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Association of public care in childhood with social, criminal, cognitive, and health outcomes in middle-age: five decades of follow-up of members of the 1958 birth cohort study
  1. Tiffany Xie,
  2. Carlos de Mestral,
  3. G David Batty
  1. Department of Epidemiology and Public Health, University College London, London, UK
  1. Correspondence to G David Batty, Department of Epidemiology & Public Health, University College London, 1-19 Torrington Place, London, UK; david.batty{at}


Background Children who have been exposed to public (out-of-home) care experience a range of negative outcomes by late adolescence and early adulthood. The longer-term impact of childhood care is, however, uncertain.

Aim To examine if there is a prospective association between childhood public care and adverse life outcomes in middle-age.

Methods We used data from the UK 1958 birth cohort study of 18 558 individuals. Parents reported offspring care status at age 7, 11 and 16. An array of social, criminal, cognitive, and health outcomes was self-reported by cohort members at age 42 (71% response proportion in eligible sample) and a cognitive test battery was administered at age 50 (62% response).

Results A total of 420 (3.8%) of 11 160 people in the analytical sample experienced childhood public care by age 16. Net of confounding factors, experience of public care (vs none) was linked to 11 of the 28 non-mutually exclusive endpoints captured in middle-age, with the most consistent effects apparent for psychosocial characteristics: 4/7 sociodemographic (eg, odds ratio; 95% confidence interval for homelessness: 2.1; 1.4 to 3.1); 2/2 antisocial (eg, use of illicit drug: 2.0; 1.2 to 3.5); 2/3 psychological (eg, mental distress: 1.6; 1.2 to 2.1); 1/3 health behaviours (eg, current cigarette smoker: 1.7; 1.3 to 2.2); 2/8 somatic health (physical disability: 2.7; 1.9 to 3.8); and 0/5 cognitive function (eg, beta coefficient; 95% confidence interval for immediate word recall: −0.1; −0.3 to 0.1) endpoints.

Conclusions The present study suggests that selected associations apparent between childhood care and outcomes in adolescence and early adulthood are also evident in middle-age.

  • Life course epidemiology
  • Public health
  • Lifecourse/ childhood circumstances

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  • Contributors TX analysed the data, interpreted the results, and jointly drafted the manuscript. CdM built the data set, interpreted the results, and revised the manuscript. GDB generated the idea for the study, formulated an analytical plan, interpreted the results, and jointly drafted the manuscript. All authors approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available in a public, open-access repository.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.