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

摘要

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.