Adverse Childhood Experiences and Young Adult Health Outcomes Among Youth Aging Out of Foster Care

Acad Pediatr. 2018 Jul;18(5):502-509. doi: 10.1016/j.acap.2018.04.011. Epub 2018 Apr 27.


Objective: Former youth in foster care (YFC) are at greater risk of chronic health conditions than their peers. Although research in general population samples has shown a dose-response relationship between adverse childhood experiences (ACEs) and adult health outcomes, few studies have conducted similar analyses in highly stress-exposed populations such as YFC. In this study we used person-centered latent class analysis methods to examine the relationship between different profiles of ACE exposures and divergent health trajectories among this high-risk population.

Methods: Data are from longitudinal research that followed transition-age YFC from age 17 to 26 (N = 732). Using 3 subgroups previously identified by their ACEs histories-complex, environmental, and lower adversity groups-we applied group mean statistics to test for differences between the groups for physical and sexual health outcomes in young adulthood.

Results: In contrast to previous research that showed that the environmental group was at the highest risk of criminalbehavior outcomes, for most of the physical and sexual health risk outcomes evaluated in this study, the complex adversity group had the highest risk.

Conclusions: This study shows that there are subgroups of YFC, which each have a distinct profile of risk in young adulthood, with the complex group being at highest risk of the physical and sexual health risk outcomes evaluated. Findings strongly suggest the need for targeted strategies to promote screening for ACEs and chronic health conditions, linkage to adult health care, and continuity of care for adolescents and young adults in foster care to offset these trajectories.

Keywords: adverse childhood experiences; aging out; foster care; latent class analysis; young adults; youth.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Adverse Childhood Experiences*
  • Cardiovascular Diseases / epidemiology
  • Chronic Disease / epidemiology*
  • Criminal Behavior
  • Female
  • Foster Home Care / statistics & numerical data*
  • Health Status
  • Health Status Disparities*
  • Humans
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Midwestern United States / epidemiology
  • Risk Factors
  • Sexual Behavior / statistics & numerical data
  • Sexually Transmitted Diseases / epidemiology
  • Young Adult