The November issue of the journal PEDIATRICS contains a landmark study powerfully documenting how remediation of poverty and socio-economic disparities makes a significant contribution to child abuse prevention. "State Spending on Public Benefit Programs and Child Maltreatment" by Henry T. Puls, MD, Matthew Hall, PhD, James D. Anderst, MD, MSCI, Tami Gurley, PhD, James Perrin, MD,and Paul J. Chung, MD, MSg, Pediatrics Nov 2021; 148(5):e2021050685 (full article is attached) precisely and dramatically evaluates each state's anti-poverty measures and their impact on child abuse parameters. The study finds:
"States’ total spending was inversely associated with all maltreatment outcomes. For
each additional $1000 states spent on benefit programs per person living in poverty, there was an associated 4.3% difference in reporting, a 4.0% difference in substantiations, a 2.1% difference in foster care placements, and a 7.7% difference in fatalities. In 2017,
extrapolating $1000 of additional spending for each person living in poverty ($46.5 billion nationally, or 13.3% increase) might have resulted in 181 850 fewer reports, 28 575 fewer substantiations, 4168 fewer foster care placements, and 130 fewer fatalities."
Mical Raz's book "ABUSIVE POLICIES" dramatically and in detail discusses the origins of CAPTA in the 1970s: Sen (D-Wisc) Mondale mindful of Nixon's veto of a national child care bill and with Republican backlash to the War on Poverty in full bloom, allied with Parents Anonymous to promote "a white middle class social work approach to child abuse," which has been the main public policy model ever since. This paper may return the field back to basics! Child maltreatment occurs on a foundation of socioeconomic stress (although there are other contributing factors, of course) with all aspects of poverty being an accelerator of parental frustration and stress intolerance. To my knowledge no other clinical medical, social work, legal or political treatment or policy has been documented to have such a profound and well documented effect on preventing or remediating this scourge. Clinical medicine, social work, therapy, and child welfare advocacy will continue to be crucial in treating the effects of child maltreatment, but now we know where to focus for our prevention efforts. Every child care worker should be involved in anti-poverty public policy.
Comments (1)