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Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK

Emily Lowthian Orcid Logo, Graham Moore, Annette Evans, Rebecca Anthony, Muhammad Azizur Rahman, Rhian Daniel, Sinead Brophy Orcid Logo, Jonathan Scourfield, Chris Taylor, Shantini Paranjothy, Sara Long

BMC Public Health, Volume: 24, Start page: 2912

Swansea University Authors: Emily Lowthian Orcid Logo, Sinead Brophy Orcid Logo

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DOI (Published version): 10.1186/s12889-024-20204-6

Abstract

Background: Research consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care....

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Published in: BMC Public Health
ISSN: 1471-2458
Published: Springer Nature 2024
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Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care. Children receiving social services interventions often experience Adverse Childhood Experiences (ACEs), and deprivation, which are known to negatively impact outcomes. We aimed to estimate the association of different social services interventions with educational outcomes and hospital admissions, while adjusting for ACEs and deprivation. Methods: We linked retrospective, routinely collected administrative records from health, education, and social care to create a cohort via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and household members (N&#x2009;=&#x2009;30,439) across four different groups: [1] no social care intervention; [2] children in need but not in care (CIN); [3] children on the Child Protection Register but not in care (CPR); [4] children in care - i.e. removed from the family home and looked after by the local authority (CLA). Our primary outcome was education outcomes at age 16 years. Secondary outcomes were all cause emergency hospital admissions, and emergency admissions for external causes/injuries. Results: Children in receipt of social services intervention were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics (for children who had been in out-of-home care (conditional OR: 1&#xB7;76, (95%CI) 1&#xB7;25&#x2009;&#x2212;&#x2009;2&#xB7;48), in need (2&#xB7;51, 2&#xB7;00&#x2013;3&#xB7;15) and those at risk (i.e., on the child protection register) (4&#xB7;04, 2&#xB7;44&#x2009;&#x2212;&#x2009;6&#xB7;68). For all-cause emergency admissions, all social care groups were at greater risk compared to children in the general population (children in care (conditional HR: 1&#xB7;31, 1&#xB7;01&#x2013;1&#xB7;68), children in need (1&#xB7;62, 1&#xB7;38&#x2009;&#x2212;&#x2009;1&#xB7;90), and children at risk (1&#xB7;51, 1&#xB7;11&#x2009;&#x2212;&#x2009;2&#xB7;04). Conclusions: All groups receiving social service intervention experience poorer educational and health outcomes than peers in the general population. Children who remain with their home parents or caregivers but are identified as &#x2018;in need&#x2019; or &#x2018;at risk&#x2019; by social care practitioners require further research. 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The funding body played no role in designing the study, in the analysis and interpretation of the data, or in writing the manuscript.</funders><projectreference/><lastEdited>2024-11-04T12:09:52.0053403</lastEdited><Created>2024-09-26T13:15:19.1848756</Created><path><level id="1">Faculty of Humanities and Social Sciences</level><level id="2">School of Social Sciences - Education and Childhood Studies</level></path><authors><author><firstname>Emily</firstname><surname>Lowthian</surname><orcid>0000-0001-9362-0046</orcid><order>1</order></author><author><firstname>Graham</firstname><surname>Moore</surname><order>2</order></author><author><firstname>Annette</firstname><surname>Evans</surname><order>3</order></author><author><firstname>Rebecca</firstname><surname>Anthony</surname><order>4</order></author><author><firstname>Muhammad Azizur</firstname><surname>Rahman</surname><order>5</order></author><author><firstname>Rhian</firstname><surname>Daniel</surname><order>6</order></author><author><firstname>Sinead</firstname><surname>Brophy</surname><orcid>0000-0001-7417-2858</orcid><order>7</order></author><author><firstname>Jonathan</firstname><surname>Scourfield</surname><order>8</order></author><author><firstname>Chris</firstname><surname>Taylor</surname><order>9</order></author><author><firstname>Shantini</firstname><surname>Paranjothy</surname><order>10</order></author><author><firstname>Sara</firstname><surname>Long</surname><order>11</order></author></authors><documents><document><filename>67842__32829__724c826cc4f54c8b966beac1ead764ae.pdf</filename><originalFilename>67842.VOR.pdf</originalFilename><uploaded>2024-11-04T12:06:31.8920614</uploaded><type>Output</type><contentLength>1675317</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>&#xA9; The Author(s) 2024. 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spelling 2024-11-04T12:09:52.0053403 v2 67842 2024-09-26 Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK db5bc529b8a9dfca2b4a268d14e03479 0000-0001-9362-0046 Emily Lowthian Emily Lowthian true false 84f5661b35a729f55047f9e793d8798b 0000-0001-7417-2858 Sinead Brophy Sinead Brophy true false 2024-09-26 SOSS Background: Research consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care. Children receiving social services interventions often experience Adverse Childhood Experiences (ACEs), and deprivation, which are known to negatively impact outcomes. We aimed to estimate the association of different social services interventions with educational outcomes and hospital admissions, while adjusting for ACEs and deprivation. Methods: We linked retrospective, routinely collected administrative records from health, education, and social care to create a cohort via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and household members (N = 30,439) across four different groups: [1] no social care intervention; [2] children in need but not in care (CIN); [3] children on the Child Protection Register but not in care (CPR); [4] children in care - i.e. removed from the family home and looked after by the local authority (CLA). Our primary outcome was education outcomes at age 16 years. Secondary outcomes were all cause emergency hospital admissions, and emergency admissions for external causes/injuries. Results: Children in receipt of social services intervention were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics (for children who had been in out-of-home care (conditional OR: 1·76, (95%CI) 1·25 − 2·48), in need (2·51, 2·00–3·15) and those at risk (i.e., on the child protection register) (4·04, 2·44 − 6·68). For all-cause emergency admissions, all social care groups were at greater risk compared to children in the general population (children in care (conditional HR: 1·31, 1·01–1·68), children in need (1·62, 1·38 − 1·90), and children at risk (1·51, 1·11 − 2·04). Conclusions: All groups receiving social service intervention experience poorer educational and health outcomes than peers in the general population. Children who remain with their home parents or caregivers but are identified as ‘in need’ or ‘at risk’ by social care practitioners require further research. Integrated support is needed from multiple sectors, including health, educational and social care. Journal Article BMC Public Health 24 2912 Springer Nature 1471-2458 Children in need, children in care, adversity, education attainment, public health, hospital admissions, administrative data, data linkage, routinely collected data 21 10 2024 2024-10-21 10.1186/s12889-024-20204-6 COLLEGE NANME Social Sciences School COLLEGE CODE SOSS Swansea University Another institution paid the OA fee This work was funded by the Economic and Social Research Council Secondary Data Analysis Initiative (ES/R005478/1), and further supported by the Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), funded by Welsh Government through Health and Care Research Wales from 2020, and previously a UKCRC Public Health Research Centre of Excellence. The funding body played no role in designing the study, in the analysis and interpretation of the data, or in writing the manuscript. 2024-11-04T12:09:52.0053403 2024-09-26T13:15:19.1848756 Faculty of Humanities and Social Sciences School of Social Sciences - Education and Childhood Studies Emily Lowthian 0000-0001-9362-0046 1 Graham Moore 2 Annette Evans 3 Rebecca Anthony 4 Muhammad Azizur Rahman 5 Rhian Daniel 6 Sinead Brophy 0000-0001-7417-2858 7 Jonathan Scourfield 8 Chris Taylor 9 Shantini Paranjothy 10 Sara Long 11 67842__32829__724c826cc4f54c8b966beac1ead764ae.pdf 67842.VOR.pdf 2024-11-04T12:06:31.8920614 Output 1675317 application/pdf Version of Record true © The Author(s) 2024. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). true eng http://creativecommons.org/licenses/by/4.0/
title Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
spellingShingle Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
Emily Lowthian
Sinead Brophy
title_short Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
title_full Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
title_fullStr Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
title_full_unstemmed Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
title_sort Receipt of social services intervention in childhood, educational attainment and emergency hospital admissions: longitudinal analyses of national administrative health, social care, and education data in Wales, UK
author_id_str_mv db5bc529b8a9dfca2b4a268d14e03479
84f5661b35a729f55047f9e793d8798b
author_id_fullname_str_mv db5bc529b8a9dfca2b4a268d14e03479_***_Emily Lowthian
84f5661b35a729f55047f9e793d8798b_***_Sinead Brophy
author Emily Lowthian
Sinead Brophy
author2 Emily Lowthian
Graham Moore
Annette Evans
Rebecca Anthony
Muhammad Azizur Rahman
Rhian Daniel
Sinead Brophy
Jonathan Scourfield
Chris Taylor
Shantini Paranjothy
Sara Long
format Journal article
container_title BMC Public Health
container_volume 24
container_start_page 2912
publishDate 2024
institution Swansea University
issn 1471-2458
doi_str_mv 10.1186/s12889-024-20204-6
publisher Springer Nature
college_str Faculty of Humanities and Social Sciences
hierarchytype
hierarchy_top_id facultyofhumanitiesandsocialsciences
hierarchy_top_title Faculty of Humanities and Social Sciences
hierarchy_parent_id facultyofhumanitiesandsocialsciences
hierarchy_parent_title Faculty of Humanities and Social Sciences
department_str School of Social Sciences - Education and Childhood Studies{{{_:::_}}}Faculty of Humanities and Social Sciences{{{_:::_}}}School of Social Sciences - Education and Childhood Studies
document_store_str 1
active_str 0
description Background: Research consistently finds poorer health and educational outcomes for children who have experienced out-of-home care relative to the general population. Few studies have explored differences between those in care and those in receipt of intervention from social services but not in care. Children receiving social services interventions often experience Adverse Childhood Experiences (ACEs), and deprivation, which are known to negatively impact outcomes. We aimed to estimate the association of different social services interventions with educational outcomes and hospital admissions, while adjusting for ACEs and deprivation. Methods: We linked retrospective, routinely collected administrative records from health, education, and social care to create a cohort via the Secure Anonymised Information Linkage (SAIL) databank in Wales, UK. We analysed data for children and household members (N = 30,439) across four different groups: [1] no social care intervention; [2] children in need but not in care (CIN); [3] children on the Child Protection Register but not in care (CPR); [4] children in care - i.e. removed from the family home and looked after by the local authority (CLA). Our primary outcome was education outcomes at age 16 years. Secondary outcomes were all cause emergency hospital admissions, and emergency admissions for external causes/injuries. Results: Children in receipt of social services intervention were more likely to not attain the expected level upon leaving statutory education at age 16 after adjusting for ACEs and other characteristics (for children who had been in out-of-home care (conditional OR: 1·76, (95%CI) 1·25 − 2·48), in need (2·51, 2·00–3·15) and those at risk (i.e., on the child protection register) (4·04, 2·44 − 6·68). For all-cause emergency admissions, all social care groups were at greater risk compared to children in the general population (children in care (conditional HR: 1·31, 1·01–1·68), children in need (1·62, 1·38 − 1·90), and children at risk (1·51, 1·11 − 2·04). Conclusions: All groups receiving social service intervention experience poorer educational and health outcomes than peers in the general population. Children who remain with their home parents or caregivers but are identified as ‘in need’ or ‘at risk’ by social care practitioners require further research. Integrated support is needed from multiple sectors, including health, educational and social care.
published_date 2024-10-21T05:25:35Z
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