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First-of-its-kind Study Finds Children in Foster Care More Likely to Die Than Children Overall in the U.S.

Systemic health, social disparities important factors in impacting child mortality rates

Philadelphia, Pa. – April 20, 2020 – Children in foster care are 42% more likely to die than children in the general population, largely irrespective of race or age, according to a new JAMA Pediatrics research letter published today. The study, conducted by PolicyLab at Children’s Hospital of Philadelphia, is the first to contrast mortality rates and trends for children in the U.S. foster care system with those of their peers, though it was unable to conclude the cause of observed mortality disparities.

Comparing mortality data of children in foster care with that of the general child population between 2003-2016, the researchers also found that deaths of youth in foster care remained steady during this time period while deaths among children overall in the U.S. decreased 2.5% each year.

A statement on how to interpret the results from the study’s lead author Dr. Barbara Chaiyachati, a fellow in Child Abuse Pediatrics at Children’s Hospital of Philadelphia, follows:

“Our study adds an important finding to the foster care literature, further supporting that children in foster care are a medically and socially vulnerable population.

“Importantly, our study does not conclude that foster care itself is contributing to the observed mortality differences. There are multiple factors that may have influenced our findings. Even when first entering foster care, these children have experienced many adverse experiences and have more medical and mental health needs than their peers. And once in care, children may face barriers to getting adequate health care—from incomplete medical records, to frequent placement changes, to challenges with consent among caregivers. It’s logical to conclude that these health and social disparities—among other challenges—are contributing to the concerning difference we saw in mortality rates. Yet, we need more data in order to inform evidence-based policy solutions to correct these trends.

“When considered in today’s context, while thus far children are not proving to be at high risk for death from COVID-19, I am deeply concerned that the pandemic could exacerbate morbidity and mortality disparities for youth in foster care, as there is data to suggest that this virus will have a greater impact on our most vulnerable populations. 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.”


About PolicyLab at Children’s Hospital of Philadelphia: PolicyLab at Children’s Hospital of Philadelphia (CHOP) is dedicated to achieving optimal child health and well-being by informing program and policy changes through interdisciplinary research. Founded in 2008, PolicyLab is a Center of Emphasis within the CHOP Research Institute, one of the largest pediatric research institutes in the country. With more than 30 highly regarded faculty and 60 passionate staff who bring expertise from myriad of fields covering health, research and health policy, our work focuses on improving public systems, improving health care delivery and improving child health outcomes. For more information, visit