Health-risk behaviors in young adolescents in the child welfare system

J Adolesc Health. 2010 Jul;47(1):26-34. doi: 10.1016/j.jadohealth.2009.12.032. Epub 2010 Mar 15.


Purpose: To examine rates and patterns of health-risk behavior (e.g., sexuality, depression/suicidality, substance use, delinquency) among a national probability sample of youth active to the child welfare/child protective services system. Recent federal legislation, P.L. 110-351, encourages child welfare systems, Medicaid, and pediatric experts to collaborate to ensure youth entering foster care receive comprehensive health examinations.

Methods: Analysis of baseline caregiver, caseworker, and child interviews, and assessment data for a subsample (n = 993) of youth, aged 11-15 years, from the National Survey of Child and Adolescent Well-Being, a national probability sample of children and adolescents undergoing investigation for abuse or neglect.

Results: Almost half of the sample (46.3%) endorsed at least one health-risk behavior. On Poisson multivariate regression modeling, factors related to higher rates of health-risk behaviors included older age, female gender, abuse history, deviant peers, limited caregiver monitoring, and poor school engagement.

Conclusion: Given the heightened vulnerability of this population, early screening for health-risk behaviors must be prioritized. Further research should explore specific subpopulations at risk for health-risk behaviors and possible interventions to change these youths' trajectories.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Achievement
  • Adolescent
  • Age Factors
  • Child
  • Child Abuse / psychology
  • Child Abuse / statistics & numerical data
  • Child Welfare / psychology
  • Child Welfare / statistics & numerical data*
  • Cross-Sectional Studies
  • Depressive Disorder / epidemiology*
  • Depressive Disorder / psychology
  • Female
  • Health Surveys
  • Humans
  • Juvenile Delinquency / psychology
  • Juvenile Delinquency / statistics & numerical data*
  • Male
  • Multivariate Analysis
  • Parenting / psychology
  • Peer Group
  • Pregnancy
  • Regression Analysis
  • Risk-Taking*
  • Sex Factors
  • Social Environment
  • Social Facilitation
  • Socialization
  • Suicide, Attempted / psychology
  • Suicide, Attempted / statistics & numerical data*
  • United States
  • Unsafe Sex / psychology
  • Unsafe Sex / statistics & numerical data*