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

摘要 虐待儿童和忽视儿童是代价高昂的公共卫生问题，可能导致儿童发病率和死亡率 并增加成年后出现健康问题的风险。来自全国虐待和忽视儿童数据的数据 NCANDS系统(NCANDS)显示，有几个州的儿童生育率大幅上升 在大衰退期间被忽视，而其他人则经历了衰退。据推测，在 一些州忽视儿童的部分原因是经济和社会安全网政策的变化 在这段时间内，国家一级。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。然而，这些研究一直是 在很大程度上局限于对相关关系的检查。这项研究通过研究 国家政策变化与儿童疏忽发生率的因果关系。阶段1首先创建一个 综合纵向数据库，以检查对贫困家庭临时援助的变化，赚取的 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 州和县两级的方案涉及NCANDS和 收养和寄养护理报告系统。在阶段2中，政策更改被用作自然实验 确定社会安全网政策在各州和时间上对儿童忽视的因果影响 2014年。这项研究还考察了国家政策变化对基于年龄的儿童亚群的影响， 种族/族裔和性别，为有针对性的预防战略提供信息。初步研究结果表明，减少 在TANF中，案件量与虐待和忽视儿童的大幅增加有关，而在 国家最低工资与削减有关。如果经济和社会安全网政策之间存在因果关系 与忽视儿童有关的现有政策可以用来防止忽视儿童和改善公共卫生，方法是 解决在被忽视儿童群体中非常普遍的已知经济风险因素。 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 站台。调查人员在虐待和忽视儿童、经济政策和 计量经济学为确定政策变化的因果机制提供了概念和实证工具 潜在的儿童忽视。这项研究将帮助各州实现2020年健康人群倡议的目标 通过使用知情经济手段，将虐待和忽视儿童的比率降低到每100,000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.