Background There is little quantitative evidence on how the health of care experienced children compares to children in the general population in Scotland or the UK. Invariably, the evidence that is available suggests that care experience is related to poorer health, but often this is based on small sample sizes or without comparison to children who have not been in care. The CHiCS study was set up to provide the first population-wide evidence on health outcomes (mortality, hospitalisation, prescribing and pregnancy rates) of care experienced children (CEC) compared to children in the general population (CGP).

Methods We undertook an individual level linkage of the Children Looked After in Scotland (CLAS) return to the Pupil Census (PC), Scottish Morbidity Records (SMR00, 01, 02, 04), Accidents and Emergency data, Prescribing Information System, and Death and Birth Registrations from August 2009 to July 2016. The CEC cohort was defined as all children who were on the 2009/2010 CLAS return and the CGP cohort was defined as children who were on the 2009 PC but had not been in care. Age-standardized rates by area deprivation will be calculated for various outcomes for both cohorts to provide the first national evidence on the health of looked after children. Event history analysis will be used on matched cohorts to investigate the impact of placement histories and parental socioeconomic status (SES) on health.

Results The data became available for analysis in December 2020. The initial results show that CEC have, on average, lower SES and live in areas of higher deprivation, they also experienced higher average rates of mortality, prescriptions, and all types of hospitalisations during the study period (not adjusted). There are also substantial differences in the types of prescriptions and reasons for hospital admission between the cohorts, e.g. CEC are more likely to be prescribed antidepressant and ADHD medication and have almost three times as many psychiatric outpatient appointments (not adjusted). Additional results will be submitted before the June 28th deadline. We expect the results adjusted for confounders to show substantial differences in the frequency and reasons for contact with health services between the two cohorts.

Results Adverse childhood experiences have a profound negative impact on health and these effects last long into adulthood. Identifying how care experiences are related to health will provide evidence to develop interventions for health improvement and to reduce inequalities. Interventions in childhood are among the most effective in improving long-term health and are cost-effective.