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

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

BMC Public Health, Volume: 24, Start page: 2912

Swansea University Authors: Emily Lowthian Orcid Logo, Sinead Brophy Orcid Logo

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Abstract

Background: Research consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care....

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Published in: BMC Public Health
ISSN: 1471-2458
Published: Springer Nature 2024
Online Access: Check full text

URI: https://cronfa.swan.ac.uk/Record/cronfa67842
Abstract: Background: Research consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care. Children receiving social services interventions often experience Adverse Childhood Experiences (ACEs), and deprivation, which are known to negatively impact outcomes. We aimed to estimate the association of different social services interventions with educational outcomes and hospital admissions, while adjusting for ACEs and deprivation. Methods: We linked retrospective, routinely collected administrative records from health, education, and social care to create a cohort via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and 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 in care - i.e. removed from the family home and looked after by the local authority (CLA). Our primary outcome was education outcomes at age 16 years. Secondary outcomes were all cause emergency hospital admissions, and emergency admissions for external causes/injuries. Results: Children in receipt of social services intervention were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics (for children who had been in out-of-home care (conditional OR: 1·76, (95%CI) 1·25 − 2·48), in need (2·51, 2·00–3·15) and those at risk (i.e., on the child protection register) (4·04, 2·44 − 6·68). For all-cause emergency admissions, all social care groups were at greater risk compared to children in the general population (children in care (conditional HR: 1·31, 1·01–1·68), children in need (1·62, 1·38 − 1·90), and children at risk (1·51, 1·11 − 2·04). Conclusions: All groups receiving social service intervention experience poorer educational and health outcomes than peers in the general population. Children who remain with their home parents or caregivers but are identified as ‘in need’ or ‘at risk’ by social care practitioners require further research. Integrated support is needed from multiple sectors, including health, educational and social care.
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.
Start Page: 2912