Exploring the Causal Impacts of Economic and Social Safety Net Policies on Child Neglect in the U.S.: Implications for Primary Prevention

摘要 虐待和忽视儿童是代价高昂的公共卫生问题，可导致儿童期发病和死亡 并增加成年后健康问题的风险。国家儿童虐待和虐待数据 NCANDS系统显示，几个州的儿童死亡率大幅上升， 在大衰退期间被忽视，而其他人则经历了衰退。据推测， 一些州忽视儿童的部分原因是， 国家级在此期间。一小部分研究表明， 经济和社会安全网政策以及虐待和忽视儿童问题。然而，这些研究一直 主要限于相关关系的检查。这项研究通过检查 国家政策变化与儿童忽视率之间的因果关系。第一阶段首先创建一个 一个综合的纵向数据库，以研究对贫困家庭的临时援助、 所得税抵免，补充营养援助计划，特别补充营养 妇女、婴儿和儿童计划、医疗补助计划、儿童健康保险计划和其他 州和县一级的方案涉及NCANDS和 收养和寄养报告系统。在第二阶段，政策变化被用作自然实验， 确定1995年至2000年期间社会安全网政策对各州和各时期忽视儿童的因果影响; 2014.该研究还考察了国家政策变化对基于年龄的儿童分组的影响， 种族/民族和性别，为有针对性的预防战略提供信息。试点研究结果表明， 在TANF案件量与虐待和忽视儿童的大幅增加有关，而 国家最低工资与减少有关。如果经济和社会安全网政策是因果关系 与忽视儿童有关，现有政策可用于防止忽视儿童和改善公共卫生， 解决在被忽视儿童中普遍存在的已知经济风险因素。 该研究的第三阶段将通过开发新的成本分析直接为预防工作提供信息 平台调查人员在虐待和忽视儿童、经济政策和 计量经济学提供了概念和经验的工具，以确定政策变化的因果机制 潜在的儿童忽视。该研究将帮助各州实现健康人2020倡议的目标 通过使用知情的经济和社会政策，将虐待和忽视儿童的比率降至每10万名儿童2.1人; 政策

Abstract Child abuse and neglect are costly public health problems that can lead to morbidity and mortality in childhood and increased risk for health problems into adulthood. Data from the National Child Abuse and Neglect Data System (NCANDS) demonstrate that several states experienced considerable increases in rates of child neglect during the Great Recession while others experienced declines. It is hypothesized that increases in child neglect in some states were partly induced by changes in economic and social safety net policies at the state level during this period. A small body of research has demonstrated significant relationships between economic and social safety net policies and child abuse and neglect. However, these studies have been largely limited to examinations of correlational relationships. This study advances science by examining the causal relationship of state policy changes to rates of child neglect. Phase 1 starts by creating an integrated, longitudinal database to examine how changes in Temporary Aid to Needy Families, the Earned Income Tax Credit, the Supplemental Nutrition Assistance Program, the Special Supplemental Nutrition Program for Women, Infants, and Children, Medicaid, the Children's Health Insurance Program and other programs at the state and county levels relate to multiple measures of child neglect from the NCANDS and the Adoption and Foster Care Reporting System. In Phase 2, policy changes are used as natural experiments to identify the causal effects of social safety net policies on child neglect across states and time from 1995 to 2014. The study also examines the effects of state policy changes on subgroups of children based on age, race/ethnicity, and gender to inform targeted prevention strategies. Pilot study results indicate that reductions in TANF caseloads are associated with substantial increases in child abuse and neglect, whereas increases in the state minimum wage are associated with reductions. If economic and social safety net policies are causally related to child neglect, existing policies can be used to prevent child neglect and improve public health by addressing known economic risk factors that are highly prevalent in the population of neglected children. Phase 3 of the study will directly inform prevention efforts through the development of a novel cost analysis platform. The combined expertise of the investigators in child abuse and neglect, economic policy, and econometrics provides the conceptual and empirical tools to identify the causal mechanisms of policy changes underlying child neglect. The research will assist states in meeting the Healthy People 2020 Initiative goal of reducing abuse and neglect rates to 2.1 per 100,000 children through the use of informed economic policy.