Addressing Unaddressed Needs: Helping Agencies Target Services to Children and Caregivers in Child Welfare

Each year in the United States, hundreds of thousands of children are reported to the child welfare system for abuse or neglect. In 2014, 702,000 children were deemed victims of child maltreatment, and 147,462 entered foster care.Despite contact with a child protection agency, many families struggle to obtain the right services to ensure a safe and nurturing environment for their children. It'a vital to understand these families' health care needs and how to meet them effectively and efficiently, especialyl given the limited resources for child welfare services. This brief presents current data on this topic and highlights areas for future research

Child Welfare Agency Performance: How are Child, Agency, and County Factors Related to Achieving Timely Permanency Outcomes for Children in Foster Care?

Performance measurement and accountability have become increasingly important for state and local child welfare agencies, motivating a great need for understanding what factors are related to achievement of performance outcomes. This study evaluated how child characteristics, local child welfare agency factors, and county demographics are related to achievement of timely permanency outcomes. This study used longitudinal administrative data of 22,316 children who entered foster care for the first time in North Carolina between 2002 and 2005, along with readily available local agency and county data. A multi-level survival approach was used to assess individual and contextual factors related to timely achievement of several permanency outcomes, specifically reunification, adoption, guardianship or custody, and emancipation. Furthermore, a competing risks analytical framework was used to simultaneously assess how child, agency, and county factors relate to achievement of different permanency outcomes, which was stratified by age, to identify differences in these relationships among infants, children ages 2 through 12, and adolescents. Study results demonstrated that multiple child, agency, and county factors were related to how quickly children in foster care achieved permanency outcomes, yet the strength and direction of these relationships differed by age and type of permanency. In particular, the child characteristics of age, gender, race, ethnicity, and reason for placement into foster care were all shown to have significant relationships with timely achievement of permanency. Local child welfare agency characteristics, specifically caseload size, use of relative placements, agency engagement in alternative response, and agency history of implementing reform efforts, as well as county demographics of poverty and unemployment were significantly related to timely achievement of several permanency outcomes. These findings provide insight into how individual- and macro-level contextual factors play a role when measuring agency performance. This research also provides a needed evidence base to identify specific factors that may be useful for estimating stratified performance measures, allowing agencies to assess performance of particular subpopulations of children in foster care. Ultimately knowing how individual, agency, and county factors are related to permanency can help child welfare agencies better understand their own performance and help target limited resources for improvement efforts

Reentry of elementary aged children following reunification from foster care

A recognized goal of family reunification programs is preventing the reentry of children into foster care. Using data from the National Survey of Child and Adolescent Well-Being, this study examined reentry for 273 children between the ages of 5 and 12 years. In multivariate models, reentry into foster care was associated with higher Child Behavior Checklist (CBCL) scores and higher numbers of children in the household when the child is living at home. Although these are not the only risk factors that should be considered in deciding whether to reunify a child, these characteristics appear to be high valence problems for families and their children who are reunified. Future research on reentry and on placement disruptions from foster care should routinely include information about the number of children in the family and behavior problems when endeavoring to explain caseload dynamics

Young people with Type 1 diabetes of non-white ethnicity and lower socio-economic status have poorer glycaemic control in England and Wales

Background The impact of ethnicity and socio-economic status (SES) on glycaemic control during childhood Type 1 diabetes is poorly understood in England and Wales. Methods We studied 18 478 children with Type 1 diabetes

Effects of an Intravenous Lipid Challenge and Free Fatty Acid Elevation on In Vivo Insulin Sensitivity in African American Versus Caucasian Adolescents

OBJECTIVE—African American youth have lower insulin sensitivity than their Caucasian peers, but the metabolic pathways responsible for this difference remain unknown. Free fatty acids (FFAs) are associated with insulin resistance through the Randle cycle. The present investigation determined whether elevating FFA is more deleterious to insulin sensitivity in African American than in Caucasian adolescents

The Association between Midnight Salivary Cortisol and Metabolic Syndrome in Korean Adults

BackgroundThe common characteristics of metabolic syndrome (MetS) and Cushing's syndrome suggest that excess cortisol may be involved in the pathogenesis of MetS. Salivary cortisol measurements are simple and can be surrogates for plasma free cortisol, which is the most biologically active form. We evaluated the association between levels of midnight salivary cortisol and MetS in Korean adults.MethodsA total of 46 subjects, aged 20 to 70 years, who visited the Health Care Center at Konkuk University Hospital from August 2008 to August 2009 were enrolled. We compared the levels of midnight salivary cortisol in subjects with MetS with those in subjects without MetS. We analyzed the associations between midnight salivary cortisol levels and components of MetS.ResultsMidnight salivary cortisol levels were higher in the MetS group (70±42.4 ng/dL, n=12) than that in the group without MetS (48.1±36.8 ng/dL, n=34) (P=0.001). Positive correlations were observed between midnight salivary cortisol levels and waist circumference, fasting blood glucose, and homeostasis model assessment of insulin resistance. The risk for MetS was significantly higher in subjects with midnight salivary cortisol levels ≥100 ng/dL than in those with levels <50 ng/dL (odds ratio, 5.9; 95% confidence interval, 2.35 to 36.4).ConclusionThe results showed a positive correlation between midnight salivary cortisol levels and MetS, suggesting that hypercortisolism may be related to MetS