Socioeconomic conditions and children’s out-of-home care in high-income countries: a systematic review and meta-analysis

ICON members Viviane S. Straatmann, Ylva B. Almquist and Tanishta Rajesh participated in a systematic review and meta-analysis examining the relationship between socioeconomic disadvantage and children’s risk of entering out-of-home care across high-income countries.

About the study

Socioeconomic inequalities in children’s out-of-home care (OHC) are an important public health concern. Although previous research has repeatedly linked socioeconomic disadvantage with a greater likelihood of children entering care, evidence from high-income countries had not previously been systematically synthesised. The study therefore examined whether children experiencing disadvantaged socioeconomic conditions face a higher risk of OHC compared with those living in more advantaged circumstances.

The researchers conducted a systematic review and meta-analysis of observational studies from OECD countries published between January 1980 and April 2026. Eight databases were searched, resulting in 12,328 unique records. A total of 150 studies from 13 countries met the inclusion criteria, providing 447 estimates across socioeconomic factors including area deprivation, parental employment and education, income and eligibility for social assistance.

Of the 447 estimates, 390 showed an association between socioeconomic disadvantage and an increased risk of OHC. Associations were consistently positive across the different socioeconomic measures and were particularly consistent for area deprivation and eligibility for social assistance. Although very high heterogeneity between studies limited the interpretation of pooled estimates, sensitivity analyses based on higher-quality studies strengthened the overall findings.

Overall, the findings demonstrate a consistent relationship between socioeconomic disadvantage and children’s entry into out-of-home care across high-income countries. The authors suggest that policies addressing the socioeconomic drivers of childhood adversity may help reduce care entry and highlight the need for future research evaluating how social and economic policy reforms influence the risk of OHC.

Highlights

“Socioeconomic disadvantage was consistently associated with an increased risk of children entering out-of-home care across high-income countries, with particularly consistent associations for area deprivation and eligibility for social assistance.”

Publication details

Bennett, D., Melis, G., Lee, P., Maudsley, G., Maden, M., Donegan, S., Hill, R., Straatmann, V. S., Almquist, Y. B., Rajesh, T., Forsman, H., & Taylor-Robinson, D. (2026). Socioeconomic conditions and children’s out-of-home care in high-income countries: A systematic review and meta-analysis. Journal of Epidemiology & Community Health.

Read more: https://doi.org/10.1136/jech-2025-225253

Featured authors