Health status in children and youths in social care A descriptive study of health condition in children and youths in social care, Skåne region, Lottie Sällström Randsalu, Medical student 1, Louise Laurell, M.D., Ph.D. 2 Lund University 1, Skåne University hospital 2 Sweden

Background Almost 4 % of Swedish children experience out-of-home care. Previous research shows that these children have poor somatic and mental health. To strengthen their position, the Swedish National Board of Health and Welfare introduced ”Barns behov i centrum”, BBiC.

BBiC Systematized support system. BBiC includes a thorough health assessment: clinical examination, review of acquired medical records from birth and onwards. Aim: identifying present, and/or previously neglected, illnesses and healthcare needs in order to ensure adequate measures and continued monitoring. Implemented in the Skåne region 2012.

Aim of the study To study the somatic and mental health of children in social child welfare, based on patient records, medical history and physical examinations.

Method Inventory of patient records of children who underwent the BBiC health assessment in hospital care at SUS, SUND and KRYH medical regions Comparisons between the subgroups sex, age and form of judicial placement. 409 record audits in total.

Results Only a fraction of children placed in out-of- home care in the Skåne region were referred to the BBiC health assessment SoL LVU Total BBiC

Results Poor dental health 31 %. Failure to attend dental health programs 36 %. Failure to attend child health programs 39 %. Failure to attend preschool 39 %. Failure to fulfil compulsory school attendance 39 %.

Results Incomplete vaccination status 36 %. Overweight 22 % Obesity 8 % Injuries having required medical care 36 % Current injuries 24 % Signs of abuse 17 %

LVU vs SoL – are there differences? SoLLVU Presence of violence29 %71 % Exposed to abuse37 %63 % Incomplete vaccination status 60 %40 % Poor dental health59 %41 % Referral(s) issued56 %44 % Incorrect grade in comparison to age 63 %37 %

Conclusions High rates of various health issues were found in the study group. Only a fraction of children placed in out-of- home care were referred to the BBiC health assessment. SoL-children have at least as poor health as LVU-children.

Future actions Mandatory health assessment for all children in social welfare care - SoL as well as LVU. Raise awareness of the need for referrals to the BBiC health assessment.