Children growing up in disadvantaged socioeconomic circumstances are more likely to enter out-of-home care, but evidence across high-income countries has not previously been systematically synthesised. A new systematic review and meta-analysis brings together research from OECD countries to examine how socioeconomic conditions are associated with children’s risk of entering out-of-home care.
Socioeconomic inequalities in children’s out-of-home care represent an important public health issue. Although individual studies have linked socioeconomic disadvantage with a greater likelihood of care placement, differences in measures, populations and national contexts have made it difficult to assess the consistency of this relationship across countries. The researchers therefore examined whether children experiencing disadvantaged socioeconomic conditions have a higher risk of entering out-of-home care than children in more advantaged circumstances.
The systematic review included 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 relating to socioeconomic factors such as area deprivation, parental employment and education, household income and eligibility for social assistance.
Of the 447 estimates, 390 showed an association between socioeconomic disadvantage and an increased risk of out-of-home care. Associations were particularly consistent for area deprivation and eligibility for social assistance. Although substantial differences between studies limited the interpretation of pooled estimates, sensitivity analyses restricted to higher-quality studies strengthened the overall findings.
Overall, the findings show a consistent relationship between disadvantaged socioeconomic conditions and children’s entry into out-of-home care across high-income countries. The authors suggest that policies addressing the social and economic circumstances contributing to childhood adversity may help reduce the need for care placement, while future research should examine how changes in social and economic policy affect the risk of entering out-of-home care.
Read more: https://doi.org/10.1136/jech-2025-225253