Learning Objective #1: Describe the health issues and key variables of support needed to improve Hawaii foster children’s health

Learning Objective #2: Identify gaps in parent and provider support needed to meet physical, mental, and emotional health needs of foster children

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Foster children regularly come into a state's care with a greater number, more serious and more complex health problems than other children in our nation. Although the first opportunity for suitable health care often comes through the foster system, serious health needs frequently remain unmet. Recent data suggests that inadequate health care is provided at least 43 percent of the time in Hawaii's foster system. The specific type of support needed to better obtain the health care is largely unknown. Furthermore, little attention has been given to the foster children's perspective of the support they need.

The specific aim of this research was to describe the health issues and key variables of support needed to optimize Hawaii foster children's physical, mental and emotional health. The research method was qualitative analysis of seven tape-recorded and transcribed focus groups, conducted separately with 18 and 19 year old former foster youth, with foster parents and with professionals involved in the foster care system. Human subject approval was obtained from the University of Hawaii.

Although a number of physical health issues were addressed by the former foster youth, the data indicate that the perceived needed health care is overwhelmingly linked to psychological and emotional support. Depression, feelings of isolation, trauma, frustration related to lack of communication, fear of being happy, and hiding feelings are a few of the dominant issues. The importance of providers nurturing self-care ability within the youth was recognized. Parent and provider focus was geared more to meeting physical needs and dealing with systems.

This study begins to recognize the health disparities experienced by Hawaii's foster children at the basic level of health care. By identifying the health care and support needed, there is a potential to ultimately have significant impact on the health of this underserved and vulnerable population.