Download Full Text (394 KB)
State spending on programs with the capacity to mitigate poverty have been shown to reduce child maltreatment overall. However, given pervasive racial/ethnic disparities across child maltreatment outcomes, it remains unclear if current spending and policies have different effects on child maltreatment by race/ethnicity.
To determine if associations between state-level spending on public benefit programs and rates of child maltreatment reporting differ by race and ethnicity. We hypothesized that inverse associations between spending and maltreatment would be greater for non-Hispanic White children than for non-Hispanic Black or Hispanic children.
This was an ecological study of all U.S. states during Federal fiscal years 2010-2019. The primary exposure was states’ total annual spending per person living below the Federal poverty limit on local, state, and federal benefit programs, which was the sum of 1) cash, housing, and in-kind assistance, 2) housing infrastructure, 3) childcare assistance, 4) refundable Earned Income Tax Credit, and 5) Medical Assistance Programs. The outcome was race/ethnicity-specific rates of maltreatment reporting to Child Protective Services. Generalized estimating equations, with an interaction between race and spending and repeated measures of states, estimated β coefficients and 95% confidence intervals (CI) after adjustment for federal spending, year, and race/ethnicity-specific child poverty rates.
There were 493 state-year observations after exclusions for missing maltreatment data. The relationship between total spending and maltreatment reporting differed significantly by race/ethnicity (p= 0.029). There was an inverse association between total state spending and maltreatment reporting for non-Hispanic White children (β= -0.043 [CI -0.0782, -0.0076]) but not for non-Hispanic Black or Hispanic children. Likewise, inverse associations were significant for only non-Hispanic White children with respect to spending on housing infrastructure, childcare assistance, Earned Income Tax Credit, and Medical Assistance Programs (Table).
Public benefits may be disproportionately received by or effective in preventing maltreatment for non-Hispanic White children, potentially perpetuating racial/ethnic disparities in child maltreatment. Benefit programs’ eligibility criteria and distribution strategies should be carefully examined to ensure equitable impacts mitigating adverse child outcomes.
Puls, Henry T.; Hall, Matthew; Boyd, Reiko; and Chung, Paul J., "State Spending on Public Benefit Programs and the Differential Impact on Child Maltreatment by Race and Ethnicity" (2023). Research at Children's Mercy Month 2023. 31.