Commentary: State spending on poverty reduction programs could dramatically reduce child abuse and neglect


The research brief is a brief overview of interesting academic work.
The big idea
State financial investments in public benefit programs for low-income families are associated with less child abuse and neglect, also known as maltreatment. These investments are also associated with a lower need for foster care and abuse-related deaths, according to our recent publication in the journal Pediatrics.
Our research team included both of us – Hank Puls, a pediatrician who conducts research on preventing child abuse, and Paul Chung, who studies the determinants of adult health in children – as well as Matthew Hall, James Anderst, Tami Gurley and James Perrin. .
Our study examined the relationship between states’ child abuse rates and their annual spending per person living in poverty on major benefit programs from 2010 to 2017. Benefit programs included those that provided money, a housing or material resources, child care assistance, refundable earned income tax credits, and medical assistance programs such as Medicaid.
Our results indicate that an increase of $ 1,000, or 13%, in annual spending per person living in poverty on these programs in all 50 states and Washington, DC, could be associated with about 181,000 fewer children reported for. abuse, 28,500 fewer victims, 4,100 fewer foster children and 130 fewer children dying – every year.
Our results also suggest that reductions in child abuse could provide long-term tax returns for states and society. The 13% increase in spending was $ 46.5 billion nationally. We estimate that these reductions could yield $ 1.5 billion to $ 9.3 billion in avoided economic burdens associated with child abuse in the short term, but $ 25.8 billion to $ 153.2 billion over the lifespan of children.
Why is this important
Child abuse is a public health crisis. By age 18, at least 1 in 8 American children will have been abused or neglected. This leads to poorer overall and mental health, as well as poorer socio-economic outcomes, for these individuals and for society.
We believe our study serves as an example of how benefit programs could have positive effects beyond their stated objectives. Benefit programs are likely to have powerful, widespread, and unmeasured effects on a host of health problems – the combined impacts of which could eclipse those seen solely for child abuse.
For example, the expansion of Medicaid improves access to health care and some health and mental health outcomes. Medicaid also dramatically reduces poverty and can reduce parenting stress. Our study suggests that one of these “side effects” of benefit programs may be the improvement in the general well-being of families as fewer children are abused or neglected.
What is not yet known
A more nuanced understanding of how benefit programs might prevent child abuse is needed. Poverty is not evenly distributed among all children in the United States, and how these programs might affect child abuse and other health-related disparities in specific populations remains unknown.
The COVID-19 pandemic may have resulted in an increased risk of child abuse. But it remains unclear whether economic relief, such as the CARES law and eviction protections, helped reduce some of the perceived risk, if at all.
More recently, the American Rescue Plan Act brought direct economic relief to Americans and made fundamental changes to tax credits, such as the Child Tax Credit and the Earned Income Tax Credit. These changes have increased family incomes and, in some cases, more evenly distributed benefits to Americans with lower incomes. President Biden’s U.S. Plan for Families proposes to expand these tax credit reforms and further invest in child care and preschool education. It will be essential to consider how these policy shifts for the benefit of programs might influence poverty, child abuse and general well-being.
And after
We believe that there are still many opportunities to invest responsibly in programs of public interest. For example, 12 states have yet to expand Medicaid, over 30 million Americans are still uninsured, 6 in 7 eligible families are not receiving child care assistance, and 1 in 6 American children are living. still in poverty.
Our results give optimism that public service programs can not only lift families out of poverty, but also fight child abuse and improve health more generally.

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