Background

Children in care face adverse health outcomes throughout their life course compared with their peers. In England, over the past decade, the stark rise in the number of cared-for children has coincided with rising child poverty, a key risk factor for children entering care. We aimed to assess the contribution of recent trends in child poverty to trends in care entry.

Methods

In this longitudinal, ecological study of 147 local authorities in England, we linked data from the Department for Work and Pensions and HM Revenue & Customs on the proportion of children younger than 16 years living in families with income less than 60% of the contemporary national median income, before housing costs, with Department for Education data on rates of children younger than 16 years entering care. Using within-between regression models, and controlling for employment trends, we estimated the association of changing child poverty rates with changing care entry rates within different areas. Our primary outcome was the annual rate of children younger than 16 years starting to be looked after by local authorities in England.

Findings

Between 2015 and 2020, controlling for employment rates, a 1 percentage point increase in child poverty was associated with an additional five children entering care per 100 000 children (95% CI 2–8). We estimate that, over the study period, 8·1% of the total number of children under the age of 16 entering care (5·0–11·3) were linked to rising child poverty, equivalent to 10 351 (6447–14 567) additional children.

Interpretation

We report evidence that rising child poverty rates might be contributing to an increase in children entering care. Children's exposure to poverty creates and compounds adversity, driving poor health and social outcomes in later life. National anti-poverty policies are key to tackling adverse trends in children's care entry in England.

Funding

National Institute for Health Research (NIHR) School for Public Health Research, NIHR Public Health Policy Research Unit, Swedish Research Council, Wellcome Trust, Medical Research Council, and NIHR Applied Research Collaboration North West Coast.

中文翻译：

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2015-20 年英格兰的儿童贫困和接受照料的儿童：地方层面的纵向生态研究

背景

与同龄人相比，接受照料的儿童在整个生命过程中都面临着不利的健康结果。在英格兰，在过去的十年中，受照料儿童数量的急剧增加与儿童贫困的加剧同时发生，这是儿童进入照料中心的一个关键风险因素。我们的目的是评估近期儿童贫困趋势对进入护理趋势的贡献。

方法

在这项对英格兰 147 个地方当局进行的纵向生态研究中，我们将英国工作和养老金部以及英国税务海关总署关于生活在收入低于当代国民收入 60% 的家庭中的 16 岁以下儿童比例的数据联系起来收入中位数（扣除住房成本），以及教育部关于 16 岁以下儿童进入托儿所的数据。使用组间回归模型并控制就业趋势，我们估计了不同地区不断变化的儿童贫困率与不断变化的护理进入率之间的关联。我们的主要成果是英国地方当局开始照顾 16 岁以下儿童的年增长率。

发现

2015 年至 2020 年间，在控制就业率的情况下，儿童贫困率每增加 1 个百分点，每 10 万名儿童中就会有 5 名儿童进入托儿所（95% CI 2–8）。我们估计，在研究期间，接受护理的 16 岁以下儿童总数的 8·1% (5·0–11·3) 与儿童贫困加剧有关，相当于 10 351 (6447–14 567) 额外的孩子。

解释

我们报告的证据表明，不断上升的儿童贫困率可能会导致更多儿童进入托儿所。儿童陷入贫困会造成并加剧逆境，导致晚年健康状况不佳和社会后果不佳。国家反贫困政策是解决英格兰儿童保育不利趋势的关键。

资金

国家卫生研究院 (NIHR) 公共卫生研究学院、NIHR 公共卫生政策研究组、瑞典研究委员会、Wellcome Trust、医学研究委员会和 NIHR 西北海岸应用研究合作组织。