Racial disparities among the nation’s youngest children across major domains of health and well-being perpetuate inequality and represent one of the most pressing social justice issues of our time. Black infants represent a high-risk population at the center of both health and child welfare disparities. Despite consistent documentation of disparate outcomes for Black infants, child welfare research has devoted scant attention to the health-related vulnerability of this group and its potential contribution to their experiences in foster care. Furthermore, research on racial disproportionality and disparities has focused overwhelmingly on making Black/White comparisons. This analysis will demonstrate key limitations of this traditional approach and apply an epidemiological approach to conduct a within-group examination of Black infants who have been reported to child welfare systems.
This analysis linked data from the child files of the National Child Abuse and Neglect Data System and the foster care files of the Adoption and Foster Care Analysis and Reporting System for FY2015. The study sample included the population of Black children between ages 0 to 1 year who received a disposition for a maltreatment investigation during the study year (n= 153,939). Information pertaining to investigations, including child characteristics, caregiver risks, health-related risks, report sources, report dispositions and services provided was analyzed. Differences in case characteristics among Black infants by age subgroup (0 vs 1) were assessed using chi-square statistics. Multivariable logistic regression models were specified to estimate the independent effect of child health risk on more intensive child welfare involvement among this population.
Black infants comprised 27% of the infant population (ages 0-1) that received a disposition for a maltreatment investigation in 2015. The youngest infants in this study sample differed significantly from older infants with respect to child characteristics, caregiver risk factors, characteristics of the investigation, and the presence of health risks. Infants under one year were more likely to have one or more health risks recorded in their case record compared to infants who were older (p=<.001). Infants with at least one indicated health risk had greater odds (OR=2.32; 95% CI: 2.32, 2.58; p=<.001) of being placed in foster care compared to infants with no health risks. Infants with more than one health risk had even greater odds of foster care placement (OR=2.80; 95% CI: 2.01, 3.91; p=<.001) compared to other infants.
Conclusions and Implications
Black infants represent a substantial percentage of infants investigated for alleged maltreatment with significant health vulnerabilities that can influence their case outcomes. This analysis builds on previous evidence that differently-aged infants are heterogeneous with respect to key risk factors and child welfare outcomes. Furthermore, this study underscores the need for further attention to the heterogeneity among the Black children in contact with the child welfare system, including potential influences related to distinct developmental stages. Future analyses that focus explicitly on experiences of Black infants can inform targeted efforts that aim to address disparities by improving services and outcomes for this vulnerable population.