State Care in Childhood and Adult Mortality: A Systematic Review and Meta-Analysis of Prospective Cohort Studies

G David Batty, Mika Kivimäki, Philipp Frank

Removal from family of origin to state care can be a highly challenging childhood experience and is itself linked to an array of unfavourable outcomes in adult life. This systematic review aimed to synthetise evidence on the risk of adult mortality in people with a history of state care in early life, and assess the association according to different contexts. 

The present synthesis of existing evidence found that the excess risk of adult mortality in this group was not attributable to other measures of adversity captured in included studies, suggesting that, in the countries represented (ie, Canada, the USA, western Europe, and Australia), child protection systems, social policy, and health services following care graduation are insufficient to mitigate the adverse experiences that might have preceded placement into care and those that might accompany it.