The transition from childhood to adulthood is a challenge in the best of circumstances. It takes a network of strong and stable connections with family, friends, and community to help young people learn and grow into healthy adults, and to support the incredible brain development that occurs during this time. But what about young people who have spent some or all of their childhood in foster care? Many of them lack these stable connections. They are also more likely to have faced, and continue to face, a host of disruptive and traumatic experiences including school instability, mental and physical health issues, and homelessness. What does the research tell us about the unique circumstances of their transition to adulthood?
Each year, about 23,000 young people “age out” of foster care because they reach the age of legal adulthood—anywhere from 18 to 21, depending on the state. All of these young people lack a permanent legal relationship with a biological or adoptive parent or adult guardian. And there are a lot of children on the same path: nearly 36,000 U.S. children are at risk of aging out of foster care, meaning that they are age 9 or older with a case goal of long-term foster care or “emancipation,” as aging-out is sometimes called.
When connections with birth families, siblings, or a home community are developed and supported, it can help young people when they age out of foster care. For example, when extended family members serve as foster parents, it allows young people to maintain strong family connections (and reduces the trauma of entry into foster care to begin with). And, young people who have adults to rely on are significantly more likely to have savings, and less likely to have debt.
Extension of foster care—including room and board, case and permanency planning, and judicial oversight—gives young people additional time to grow and learn without the challenges of complete independence. Research has shown that young people who remain in care to age 21 are less likely to experience homelessness, less likely to become pregnant before age 21, and more likely to be employed and attend college compared to those who leave care at age 18.
For example, youth who have experienced foster care face a disproportionately high number of physical and mental health problems. The federal Affordable Care Act extends Medicaid coverage for people aging out of foster care to age 26, paralleling the provision that allows young people to stay on their parents’ health insurance until that age. We’re starting to see how that plays out for young people. In the past five years, the rate of health insurance coverage among Jim Casey Youth Opportunity Initiative participants (all of whom experienced foster care as teenagers) has increased substantially: from 69 to 79 percent for 18- to 21-year-olds, and from 50 to almost 75 percent for 22- to 26-year-olds—a staggering increase.
 Information provided by the Jim Casey Youth Opportunities Initiative.
Thankfully, there is growing awareness of the challenges faced by young people who transition out of foster care without permanent connections to adults. But we need data in order to really understand the complexities of their lives and what services and programs make a difference. Groundbreaking work done by the Jim Casey Youth Opportunities Initiative and studies like the Midwest Evaluation of the Adult Functioning of Former Foster Youth and the Northwest Foster Care Alumni Study have provided invaluable snapshots of these young people’s lives, but more comprehensive federal data—such as those in the National Youth in Transition Database—have been slower to develop. Response rates remain low, but this important resource could eventually reveal the services that these young people receive during their transition, and the reality of their lives as young adults.