Centering the Needs of Black Children in Foster Care: Healthcare Utilization and Coordinated Medical Homes

Project Details

Description

Project Summary Youth in foster care have higher healthcare utilization and costs than the general population. Healthcare systems, state departments of Medicaid, and other organizations often shoulder this high cost without evidence of improved health outcomes for youth in foster care. Black youth in foster care are overrepresented within the healthcare system. Black youth in foster care have unique needs within the healthcare system such as being less likely to use preventative health care and significantly more emergency and urgent healthcare services than White youth. However, the mechanisms that contribute to this racial disparity are currently unknown. This study expands on Andersen’s theory of health service use by applying the framework of intersectionality (understanding the influence of multiple social identities) to identify salient factors that interact with race to influence healthcare use and wellbeing outcomes for youth in foster care. The goals of this study are to understand variation in healthcare use for Black youth in foster care and identify the role that coordinated medical care homes play in youth having better health when compared to youth who receive services from multiple systems. This study utilizes 11 years of linked child welfare and electronic health records data (N~7,500 patients) and incorporates the voices of young people in foster care through the use of a Research Participant Advisory Council to accomplish two aims: 1) Determine the mechanisms that contribute to variation in healthcare use for Black youth in foster care through the examination of child characteristics (i.e., gender, age, mental health diagnoses, health behavior) and child welfare system level characteristics (i.e., number of placement changes, placement type, number of youth in the same placement). 2) Identify how healthcare and social service systems factors contribute to variation in healthcare use and health outcomes for Black youth, such that coordinated medical care within the same system (i.e., primary and specialty care from one system) will reduce the number of unscheduled health care days and result in better health outcomes (e.g., complete vaccination records, healthy weight, stable mental health, lower health risk behaviors) when compared to youth who receive services across multiple systems. Findings from this study may provide direction for intervention targets to address inequality within the healthcare system related to coordination of care and healthcare outcomes to improve health and promote equity for Black youth in foster care. Findings may also lead to reducing the overall cost of healthcare among foster youth as well.
StatusActive
Effective start/end date9/30/249/29/25

Funding

  • Agency for Healthcare Research and Quality: $51,662.00

Fingerprint

Explore the research topics touched on by this project. These labels are generated based on the underlying awards/grants. Together they form a unique fingerprint.