Investigating Intergenerational Trauma: Alaska Native Mothers' Experiences of Interpersonal Violence and Involvement with the Child Welfare System

Background and Purpose: Alaska Native mothers and their children are continually impacted by present day disparities resulting from decades of historical oppression. Indigenous women face a substantially greater risk for experiencing violence during pregnancy. Further, Alaska Native children are disproportionately represented in the child welfare system, including both overrepresentation in out of home care, and underrepresented in preventative and restorative services in comparison to the general population.

Methods: The present work utilizes data from the Alaska Longitudinal Child Abuse and Neglect Linkage Project (ALCANLink) which follows children of Alaska mothers originally sampled in the Pregnancy Risk Assessment Monitoring System (PRAMS). The ALCANLink is a longitudinal project which annually checks if children have been reported to child welfare or other social services from public programs within the state of Alaska. There are a total of 1,236 Alaska Native mothers who responded to the PRAMS and 819 were followed up with throughout the duration of the ALCANLink project.

Three outcomes of involvement with the child welfare system were evaluated. Child protective services (CPS) contact (report of alleged maltreatment regardless of screening or outcome determination) may serve as a proxy for potential or experienced harm to child, indicating child risk or vulnerability. Accounting for complex survey design, three multilevel longitudinal survival models were conducted to analyze the proportional hazards of the three CPS outcomes. Key independent variables include maternal interpersonal violence, mental health and substance use, socioeconomic status indicators, and maternal-child health measures like prenatal care and neonatal outcomes.

Results: Among the child maltreatment model, a total of 44% of the sample was censored, indicating 56% of Alaska Native mothers were reported for child maltreatment during the study period. Several significant associations were found with measures of socioeconomic status, substance use, neonatal outcomes, and maternal interpersonal violence. Among those who were initially reported for child maltreatment, 22% of Alaska Native mothers had their reports substantiated. Several significant associations emerged among measures of socioeconomic status, substance use, and prenatal care. Finally, 10% of Alaska Native mothers in the sample had their child removed from the home. Only neonatal outcomes and maternal education level were significantly associated with removal from the home.

Conclusions and Implications: Alaska Native mothers who experienced interpersonal violence surrounding their pregnancies were more likely to be reported for child maltreatment. This demonstrates the intergenerational impact of trauma as mothers who experienced violence surrounding pregnancy also had children who experienced some form of harm, thus leading to them being reported for child maltreatment. Native children in Alaska have high rate of child removal from their families and placement in out of home care, demonstrating a legacy of harm against Indigenous mothers and their children. Findings suggest the need of integrated care models that can connect mothers to social services to alleviate poverty, provide substance use treatment without criminalization, and ultimately treat trauma of both mothers and their children. In order to ensure the continuance of Native families and survivance of Native nations, it is vital to interrupt the transmission of intergenerational trauma.