Kinship foster care for children in the child welfare system

Evidence Rating  
Evidence rating: Scientifically Supported

Strategies with this rating are most likely to make a difference. These strategies have been tested in many robust studies with consistently positive results.

Health Factors  
Decision Makers
Date last updated

Kinship foster care is an out-of-home arrangement for full-time care by relatives such as grandparents or uncles and aunts, or tribe members, godparents, or others who are not a child’s parent but have a family relationship with the child, when a child is removed from home due to a safety concern such as child maltreatment. Children may be placed in kinship foster care through a child welfare agency (i.e., formal kinship care) or through informal, private arrangements as an alternative to placement with non-relative foster parents. Licensing process and requirements for kinship care (e.g., caregiver training, background checks, and household safety assessment) vary by state1, 2. Caregiver’s monthly payment through the federal Title IV-E program or state funds also varies by state and age of child3.

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Improved mental health

  • Improved child behavior

  • Increased foster care placement stability

Potential Benefits

Our evidence rating is not based on these outcomes, but these benefits may also be possible:

  • Increased family reunification

What does the research say about effectiveness?

There is strong evidence that children in kinship foster care have fewer behavioral problems1, 4, 5 and fewer mental health problems1, 6 than children in non-kinship foster care. Kinship foster care can also lead to more stable placement, including a reduced likelihood of re-entry and placement disruption and fewer placements, than non-kinship foster care1, 7, 8, 9, 10.

Children age 6 or older in kinship care are less likely to have behavioral problems than peers in non-kinship foster care4, 5; infants in kinship care are also less likely to have developmental delays11. African American children who live with younger or healthier kinship caregivers appear less likely to have behavioral problems than those who live with older or less healthy caregivers12. Kinship foster care placement laws appear to lead to greater numbers of kinship placements and a higher stability of placement in the short-term, and greater levels of child safety in the long-term8.

Children in kinship care are as likely to reunite with their parents as children in non-kinship foster care1. Children in unlicensed kinship care are more likely to reunite with their parents than children in licensed kinship care13. Kinship care appears to lead to more guardianships and fewer adoptions than non-kinship foster care1, 7. Kinship caregivers are less likely to use mental health services for foster children than non-kin foster parents, perhaps due to caregiver’s characteristics and their relationship with the child welfare system, and differences in service needs1, 14, 15.   

Researchers suggest that kinship caregivers feel more committed to a child than non-kinship caregivers and are more likely to continue caring for the child despite behavioral problems and other difficulties16, 17. Placements with grandparents may be especially likely to last. Supervision while children visit their parents may improve kinship placement stability17. Experts recommend financial and service support for kinship caregivers to increase the quality and permanency of placement18.

How could this strategy impact health disparities? This strategy is rated likely to decrease disparities.
Implementation Examples

As of 2014, 49 states and Washington, D.C. legally prioritize or emphasize the importance of relative foster placement; West Virginia has no such legislation in place2.

As of September 2016, about 437,500 children are in out-of-home placement in the U.S.: 32% of them are in kinship care and 45% are in non-kinship foster care19.

Implementation Resources

CWIG-Kinship care resources - Child Welfare Information Gateway (CWIG). Resources for relatives and kinship caregivers.

AECF-Foster parent guide - The Annie E. Casey Foundation (AECF). The foster parent resource guide: A trauma-informed caregiving approach. Baltimore, MD: The Annie E. Casey Foundation; 2017.


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1 Cochrane-Winokur 2014 - Winokur M, Holtan A, Batchelder KE. Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment. Cochrane Database of Systematic Reviews. 2014;(1):CD006546.

2 CWIG-Foster care statutes - Child Welfare Information Gateway (CWIG). Home study requirements for prospective foster parents. Washington, D.C.: U.S. Department of Health and Human Services, Children’s Bureau; 2014.

3 Child Trends-Foster care payment - DeVooght K, Child Trends, Blazey D. Family foster care reimbursement rates in the U.S.: A report from a 2012 National Survey on Family Foster Care Provider Classifications and Rates. Bethesda, MD: Child Trends; 2013.

4 Wu 2015 - Wu Q, White KR, Coleman KL. Effects of kinship care on behavioral problems by child age: A propensity score analysis. Children and Youth Services Review. 2015;57:1-8.

5 Perry 2018 - Perry KJ, Price JM. Concurrent child history and contextual predictors of children’s internalizing and externalizing behavior problems in foster care. Children and Youth Services Review. 2018;84:125-136.

6 Stein 2014 - Stein REK, Hurlburt MS, Heneghan AM, et al. Health status and type of out-of-home placement: Informal kinship care in an investigated sample. Academic Pediatrics. 2014;14(6):559-564.

7 Bell 2017 - Bell T, Romano E. Permanency and safety among children in foster family and kinship care: A scoping review. Trauma, Violence, & Abuse. 2017;18(3):268-286.

8 Hayduk 2017 - Hayduk I. The effect of kinship placement laws on foster children’s well-being. The BE Journal of Economic Analysis & Policy. 2017;17(1):20160196.

9 Villodas 2016 - Villodas MT, Litrownik AJ, Newton RR, Davis IP. Long-term placement trajectories of children who were maltreated and entered the child welfare system at an early age: Consequences for physical and behavioral well-being. Journal of Pediatric Psychology. 2016;41(1):46-54.

10 Zorc 2013 - Zorc CS, O’Reilly ALR, Matone M, et al. The relationship of placement experience to school absenteeism and changing schools in young, school-aged children in foster care. Children and Youth Services Review. 2013;35(5):826-833.

11 Stacks 2011 - Stacks AM, Partridge T. Infants placed in foster care prior to their first birthday: Differences in kin and nonkin placements. Infant Mental Health Journal. 2011;32(5):489-508.

12 Rufa 2016 - Rufa AK, Fowler PJ. Kinship foster care among African American youth: Interaction effects at multiple contextual levels. Journal of Social Service Research. 2016;42(1):26-40.

13 Ryan 2016 - Ryan JP, Perron BE, Moore A, Victor B, Evangelist M. Foster home placements and the probability of family reunification: Does licensing matter? Child Abuse & Neglect. 2016;59:88-99.

14 Coleman 2016 - Coleman KL, Wu Q. Kinship care and service utilization: A review of predisposing, enabling, and need factors. Children and Youth Services Review. 2016;61:201-210.

15 Swanke 2016 - Swanke JR, Yampolskaya S, Strozier A, Armstrong MI. Mental health service utilization and time to care: A comparison of children in traditional foster care and children in kinship care. Children and Youth Services Review. 2016;68:154-158.

16 Rock 2015 - Rock S, Michelson D, Thomson S, Day C. Understanding foster placement instability for looked after children: A systemic review and narrative synthesis of quantitative and qualitative evidence. British Journal of Social Work. 2015;45(1):177-203.

17 Farmer 2010 - Farmer E. What factors relate to good placement outcomes in kinship care? British Journal of Social Work. 2010;40(2):426-44.

18 RAND-Ringel 2017 - Ringel JS, Schultz D, Mendelsonn J, et al. Improving child welfare outcomes: Balancing investments in prevention and treatment. Santa Monica: RAND Corporation; 2017.

19 US DHHS-AFCARS 2017 - U.S. Department of Health and Human Services (U.S. DHHS), Administration for Children and Families, Administration on Children, Youth and Families, Children's Bureau. The AFCARS report: Preliminary FY 2016 estimates as of Oct 20, 2017.