[WITHDRAWN] Child Protective Service Contact and Structural Racism: Implications for Health Equity Among Black Families

Background and Purpose:

In the US, Black families are exposed to contact with child protective service (CPS) systems at disproportionately high rates. Structural racism is the root cause of this inequity, operating through numerous direct and indirect mechanisms. While the purpose of CPS systems is to support child wellbeing, the adversarial nature of CPS contact, particularly for Black families, may have detrimental effects on health. This study examines the associations of CPS contact with the physical and mental health of Black youth and Black mothers. I assess differences in health within a sample of Black families only, recognizing the unique risks for exposure to CPS contact which Black families face due to structural racism. By comparing the health of Black youth and mothers with CPS contact to Black peers without CPS contact, I am able to highlight the effects of CPS contact independent of other mechanisms of structural racism which many Black families experience and which may also impact their health.

Methods:

I use data from the Future of Families and Child Wellbeing Study (FFCWS), an ongoing, birth cohort study of nearly 5,000 children and families, beginning at the focal children’s births in 1998-2000 and continuing in five subsequent waves, the latest when focal children were 15 years old. These data include information about CPS contact; racialized identity; validated health measures, including youth depression, anxiety, and physical health status and mother depression, anxiety, and physical health outcomes; and a rich set of family characteristics and experiences, all measured at multiple time points. The extent of these covariates allows me to control for numerous aspects of families’ identities and experiences which may confound the relationships between CPS contact and health outcomes. Additionally, FFCWS oversampled under-researched families, including low-income, unmarried, and marginalized racialized group member participants. As a consequence, these data include an unusually substantial sample of 2,584 Black families, enabling a robust analysis of within-group relationships between CPS contact and health, focused exclusively on Black youth and mothers.

Using multivariate regression, I examine the effects of CPS contact occurring by the time children were five years old on youth depression, anxiety, and physical health status when children were 15 years old. I also assess the effects of early CPS contact on mothers’ later health, examining depression and anxiety symptoms, diagnosis with physical health conditions such as diabetes, and overall health status.

Results:

Preliminary results indicate that CPS contact is associated with worse health and mental health outcomes for Black youth and mothers.

Conclusions and Implications:

These analyses demonstrate the independent consequences of CPS contact for health equity among Black youth and mothers. As researchers, practitioners, and policymakers grapple with the deeply ingrained structural racism which has shaped CPS systems in the US – a reckoning happening right now – identifying the concrete consequences of exposure to this mechanism of racism for health equity among Black youth and mothers is vital to promoting equitable and sustainable systems-level change for Black communities.