Health Conditions, Utilization, and Expenditures of Children in Foster Care. Demographic Characteristics

09/19/1999

Next, we present a demographic profile of children in foster care and compare their characteristics to those of children in other categories of Medicaid eligibility (Tables III.2A, Table III.2B, and Table III.2C and Figure III.2). As shown in Tables III.2A, foster care children averaged 9 years of age in California, similar to children receiving adoption assistance. AFDC children were younger on average (7 years), while SSI children were older on average (10 years). Despite similarities in the average age between children in foster care and adoption assistance, the age distribution was quite different; more infants and adolescents were in foster care and more 5- to 14-year old children received adoption assistance.

The overall age distributions were similar in Florida, although we observed a wider age gap between children in foster care and children receiving adoption assistance, due to a concentration of infants and preschool age children in the foster care group and 5- to 9-year-olds in the adopted group (Table III.2B). In Pennsylvania, the average age of foster care children was almost 11, nearly two years higher than the other two states (Table III.2C). Two in five foster care children in Pennsylvania were adolescents (39 percent), versus 21 to 25 percent in the other two states.

Table III.2A
Demographic Characteristics of Children in Foster Care and
Other Categories of Medicaid Eligibility:
California, 1994
    Category of Medicaid Eligibility
All Children(a)
(N=3,603,056)
Foster care
(N=111,236)
Adoption
Assistance
(N=18,922)
AFDC
(N=2,095,890)
SSI
(N=68,667)
Total 100.0% 100.0% 100.0% 100.0% 100.0%
Age
Less than 1 7.9 5.1 0.2 6.3 1.2
1 to 4 31.3 24.2 14.4 31.3 16.8
5 to 9 27.1 23.9 43.2 29.2 29.3
10 to 14 19.8 22.3 29.8 21.2 30.3
15 to 18 13.9 24.5 12.5 12.0 22.5
Mean 7.3 9.0 9.0 7.3 9.9
Gender
Male 50.2 51.9 49.7 50.2 60.7
Female 49.8 48.1 50.4 49.8 39.3
Race/Ethnicity
White 25.0 60.5 48.6 27.6 29.7
Black 13.3 19.0 25.8 18.0 23.7
Hispanic 50.1 15.9 21.9 41.9 0.2
Other/Unknown 11.6 4.7 3.9 12.5 46.5
Urban/Rural Location
Large MSA 77.6 83.7 80.4 76.2 74.6
Small MSA 18.8 13.4 16.6 20.0 21.4
Non-MSA 3.6 3.0 3.0 3.8 4.0
Source:  HCFA State Medicaid Research Files.

Note:  Numbers may not sum to total due to rounding.

a.  Includes children in other categories of Medicaid eligibility.

Table III.2B
Demographic Characteristics of Children in Foster Care and
Other Categories of Medicaid Eligibility:
Florida, 1994
    Category of Medicaid Eligibility
All Children(a)
(N=1,247,470)
Foster care
(N=14, 011)
Adoption
Assistance
(N=6,545)
AFDC
(N=638,259)
SSI
(N=60,813)
Total 100.0% 100.0% 100.0% 100.0% 100.0%
Age
Less than 1 8.4 4.2 0.3 4.7 2.2
1 to 4 32.3 26.4 11.8 30.9 15.2
5 to 9 29.6 24.9 37.3 29.6 29.4
10 to 14 18.4 23.4 33.3 21.8 33.0
15 to 18 11.3 21.0 17.3 13.0 20.1
Mean 6.8 8.6 9.8 7.5 9.8
Gender
Male 50.6 50.5 52.1 49.5 63.3
Female 49.4 49.5 47.9 50.5 36.7
Race/Ethnicity
White 39.7 46.7 54.6 34.2 29.9
Black 38.8 45.8 39.1 47.3 38.1
Hispanic 18.3 5.7 4.5 17.1 0.1
Other/Unknown 3.3 1.9 1.7 1.4 31.9
Urban/Rural Location
Large MSA 51.3 52.6 44.5 52.8 48.3
Small MSA 39.9 42.1 51.8 38.8 43.6
Non-MSA 8.8 5.3 3.7 8.5 8.1
Source:  HCFA State Medicaid Research Files.

Note:  Numbers may not sum to total due to rounding.

a.  Includes children in other categories of Medicaid eligibility.

Table III.2C
Demographic Characteristics of Children in Foster Care and
Other Categories of Medicaid Eligibility:
Pennsylvania, 1994
    Category of Medicaid Eligibility
All Children(a)
(N=860,223)
Foster care
(N=28,390)
Adoption
Assistance
(N=3,847)
AFDC
(N=456,127)
SSI
(N=38,177)
Total 100.0% 100.0% 100.0% 100.0% 100.0%
Age
Less than 1 7.4 2.6 0.1 7.2 0.9
1 to 4 29.3 18.3 7.1 29.9 12.4
5 to 9 29.1 18.9 32.3 29.9 29.1
10 to 14 20.1 21.1 36.3 20.7 33.5
15 to 18 14.1 39.3 24.2 12.4 24.1
Mean (in months) 7.4 10.8 10.9 7.3 10.4
Gender
Male 50.9 59.8 53.6 49.7 63.5
Female 49.1 40.2 46.4 50.3 36.5
Race/Ethnicity
White 56.9 42.8 59.0 42.2 59.7
Black 32.2 50.6 32.2 44.4 26.7
Hispanic 8.6 5.3 5.7 11.1 12.0
Other/Unknown 3.3 1.2 3.0 2.2 1.6
Urban/Rural Location
Large MSA 57.0 65.1 52.1 67.0 51.6
Small MSA 27.3 25.1 34.8 22.9 32.0
Non-MSA 15.7 9.8 13.1 10.1 16.5
Source:  HCFA State Medicaid Research Files.

Note:  Numbers may not sum to total due to rounding.

a.  Includes children in other categories of Medicaid eligibility.

 

Figure III.2: Demographic Characteristics of Children in Foster Care, 1994.

Figure III.2 Continued: Demographic Characteristics of Children in Foster Care, 1994.

The gender distribution was generally consistent across states and across categories of Medicaid eligibility, with a fairly even split between boys and girls. There were two exceptions, however. In Pennsylvania, the foster care population was dominated by boys (60 percent of the total), and across all three states, there were three boys for every two girls in the SSI population.

The race/ethnicity of foster care children varied considerably across the three states, compared to children in other categories of Medicaid eligibility. Sixty percent of the foster care population in California was white, while half of the adoption assistance children and only about a fourth of the AFDC children were white. We see a different pattern in Florida where black and white children represented nearly equal shares of the foster care population, but the adoption assistance children were disproportionately white and AFDC children were disproportionately black. In Pennsylvania, we see an even sharper contrast in the racial/ethnic distribution between foster care and adoption assistance children; 43 percent of the foster care children were white versus 59 percent of the adopted children. These results suggest that children receiving adoption assistance in Florida and Pennsylvania were disproportionately white, while those remaining in foster care were more likely to be from minority backgrounds. In California, however, just the opposite was found: a higher proportion of foster care children were white compared to those who were adopted.

Foster care children were concentrated in large metropolitan areas, just like the Medicaid population as a whole. Compared to foster care children, adopted children were more likely to reside in small urban areas, especially in Florida and Pennsylvania.

We also compared the demographic characteristics of foster care children according to whether they received assistance through Title IV-E. Across all three states, Title IV-E children were younger, on average, than those not receiving Title IV-E assistance (Table III.3). Adolescents between the ages of 15 and 18 comprised a much larger share of non-Title IV-E foster care children, accounting for 67 percent in Pennsylvania, 40 percent in California, and 31 percent in Florida. In general, boys dominated girls in the non-Title IV-E group, especially in Pennsylvania.

Table III.3:
Demographic Characteristics of Foster Care Children,
By Title IV-E Assistance Status, 1994
Characteristic California Florida Pennsylvania
Receiving Title IV-E Assistance
(N=77,875)
Not Receiving Title IV-E Assistance
(N=33,361)
Receiving Title IV-E Assistance
(N=9,211)
Not Receiving Title IV-E Assistance
(N=4,800)
Receiving Title IV-E Assistance
(N=21,075)
Not Receiving Title IV-E Assistance
(N=7,315)
Total 100.0% 100.0% 100.0% 100.0% 100.0% 100.0%
Age
Less than 1 5.2 4.8 4.3 4.0 3.0 1.3
1 to 4 27.8 15.7 29.3 21.0 22.3 6.5
5 to 9 26.8 17.1 27.6 19.8 23.1 6.8
10 to 14 22.3 22.3 23.1 24.0 22.0 18.4
15 to 18 17.8 40.1 15.7 31.2 29.6 67.0
Mean 8.1 10.9 7.9 10.0 9.7 14.1
Gender
Male 51.1 53.6 49.8 52.0 57.9 65.3
Female 48.9 46.4 50.2 48.0 42.1 34.7
Race/Ethnicity
White 61.5 58.1 42.3 55.2 37.1 59.1
Black 20.3 15.9 50.3 37.0 56.4 34.0
Hispanic 14.3 19.4 5.8 5.5 5.6 4.5
Other/Unknown 3.9 6.6 1.6 2.3 0.9 2.4
Urban/Rural Location
Large MSA 82.9 85.4 51.9 54.1 68.9 54.2
Small MSA 14.1 11.7 42.5 41.3 22.5 32.5
Non-MSA 3.0 2.9 5.6 4.7 8.6 13.3
Source: HCFA State Medicaid Research Files.
Note: Numbers may not sum to total due to rounding.

The racial/ethnic composition differed between the two groups, with white children disproportionately eligible through non-Title IV-E categories in Florida and Pennsylvania. There were few differences in the urban/rural distribution, except in Pennsylvania, where children from small urban and rural areas were disproportionately represented in the non-Title IV-E group. These results suggest that in Pennsylvania, more than in the other two states, state foster care assistance (non-Title IV-E funds) was targeted toward adolescents, boys, whites, and residents of small urban or rural areas.