Association Between State Supplemental Nutrition Assistance Program Policies, Child Protective Services Involvement, and Foster Care in the US, 2004-2016.
Association Between State Supplemental Nutrition Assistance Program Policies, Child Protective Services Involvement, and Foster Care in the US, 2004-2016.
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2004 - 2016年美国各州补充营养援助计划政策、儿童保护服务介入与寄养之间的关联
DOI：
10.1001/jamanetworkopen.2022.21509
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发表时间：
2022-07-01
影响因子：
13.8
通讯作者：
Sattler, Patricia L.
中科院分区：
文献类型：
--
作者：
Johnson-Motoyama, Michelle;Ginther, Donna K.;Oslund, Patricia;Jorgenson, Lindsay;Chung, Yoonzie;Phillips, Rebecca;Beer, Oliver W. J.;Davis, Starr;Sattler, Patricia L.
美国的州补充营养援助计划（SNAP）政策选择是否与儿童保护服务介入率以及寄养服务的使用相关？
这项涵盖美国所有50个州和哥伦比亚特区的队列研究指出，从2004年到2016年，SNAP政策的采用有所增加，与此同时，经证实的儿童被忽视的报告有所减少。在工具变量模型中，确定了通过SNAP受助人数来实施的政策。
这项研究的结果表明，增加家庭资源的慷慨程度和稳定性的SNAP政策选择可能通过预防儿童虐待以及对昂贵的儿童福利干预的需求，产生有价值的人口健康回报。
公共援助政策可能通过改善低收入家庭的家庭资源在预防儿童虐待方面发挥作用。补充营养援助计划（SNAP）是美国最大的公共援助计划之一。然而，州SNAP政策选择与儿童保护服务（CPS）结果之间的关联尚未经过严格检验。
为了模拟美国州SNAP政策随时间推移与CPS和寄养结果变化之间的关联。
这项队列研究使用面板数据，在双向固定效应回归模型中检验了2004年到2016年美国50个州和哥伦比亚特区的SNAP政策选择与研究结果之间的关联。在工具变量模型中，SNAP政策的数量被用作SNAP受助人数的工具。数据分析于2021年11月进行。
采用一项或多项州SNAP收入慷慨政策，这些政策改善或稳定了SNAP参与者的家庭资源。
被儿童保护服务接受调查的儿童虐待报告、经证实报告中的儿童以及因所有形式的虐待（特别是因儿童被忽视）而接受寄养服务的儿童，每10万儿童人口中的数量。
各州SNAP收入慷慨政策的平均（标准差）数量从2004年的1.47（0.95）增加到2010年的2.37（0.94），再到2016年的2.49（0.86）；同期中位数从1增加到3（范围为0 - 4）。州收入慷慨政策的数量与被儿童保护服务接受调查的报告大幅减少相关（每10万儿童 -352.6份；95%置信区间为 -557.1到 -148.2）。收入慷慨政策与每10万儿童中经证实的报告减少 -94.8份（95%置信区间为 -155.6到 -34.0）以及因忽视而经证实的报告减少 -77.0份（95%置信区间为 -125.4到 -28.6）相关。一个州每额外采用一项收入慷慨政策，与每10万儿童中寄养安置总数减少 -45.1份（95%置信区间为 -71.6到 -18.5）到 -42.3份（95%置信区间为 -64.8到 -19.8）相关。
改善和稳定家庭资源的州SNAP政策似乎与儿童保护服务介入和寄养服务使用的减少相关。实施政策的数量具有超出单个政策结果的累积效应。
这项队列研究评估了州补充营养援助计划的扩展与儿童保护服务的使用和寄养之间的关联。
Are state Supplemental Nutrition Assistance Program (SNAP) policy options associated with rates of Child Protective Services involvement and use of foster care services in the US? This cohort study including all 50 states and the District of Columbia noted that adoption of SNAP policies increased from 2004 to 2016 and, accompanying the increases, substantiated reports of childhood neglect decreased. In instrumental variables models, policies to operate through SNAP caseloads were identified. The findings of this study suggest SNAP policy options that increase the generosity and stability of household resources may yield valuable population health returns by preventing child maltreatment and the need for costly child welfare interventions. Public assistance policies may play a role in preventing child maltreatment by improving household resources among families of low incomes. The Supplemental Nutrition Assistance Program (SNAP) is one of the largest public assistance programs in the US. However, the association of state SNAP policy options to Child Protective Services (CPS) outcomes has not been rigorously examined. To model the association of state SNAP policies with changes in CPS and foster care outcomes in the US over time. This cohort study used panel data to examine the association between SNAP policy options and study outcomes from 2004 to 2016 for 50 US states and the District of Columbia in 2-way fixed-effects regression models. The count of SNAP policies was used as an instrument for SNAP caseloads in instrumental variables models. Data analysis was conducted in November 2021. The adoption of 1 or more state SNAP income generosity policies that improves or stabilizes household resources for SNAP participants. Reports of child maltreatment accepted for CPS investigation, children in substantiated reports, and children receiving foster care services for all forms of maltreatment, and specifically for child neglect per 100 000 child population. The mean (SD) number of SNAP income generosity policies increased from 1.47 (0.95) in 2004 to 2.37 (0.94) in 2010, to 2.49 (0.86) in 2016 across states; the median increased from 1 to 3 (range, 0-4) over the same period. A count of state income generosity policies was associated with large reductions in reports accepted for CPS investigation (–352.6 per 100 000 children; 95% CI, –557.1 to –148.2). Income generosity policy was associated with –94.8 (95% CI, –155.6 to –34.0) fewer substantiated reports and –77.0 (95% CI, –125.4 to –28.6) fewer reports substantiated for neglect per 100 000. Each additional income generosity policy adopted by a state was associated with –45.1 (95% CI, –71.6 to –18.5) to –42.3 (95% CI, –64.8 to –19.8) fewer total foster care placements per 100 000 children. State SNAP policies that improve and stabilize household resources appear to be associated with reductions in CPS involvement and use of foster care. The number of policies implemented had cumulative outcomes beyond individual policy outcomes. This cohort study assesses the association of state Supplemental Nutrition Assistance Program expansion with use of child protective services and foster care.
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