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- Alexander Okun, MD, FAAP*
- *New Alternatives for Children, New York, NY
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AUTHOR DISCLOSURE
Dr Okun has disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Every 4 minutes in the United States, a child is placed into foster care. In 70% of cases, placement follows investigation by child protective services into reports of suspected neglect, physical abuse, sexual abuse, or psychological maltreatment. Nearly all other cases represent adolescents ordered into care by the courts, mostly as a result of a juvenile justice issue. Fewer than 1% of children in foster care are placed voluntarily by their parents or other family caregivers. Most children entering foster care are able to live in the households of relatives or unrelated foster parents, but 1 in 7 is placed in a group home or residential treatment facility.
Fewer children are in foster care than in the past. There were 400,000 in 2014, a reduction of 20% compared to 10 years previously. Although racial disparities within the system have also diminished, children classified as African-American or multiracial still comprised 25% of those in foster care in 2014, a significant overrepresentation relative to the population distribution of the United States.
More than two-thirds of children enter foster care from an environment characterized by extreme poverty; mental illness or substance abuse in a caregiver; or exposure to …
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