Children in Temporary Assistance for Needy Families (TANF) Child-Only Cases with Relative Caregivers. 2.5.5 Physical and Emotional Health Is Poor


Children who live with relatives or foster parents are more likely to have behavioral and emotional problems than children who live with their parents (Kortenkamp and Ehrle, 2002; American Academy of Pediatrics, 2000; Simms, Dubowitz, and Szilagyi, 2000). Analysis of the 1997/1999 NSAF found significant differences between children in kinship or foster care and children cared for by parents in terms of limiting conditions and physical health status. A higher percentage of children in kinship and foster care reported having physical or mental impairments, being in fair or poor health, and visiting a mental health provider during the survey year (Kortenkamp and Ehrle, 2002). In a study of kin caregivers in South Carolina, relatives reported that the children they cared for suffered from "nightmares, anxiety attacks, depressionàlearning disabilities, promiscuity, and/or aggressive behavior," much of which was likely caused by past trauma (Edelhoch, 2002). While physical and emotional health is a concern of children placed in TANF child-only relative care, states are addressing this concern through policies tying cash assistance to compliance with immunization schedules and/or well-child medical visits (Romero et al., 2001; Risely-Curtiss and Kronenfeld, 2002). However, even with this tie to cash assistance, physical and emotional health care is in question. Risely-Curtiss and Kronenfeld (2002) found that fewer than 50 percent of referrals for physical, dental, and mental health care were completed by relative caregivers within a reasonable time frame.

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