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Foster Care Instability
Foster Care Instability in United States
United States

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Foster Care Instability in depth:

Foster Care Instability by State

Percentage of children in foster care with three or more placements within 12 months

Foster Care Instability Trends

Percentage of children in foster care with three or more placements within 12 months

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Foster Care Instability

About Foster Care Instability

US Value: 14.9%

Top State(s): Nebraska, Rhode Island: 9.1%

Bottom State(s): Tennessee: 33.7%

Definition: Percentage of children in foster care with three or more placements within 12 months

Data Source and Years: U.S. Department of Health & Human Services, Children's Bureau, Child Welfare Outcomes Report, 2020

Suggested Citation: America's Health Rankings analysis of U.S. Department of Health & Human Services, Children's Bureau, Child Welfare Outcomes Report, United Health Foundation,, accessed 2023.

Children require consistency, predictability and attachments to caring adults in order to thrive. This is especially true for children in foster care, who may have experienced trauma before their foster placement. Research shows that children who experience instability in their foster care placement (i.e., frequently change foster care settings) have a harder time developing secure attachments and lose out on significant social relationships. 

Foster care instability is associated with negative outcomes, including:

Children at risk of increased foster care instability include:

Strategies to improve foster care stability include

  • Using assessment and decision-making tools to match children and foster families. The Every Child a Priority (ECAP) algorithm-based matching system has yielded strong positive results in placement stability.
  • Addressing children’s emotional and behavioral health needs. 
  • Promoting caseworker retention and ongoing education, including training on attachment theory and other factors that impact the stability of foster care. 
  • Prioritizing placement of children with relatives.

Healthy People 2030 has a goal to increase the proportion of adolescents in foster care who show signs of being ready for adulthood.

“Child Welfare Outcomes 2018 Report to Congress.” 2021. U.S. Department of Health and Human Services, Children’s Bureau (ACYF, ACF).

Courtney, Jon R., and Retta Prophet. 2011. “Predictors of Placement Stability at the State Level: The Use of Logistic Regression to Inform Practice.” Child Welfare 90 (2): 127–42.

Courtney, Mark E., Amy Dworsky, Adam Brown, Colleen Cary, Kara Love, and Vanessa Vorhies. 2011. “Midwest Evaluation of the Adult Functioning of Former Foster Youth: Outcomes at Age 26.” Chicago, IL: Chapin Hall at the University of Chicago.

Jones, Annette Semanchin, and Susan J. Wells. 2008. “PATH/Wisconsin - Bremer Project: Preventing Placement Disruptions in Foster Care.” St. Paul, MN: Center for Advanced Studies in Child Welfare, University of Minnesota.

Konijn, Carolien, Sabine Admiraal, Josefiene Baart, Floor van Rooij, Geert-Jan Stams, Cristina Colonnesi, Ramón Lindauer, and Mark Assink. 2019. “Foster Care Placement Instability: A Meta-Analytic Review.” Children and Youth Services Review 96 (January): 483–99.

Miranda, Megan, Eman Tadros, and Elizabeth Molla. 2020. “The Experience of Foster Care and Long-Term Attachment.” The American Journal of Family Therapy 48 (1): 87–106.

Noonan, Kathleen, David Rubin, Robin Mekonnen, Sarah Zlotnik, and Amanda O’Reilly. 2009. “Securing Child Safety, Well-Being, and Permanency Through Placement Stability in Foster Care.” Evidence to Action Briefs. PolicyLab at CHOP Research Institute.

Smithgall, Cheryl, Robert Matthew Gladden, Eboni Howard, Robert Goerge, and Mark Courtney. 2004. “Educational Experiences of Children in Out-Of-Home Care.” Chicago, IL: Chapin Hall Center for Children at the University of Chicago.

Stott, Tonia. 2012. “Placement Instability and Risky Behaviors of Youth Aging Out of Foster Care.” Child and Adolescent Social Work Journal 29 (1): 61–83.

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