Expansion of food insecurity programs associated with fewer child protective services reports

 1. In a cross-sectional study, expanding eligibility criteria for social programs to support food costs was associated with fewer CPS-investigated reports and reports of abuse or neglect.

2. Decreases in CPS-investigated reports persisted when stratified by race and ethnicity.

Evidence Rating Level: 2 (Good)

Study Rundown: Child protective services (CPS) investigations are common and occur in up to one-third of children in the United States. Economic stressors including household food insecurity, have been shown to increase the likelihood of CPS investigation. Certain states in the United States have implemented social programs such as the Supplemental Nutrition Assistance Program (SNAP) to address food insecurity by providing monthly benefits to support the cost of food for low-income households. States have the option to expand eligibility for the SNAP program allowing more families to gain access. Given the potential interplay of food insecurity and CPS involvement, this study examined the impacts of expanding SNAP eligibility on the number of CPS-investigated reports. Between 2006 to 2019, this cross-sectional study found decreases in the number of total CPS reports, as well as reports specifically concerning neglect or physical abuse with the expansion of eligibility for SNAP. Trends towards decreased CPS reports persisted when stratified by race/ethnicity, with decreases in cases for both Black and White children. The main limitation of this study is the unknown significance of CPS-investigated reports on confirmed cases of abuse or neglect. Additionally, the cross-sectional design limits its ability to show a causative link between SNAP eligibility and CPS investigation reports. However, this study at least suggests that state expansion of SNAP eligibility may decrease the rates of CPS-investigated reports and ultimately have impacts on prevention efforts for child abuse and neglect.

Click here to read the article in JAMA Pediatrics

Relevant Reading: Association between state Supplemental Nutrition Assistance Program policies, Child Protective Services involvement, and foster care in the US, 2004-2016

In-Depth [cross-sectional study]: In this cross-sectional study, data was collected from the SNAP Policy Database and the National Child Abuse and Neglect Data System (NCANDS) Child Files for CPS involvement. Data was extracted from NCANDS to capture CPS-investigated reports from 2006 to 2019. The primary exposure was the expansion of SNAP eligibility, more specifically state elimination of the asset test for eligibility and/or state increases in the income limit for eligibility. The outcome was the number of total CPS reports, as well as reports specifically concerning neglect or physical abuse per 1000 child population by state and year. In the study timeframe, there were over 29 million CPS-investigated reports from all 50 states. After the elimination of the asset test, in the post-policy period, there were 8.2 (95% CI, −12.6 to −4.0) fewer CPS reports overall and 4.0 (95%CI, −8.0 to −0.1) fewer reports for neglect per 1000 child population per year. However, elimination of the assets test did not change the number of reports of physical abuse. In comparison, across the post-policy period, state increases in the income limit resulted in 5.0 (95%CI, −10.8 to 0.7) fewer overall CPS reports and 4.4 (95%CI, −8.9 to 0.1) fewer reports of neglect (95%CI, −8.9 to 0.1), and 1.8 (95% CI, −3.9 to0.3) fewer reports for physical abuse per 1000 child population. For states that applied both policy changes, there were 9.3 (95% CI, −15.6 to −3.1) fewer CPS reports, 7.3 (95% CI, −12.6 to −1.9) fewer reports for neglect, and 2.4 (95% CI, −5.1 to 0.2) fewer reports for physical abuse per 1000 child population per year. When stratified by race/ethnicity, adoption of either or both policies was similarly associated with decreases in the number of CPS-investigated reports among both Black and White children.

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