Secondary Data Analysis Initiative (ES/R005478/1), and further supported by the Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), funded by Welsh Government through Health and Care Research Wales from 2020, and previously a UKCRC Public Health Research Centre of Excellence. The funding body played no role in designing the study, in the analysis and interpretation of the data, or in writing the manuscript.

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