A Birth Cohort Study of Child Protective Services Involvement through Age 5 Among Asian Children in California: The Influence of Nativity and Country/Region of Origin

Background. Research identifying racial and ethnic disparities in child protective services (CPS) involvement has largely focused on the overrepresentation of black children and the growing Latino child population. Recent work has identified differences in risk and protective factors tied to CPS involvement and dependent on maternal nativity and country of origin.  Little attention, however, has been paid to children of Asian origin, the most underrepresented group of children in the child welfare system. Epidemiological literature highlights demonstrable differences in several Asian adult health outcomes by country of origin. Yet, Asian children involved with the CPS system have, with limited exceptions, been studied as a pan-ethnic group. To our knowledge, no studies have examined whether risks for child maltreatment and CPS system involvement vary among children born to Asian mothers depending on mothers’ birthplace and country/region of origin. We contribute to the literature by following Asian children prospectively from birth through age 5 to determine whether the cumulative likelihood a child is reported or substantiated for maltreatment differs by Asian-origin and maternal nativity.

Methods. We extracted data for all Asian children born in California between 2006 and 2007 (N=138,858) from population-based birth records linked to CPS data spanning the first five years of life (through 2012). We used χ2 tests to assess distributional differences in child sex, birthweight, prenatal care, birth abnormality, maternal education, maternal age, establishment of paternity, number of children in the household, and type of insurance. We utilized generalized linear models to estimate the adjusted relative risk of report and substantiation in models stratified by nativity and country of origin. Findings are presented as rate ratios with corresponding 95% confidence intervals.

Results. Among children of foreign-born mothers, we observed significant advantages in number of risks at birth (10.6% vs. 15.3% with 3 or more risks identified; p<.001), reported (4.7% vs. 9.5% ; p<.001) and substantiated (1.3% vs. 3.3%; p<.001) maltreatment, compared to children of U.S born mothers. These advantages, however, were not observed within every Asian-origin group. Maternal nativity did not provide additional protection against CPS involvement for Chinese, Laotian, and Thai children. Relative to other Asian groups, the likelihood of CPS report was lower for children of Asian Indian, Chinese, and Hmong mothers respectively (0.70 [.64, .77]; 0.73 [.68, .79]; 0.75 [.68, .82]), and higher among Filipino and Thai mothers (1.22 [1.16, 1.28]; 1.25 [1.06, 1.47]). The relative rate of CPS report was highest among children of Hawaiian/Guamanian/Samoan and Pacific Islander mothers (1.67 [1.55, 1.81]; 1.49 [1.36, 1.63]).

Conclusions. Findings from our analysis indicate that, notwithstanding widespread perceptions to the contrary, Asian-origin children are not at uniformly lower risk of CPS involvement. Additionally, the protective effect of maternal nativity against maltreatment does not apply to all Asian groups. The presence of disparities among certain Asian-origin groups has implications for the health of Asian youth and adults across the life course, as well as for targeted maltreatment prevention strategies for Asian-origin groups. Further research is warranted to unravel the complex processes underlying observed relationships.