{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T06:35:59Z","timestamp":1785825359376,"version":"3.56.0"},"reference-count":43,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2020,10,2]]},"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:sec id=\"s1\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s2\">\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To examine if there is a prospective association between childhood public care and adverse life outcomes in middle-age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s3\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We used data from the UK 1958 birth cohort study of 18\u00a0558 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).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s4\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 420 (3.8%) of 11\u00a0160 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: \u22120.1; \u22120.3 to 0.1) endpoints.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"s5\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The present study suggests that selected associations apparent between childhood care and outcomes in adolescence and early adulthood are also evident in middle-age.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jech-2020-214737","type":"journal-article","created":{"date-parts":[[2020,10,17]],"date-time":"2020-10-17T17:25:11Z","timestamp":1602955511000},"page":"289-296","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":14,"title":["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"],"prefix":"10.1136","volume":"75","author":[{"given":"Tiffany","family":"Xie","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"de Mestral","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1822-5753","authenticated-orcid":false,"given":"G David","family":"Batty","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, University College London, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,17]]},"reference":[{"key":"2025100301322410000_75.3.289.1","doi-asserted-by":"publisher","DOI":"10.1093\/epirev\/mxh008"},{"key":"2025100301322410000_75.3.289.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38723.660637.AE"},{"issue":"8","key":"2025100301322410000_75.3.289.3","doi-asserted-by":"crossref","first-page":"e356","DOI":"10.1016\/S2468-2667(17)30118-4","article-title":"The effect of multiple adverse childhood experiences on health: a systematic review and meta-analysis","volume":"2","author":"Hughes","year":"2017","journal-title":"Lancet Public Health"},{"key":"2025100301322410000_75.3.289.4","unstructured":"US Department of Health and Human Services - Children\u2019s Bureau . The adoption and foster care analysis and reporting system report no. 25. 2018. Available https:\/\/www.acf.hhs.gov\/cb (accessed 20 Jan 2019)"},{"key":"2025100301322410000_75.3.289.5","unstructured":"UK Department of Education . Children looked after in England including adoption: 2017 to 2018. Available https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/757922\/Children_looked_after_in_England_2018_Text_revised.pdf (accessed 20 Jan 2019)"},{"key":"2025100301322410000_75.3.289.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.adolescence.2005.12.002"},{"key":"2025100301322410000_75.3.289.7","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2004-1311"},{"key":"2025100301322410000_75.3.289.8","doi-asserted-by":"publisher","DOI":"10.1097\/00004583-200011000-00016"},{"key":"2025100301322410000_75.3.289.9","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-011-0458-5"},{"key":"2025100301322410000_75.3.289.10","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/S2352-4642(18)30207-4","article-title":"Out-of-home placement in early childhood and psychiatric diagnoses and criminal convictions in young adulthood: a population-based propensity score-matched study","volume":"2","author":"Cote","year":"2018","journal-title":"Lancet Child Adolesc Health"},{"key":"2025100301322410000_75.3.289.11","doi-asserted-by":"crossref","unstructured":"Teyhan A , Wijedasa D , Macleod J . Adult psychosocial outcomes of men and women who were looked-after or adopted as children: prospective observational study. BMJ Open 2018;8(2):e019095. doi: 10.1136\/bmjopen-2017-019095","DOI":"10.1136\/bmjopen-2017-019095"},{"key":"2025100301322410000_75.3.289.12","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2011.300285"},{"key":"2025100301322410000_75.3.289.13","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1150"},{"key":"2025100301322410000_75.3.289.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2008.09.011"},{"key":"2025100301322410000_75.3.289.15","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1016\/j.chiabu.2016.11.009","article-title":"The truly disadvantaged? Midlife outcome dynamics of individuals with experiences of out-of-home care","volume":"67","author":"Brannstrom","year":"2017","journal-title":"Child Abuse Negl"},{"key":"2025100301322410000_75.3.289.16","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyi183"},{"key":"2025100301322410000_75.3.289.17","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2018-210667"},{"issue":"9596","key":"2025100301322410000_75.3.289.18","doi-asserted-by":"crossref","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","year":"2007","journal-title":"Lancet (London, England)"},{"key":"2025100301322410000_75.3.289.19","unstructured":"The Registrar General . General\u2019s decennial supplement, England and Wales 1961, occupational mortality tables . London: HMSO, 1971."},{"key":"2025100301322410000_75.3.289.20","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.64.6.668"},{"key":"2025100301322410000_75.3.289.21","unstructured":"Stott DH , Sykes EG , Marston N . The social adjustment of children: manual of the British social-adjustment guides . Stoughton: Hodder, 1974."},{"key":"2025100301322410000_75.3.289.22","unstructured":"Rutter M , Tizard J . Education, health and behaviour . London: Longman, 1970."},{"key":"2025100301322410000_75.3.289.23","doi-asserted-by":"publisher","DOI":"10.1007\/s001270050153"},{"key":"2025100301322410000_75.3.289.24","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700002658"},{"key":"2025100301322410000_75.3.289.25","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-115-10-774"},{"key":"2025100301322410000_75.3.289.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2008.09.021"},{"issue":"8","key":"2025100301322410000_75.3.289.27","doi-asserted-by":"crossref","first-page":"621","DOI":"10.1093\/abm\/kax001","article-title":"Childhood psychological distress and healthy cardiovascular lifestyle 17\u201335 years later: the potential role of mental health in primordial prevention","volume":"52","author":"Winning","year":"2018","journal-title":"Ann Behav Med"},{"key":"2025100301322410000_75.3.289.28","unstructured":"World Health Organization . Obesity: preventing and managing the global epidemic (technical report series 894) . Geneva: WHO, 2000."},{"key":"2025100301322410000_75.3.289.29","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1186\/s40359-016-0164-x","article-title":"Is mid-life social participation associated with cognitive function at age 50? Results from the British National Child Development Study (NCDS)","volume":"4","author":"Bowling","year":"2016","journal-title":"BMC Psychol"},{"issue":"3","key":"2025100301322410000_75.3.289.30","first-page":"1010","article-title":"Exposure to out-of-home care in childhood and adult all-cause mortality: a cohort study","volume":"46","author":"Gao","year":"2017","journal-title":"Int J Epidemiol"},{"key":"2025100301322410000_75.3.289.31","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.323.7306.207"},{"key":"2025100301322410000_75.3.289.32","doi-asserted-by":"crossref","unstructured":"Vinnerljung B , Ribe M . Mortality after care among young adult foster children in Sweden. 2001;10(3):164\u201373. doi: 10.1111\/1468-2397.00169","DOI":"10.1111\/1468-2397.00169"},{"key":"2025100301322410000_75.3.289.33","doi-asserted-by":"crossref","unstructured":"de Mestral C , Bell S , Hamer M , et al. Out-of-home care in childhood and biomedical risk factors in middle-age: national birth cohort study. Am J Hum Biol 2019;e23343. doi: 10.1002\/ajhb.23343","DOI":"10.1002\/ajhb.23343"},{"key":"2025100301322410000_75.3.289.34","doi-asserted-by":"crossref","unstructured":"Batty GD , Hamer M. Public care during childhood and biomedical risk factors in middle-age: the 1970 birth cohort study. Am J Epidemiol 2020 In press. doi: 10.1093\/aje\/kwaa079","DOI":"10.1093\/aje\/kwaa079"},{"key":"2025100301322410000_75.3.289.35","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1186\/s12889-019-6752-y","article-title":"Do trajectories of economic, work- and health-related disadvantages explain child welfare clients\u2019 increased mortality risk? A prospective cohort study","volume":"19","author":"Almquist","year":"2019","journal-title":"BMC Public Health"},{"key":"2025100301322410000_75.3.289.36","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291711000274"},{"key":"2025100301322410000_75.3.289.37","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.51.2.77"},{"key":"2025100301322410000_75.3.289.38","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0000000000000184"},{"key":"2025100301322410000_75.3.289.39","doi-asserted-by":"publisher","DOI":"10.1136\/jech.2008.086892"},{"key":"2025100301322410000_75.3.289.40","unstructured":"de Mestral C , Bell S , Batty GD , Public care in childhood, risk factors in adulthood, and mortality: a pooled date from two birth cohorts (Parallel sessions - A6_1 . Neuchatel, Switzerland: Swiss Public Health Conference 2018, 2018: Available https:\/\/sphc.ch\/de\/vergangene-konferenzen\/sphc-2018\/sessions\/"},{"key":"2025100301322410000_75.3.289.41","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1016\/j.chiabu.2015.10.020","article-title":"Changes in first entry to out-of-home care from 1992 to 2012 among children in England","volume":"51","author":"Mc Grath-Lone","year":"2016","journal-title":"Child Abuse Negl"},{"key":"2025100301322410000_75.3.289.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2006.04.003"},{"key":"2025100301322410000_75.3.289.43","doi-asserted-by":"crossref","unstructured":"Batty GD , Hamer M . Response to commentary on \u2018Public care during childhood and biomedical risk factors in middle-age: the 1970 birth cohort study\u2019 by Hilary K Brown entitled \u2018Biomarkers for mortality among individuals with a history of out-of-home care: implications for study design and conceptualizations of risk\u2019. Am J Epidemiol 2020. doi: 10.1093\/aje\/kwaa078","DOI":"10.1093\/aje\/kwaa078"}],"container-title":["Journal of Epidemiology and Community Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/jech-2020-214737","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T08:32:38Z","timestamp":1759480358000},"score":1,"resource":{"primary":{"URL":"https:\/\/jech.bmj.com\/lookup\/doi\/10.1136\/jech-2020-214737"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10,17]]},"references-count":43,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2021,2,10]]},"published-print":{"date-parts":[[2021,3]]}},"alternative-id":["10.1136\/jech-2020-214737"],"URL":"https:\/\/doi.org\/10.1136\/jech-2020-214737","relation":{"has-preprint":[{"id-type":"doi","id":"10.1101\/2020.03.03.20030718","asserted-by":"object"}]},"ISSN":["0143-005X","1470-2738"],"issn-type":[{"value":"0143-005X","type":"print"},{"value":"1470-2738","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10,17]]}}}