The health literacy of children who are 'looked after' by the state

It has long been recognised that an important determinant of a child's health is parental health literacy. There are, however, a large number of children living apart from their parents. In the United Kingdom, for example, there are over 90,000 children living in 'State' care. In the United States the figure exceeds 0.5 million and in Central and Eastern Europe 1.5 million (UNICEF, 2008; Rees, 2010). Children who are living in State care have long been recognised as 'vulnerable' and outcome data that are available suggests that at the group level, their physiological health, emotional literacy, mental health and educational performance is relatively poor (Rees, 2012; Scott and Hill, 2006; Dixon, 2008). Politicians and practitioners have struggled for decades with limited success to improve health outcomes for these children. Drawing on a range of statutory documents, policy initiatives and data from a range of studies on the health of children in State care, this chapter will highlight the need for greater emphasis on developing the children's health literacy; enabling them to access, understand, interpret and act on health information. The chapter will present and discuss novel data on the association between indices of multiple deprivation and the context from which children in State care come from. The data will be used to illustrate the need for targeted pre and post-care health programmes. A call is made for the adoption of an empowering life course perspective.