Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.

<h4>Background</h4>Looked after children are defined as children who are in the care of their local authority. Previous studies have reported that looked after children have poorer mental and physical health, increased behavioural problems, and increased self-harm and mortality compared...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Michael Fleming, James S McLay, David Clark, Albert King, Daniel F Mackay, Helen Minnis, Jill P Pell
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R
Acceso en línea:	https://doaj.org/article/e7b05ffd5d5641edb2e1d6c7a029a904
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:e7b05ffd5d5641edb2e1d6c7a029a904
record_format	dspace
spelling	oai:doaj.org-article:e7b05ffd5d5641edb2e1d6c7a029a9042021-12-02T19:55:59ZEducational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.1549-12771549-167610.1371/journal.pmed.1003832https://doaj.org/article/e7b05ffd5d5641edb2e1d6c7a029a9042021-11-01T00:00:00Zhttps://doi.org/10.1371/journal.pmed.1003832https://doaj.org/toc/1549-1277https://doaj.org/toc/1549-1676<h4>Background</h4>Looked after children are defined as children who are in the care of their local authority. Previous studies have reported that looked after children have poorer mental and physical health, increased behavioural problems, and increased self-harm and mortality compared to peers. They also experience poorer educational outcomes, yet population-wide research into the latter is lacking, particularly in the United Kingdom. Education and health share a bidirectional relationship; therefore, it is important to dually investigate both outcomes. Our study aimed to compare educational and health outcomes for looked after children with peers, adjusting for sociodemographic, maternity, and comorbidity confounders.<h4>Methods and findings</h4>Linkage of 9 Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions, unemployment, and looked after children provided retrospective data on 715,111 children attending Scottish schools between 2009 and 2012 (13,898 [1.9%] looked after). Compared to peers, 13,898 (1.9%) looked after children were more likely to be absent (adjusted incidence rate ratio [AIRR] 1.27, 95% confidence interval [CI] 1.24 to 1.30) and excluded (AIRR 4.09, 95% CI 3.86 to 4.33) from school, have special educational need (SEN; adjusted odds ratio [AOR] 3.48, 95% CI 3.35 to 3.62) and neurodevelopmental multimorbidity (AOR 2.45, 95% CI 2.34 to 2.57), achieve the lowest level of academic attainment (AOR 5.92, 95% CI 5.17 to 6.78), and be unemployed after leaving school (AOR 2.12, 95% CI 1.96 to 2.29). They were more likely to require treatment for epilepsy (AOR 1.50, 95% CI 1.27 to 1.78), attention deficit hyperactivity disorder (ADHD; AOR 3.01, 95% CI 2.76 to 3.27), and depression (AOR 1.90, 95% CI 1.62 to 2.22), be hospitalised overall (adjusted hazard ratio [AHR] 1.23, 95% CI 1.19 to 1.28) for injury (AHR 1.80, 95% CI 1.69 to 1.91) and self-harm (AHR 5.19, 95% CI 4.66 to 5.78), and die prematurely (AHR 3.21, 95% CI 2.16 to 4.77). Compared to children looked after at home, children looked after away from home had less absenteeism (AIRR 0.35, 95% CI 0.33 to 0.36), less exclusion (AIRR 0.63, 95% CI 0.56 to 0.71), less unemployment (AOR 0.53, 95% CI 0.46 to 0.62), and better attainment (AIRR 0.31, 95% CI 0.23 to 0.40). Therefore, among those in care, being cared for away from home appeared to be a protective factor resulting in better educational outcomes. The main limitations of this study were lack of data on local authority care preschool or before 2009, total time spent in care, and age of first contact with social care.<h4>Conclusions</h4>Looked after children had poorer health and educational outcomes than peers independent of increased neurodevelopmental conditions and SEN. Further work is required to understand whether poorer outcomes relate to reasons for entering care, including maltreatment and adverse childhood events, neurodevelopmental vulnerabilities, or characteristics of the care system.Michael FlemingJames S McLayDavid ClarkAlbert KingDaniel F MackayHelen MinnisJill P PellPublic Library of Science (PLoS)articleMedicineRENPLoS Medicine, Vol 18, Iss 11, p e1003832 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R
spellingShingle	Medicine R Michael Fleming James S McLay David Clark Albert King Daniel F Mackay Helen Minnis Jill P Pell Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.
description	<h4>Background</h4>Looked after children are defined as children who are in the care of their local authority. Previous studies have reported that looked after children have poorer mental and physical health, increased behavioural problems, and increased self-harm and mortality compared to peers. They also experience poorer educational outcomes, yet population-wide research into the latter is lacking, particularly in the United Kingdom. Education and health share a bidirectional relationship; therefore, it is important to dually investigate both outcomes. Our study aimed to compare educational and health outcomes for looked after children with peers, adjusting for sociodemographic, maternity, and comorbidity confounders.<h4>Methods and findings</h4>Linkage of 9 Scotland-wide databases, covering dispensed prescriptions, hospital admissions, maternity records, death certificates, annual pupil census, examinations, school absences/exclusions, unemployment, and looked after children provided retrospective data on 715,111 children attending Scottish schools between 2009 and 2012 (13,898 [1.9%] looked after). Compared to peers, 13,898 (1.9%) looked after children were more likely to be absent (adjusted incidence rate ratio [AIRR] 1.27, 95% confidence interval [CI] 1.24 to 1.30) and excluded (AIRR 4.09, 95% CI 3.86 to 4.33) from school, have special educational need (SEN; adjusted odds ratio [AOR] 3.48, 95% CI 3.35 to 3.62) and neurodevelopmental multimorbidity (AOR 2.45, 95% CI 2.34 to 2.57), achieve the lowest level of academic attainment (AOR 5.92, 95% CI 5.17 to 6.78), and be unemployed after leaving school (AOR 2.12, 95% CI 1.96 to 2.29). They were more likely to require treatment for epilepsy (AOR 1.50, 95% CI 1.27 to 1.78), attention deficit hyperactivity disorder (ADHD; AOR 3.01, 95% CI 2.76 to 3.27), and depression (AOR 1.90, 95% CI 1.62 to 2.22), be hospitalised overall (adjusted hazard ratio [AHR] 1.23, 95% CI 1.19 to 1.28) for injury (AHR 1.80, 95% CI 1.69 to 1.91) and self-harm (AHR 5.19, 95% CI 4.66 to 5.78), and die prematurely (AHR 3.21, 95% CI 2.16 to 4.77). Compared to children looked after at home, children looked after away from home had less absenteeism (AIRR 0.35, 95% CI 0.33 to 0.36), less exclusion (AIRR 0.63, 95% CI 0.56 to 0.71), less unemployment (AOR 0.53, 95% CI 0.46 to 0.62), and better attainment (AIRR 0.31, 95% CI 0.23 to 0.40). Therefore, among those in care, being cared for away from home appeared to be a protective factor resulting in better educational outcomes. The main limitations of this study were lack of data on local authority care preschool or before 2009, total time spent in care, and age of first contact with social care.<h4>Conclusions</h4>Looked after children had poorer health and educational outcomes than peers independent of increased neurodevelopmental conditions and SEN. Further work is required to understand whether poorer outcomes relate to reasons for entering care, including maltreatment and adverse childhood events, neurodevelopmental vulnerabilities, or characteristics of the care system.
format	article
author	Michael Fleming James S McLay David Clark Albert King Daniel F Mackay Helen Minnis Jill P Pell
author_facet	Michael Fleming James S McLay David Clark Albert King Daniel F Mackay Helen Minnis Jill P Pell
author_sort	Michael Fleming
title	Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.
title_short	Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.
title_full	Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.
title_fullStr	Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.
title_full_unstemmed	Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.
title_sort	educational and health outcomes of schoolchildren in local authority care in scotland: a retrospective record linkage study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/e7b05ffd5d5641edb2e1d6c7a029a904
work_keys_str_mv	AT michaelfleming educationalandhealthoutcomesofschoolchildreninlocalauthoritycareinscotlandaretrospectiverecordlinkagestudy AT jamessmclay educationalandhealthoutcomesofschoolchildreninlocalauthoritycareinscotlandaretrospectiverecordlinkagestudy AT davidclark educationalandhealthoutcomesofschoolchildreninlocalauthoritycareinscotlandaretrospectiverecordlinkagestudy AT albertking educationalandhealthoutcomesofschoolchildreninlocalauthoritycareinscotlandaretrospectiverecordlinkagestudy AT danielfmackay educationalandhealthoutcomesofschoolchildreninlocalauthoritycareinscotlandaretrospectiverecordlinkagestudy AT helenminnis educationalandhealthoutcomesofschoolchildreninlocalauthoritycareinscotlandaretrospectiverecordlinkagestudy AT jillppell educationalandhealthoutcomesofschoolchildreninlocalauthoritycareinscotlandaretrospectiverecordlinkagestudy
_version_	1718375874759229440

Educational and health outcomes of schoolchildren in local authority care in Scotland: A retrospective record linkage study.

Ejemplares similares