Which population groups are at risk and why?
This section will focus on core epidemiological issues that take account of fixed risk factors (such as age, gender, ethnicity, family history) and modifiable risk factors (such as behaviour). The wider determinants of health (such as housing, transport and environment) are also considered.
Age
Infants (pre-birth and first year) have the highest risk, a survival analysis study found that children known to social care services pre-birth or in their first year of life were significantly more likely to become looked after. Perinatal and early-life involvement is identified as a key predictor of entering care even when controlling for other risk factors3, 4.
Socioeconomic status
Children living in the most deprived socioeconomic areas are at highest risk. Children in the most deprived 10% of neighbourhoods in England are over 10 times more likely to be in care compared with children in the least deprived5. Large-scale longitudinal research demonstrates that rising child poverty rates directly increase the rate of children entering care, with a 1 percentage point rise in child poverty is associated with 5 additional children entering care per 100,0006.
Many factors strongly associated with care entry are concentrated in lower-income households: household mental ill-health; domestic abuse; drug and alcohol misuse; and neglect and multiple forms of abuse7.
Ethnicity
A study (survival analysis) of Children’s Social Care data in Liverpool (2019-2022) found Black children were more likely to become looked-after than children of other ethnicities. Asian children were also more likely to become looked-after than their White counterparts3. Although local to Liverpool it aligns with broader patterns in national social care analysis, ethnic disparities intersect with socioeconomic inequalities; area-level deprivation; and exposure to family stressors.
Vulnerable Children
Children with key vulnerability indicators have a higher hazard of becoming looked-after, including neglect; sexual abuse; emotional abuse; drug and/or alcohol misuse in the household or by the child; and mental ill-health in the household. These vulnerability factors substantially increase the statistical likelihood that a child known to social services would transition into looked-after status3.
Rising child poverty rates directly increase the rate of children entering care, with a 1 percentage point rise in child poverty is associated with 5 additional children entering care per 100,0006. Children in the most deprived 10% of neighbourhoods in England are over 10 times more likely to be in care compared with children in the least deprived5.
Children known to social care pre-birth or in their first year of life had higher odds of becoming looked-after in a recent social care data study3.