The health and well-being of adopted children.

Objective: We compared the health and well-being of adopted and biological children and examined whether observed differences may be a result of differences between these 2 groups in demographic characteristics and special health care needs.

Methods: The 2003 National Survey of Children's Health was funded by the Maternal and Child Health Bureau, Health Resources and Services Administration, and was conducted as a module of the State and Local Area Integrated Telephone Survey by the National Center for Health Statistics, Centers for Disease Control and Prevention. The nationally representative sample consisted of 102,353 children, including 2903 adopted children. We compared estimates for 31 indicators of health and well-being for adopted and biological children and present adjusted estimates that control for differences in demographic characteristics and special health care needs prevalence.

Results: Adopted children are more likely than biological children to have special health care needs, current moderate or severe health problems, learning disability, developmental delay or physical impairment, and other mental health difficulties. However, adopted children are more likely than biological children to have had a preventive medical visit or a combination of preventive medical and dental visits during the previous year, to receive needed mental health care, and to receive care in a medical home; they are more likely to have consistent health insurance coverage, to be read to daily, or to live in neighborhoods that are supportive, and they are less likely to live in households in which someone smokes. These differences between adopted and biological children remain statistically significant even after adjustments for differences in demographic characteristics and the prevalence of special health care needs.

Conclusion: The results suggest that, although adopted children may have poorer health than biological children, their parents may be doing more to ensure that they have needed health care and supportive environments.