Racial and Ethnic Differences in Crisis Nursery Service Utilization and Subsequent Foster Care Placement - The Role of Engagement

Background and Purpose: Crisis nurseries provide temporary respite child care for young children at risk of maltreatment and offer support services to the families of these children. Although crisis nursery services may play a pivotal role in preventing and reducing child maltreatment and foster care, racial disparities in crisis nursery services utilization and outcomes are relatively unexplored.  This study posed two research questions: 1) is there significant variation in crisis nursery services utilization by race? 2) is race a significant predictor of subsequent foster care placement?

Methods: The analysis includes 326 children (Black: 71.3%, White: 10.8%, Biracial 17.8%) who were placed in a crisis nursery located in a large Midwestern city, between 2003 and 2009. A dataset which includes demographics, referral sources, and crisis nursery services was obtained from the agency and linked to public child welfare records. Probabilistic matching was used to match the children served by the crisis nursery to the public child welfare records, and the variables used for matching included: child’s date of birth, child’s name, mother’s date of birth, mother’s name, address, sex, race, and social security number. T-test and Chi-square statistics were performed to examine racial differences in crisis nursery services utilization. Hierarchical logistic regression was conducted to assess whether race predicts the odds of subsequent foster care placement, after controlling for covariates.

Results: White children had a significantly shorter length of placement than Black children and Biracial children (White: 17days vs. Black & Biracial: 21days; P < .05). In terms of other crisis nursery services utilization, families with White children were less likely to engage in recommended parent education compared to families with Black or Biracial children (White: 17.9% vs. Black: 48.6% vs. Biracial: 44.4%; p< .05) and after-care services (White: 18.2% vs. Black: 48.6% vs. Biracial: 44.4%; p< .01). The hierarchical logistic regression result indicated that White children were 5.8times more likely to have subsequent foster care placement after they leave the crisis nursery than Biracial children (OR: 5.80, 95% CI: 1.867 - 18.027). Black children were 2.5 time more likely to have subsequent foster care placement than Biracial children (OR: 2.50, 95% CI: 1.100 - 5.677). Our sample also included a small number of Hispanic children (n=10). Given the small sample, these children were excluded from the regression analysis. However, Hispanic families revealed interesting trends. For instance, the Hispanic families were more likely to identify medical related reasons as their presenting concerns (70%) when compared to Black (22.1%), White (16.1%), and Biracial groups (18.9%). Hispanic children were also likely to have shorter days of placement (M=13.60, SD=21.33) compared to that of Black (M=27.16, SD=21.20), White (M=16.74, SD=14.47), and Biracial children (M=24.19, SD=21.50)

Conclusions and Implications: Biracial children and their families were much more engaged in crisis nursery services and had a lower probability of experiencing subsequent foster care placement. These differences in engagement suggest a need to further explore cultural compentency in both tradional child welfare and crisis nursery services, especially for Biracial families.