Financial and Health Risks As Predictors of Neglect Subtypes in Adolescence

Background and Purpose: Neglect during adolescence impedes health and development. The relationship between poverty and neglect is well established. However, past research has mainly considered childhood neglect as a single dimension. This leaves unclear how poverty may contribute to heterogenous subtypes of adolescent neglect. This study aims to help close this gap in knowledge by addressing the following research question: how do poverty and financial hardship, in confluence with caregiver and child health risk, contribute to adolescent neglect subtypes?

Methods: This study draws from the high-risk Longitudinal Studies for Child Abuse and Neglect cohort (N = 1,039). It utilizes an empirically derived measurement model of the 43-item, 16-year youth self-reported Mid-adolescent Neglect Scale. The measurement model contains five factors (Inattention to Basic Needs, Inadequate Monitoring, Exposure to Risky Situations, Permitting Misbehavior, and Inadequate Support) and has excellent fit: RMSEA = .056, [.054, .058]), TLI = .952, SRMR = .057). Structural equation modeling was used to examine family financial hardship, caregiver health risk, and child behavioral problems as predictors of the five adolescent neglect factors. Three nested models were tested, all controlling for child gender (boy, girl), race (White, Black, Other), Latinx ethnicity, and caregiver years of education. Model 1 included dichotomous composite measures of family financial hardship from 0-12 years: poverty (≤100%) and housing instability (any eviction, homelessness/shelter stay, or ≥3 moves), and any food security reported at 12 years. Model 2 added three dichotomous composites of family health risk from 0-12: domestic violence, caregiver depression, and caregiver substance use. Model 3 added an indicator for any child clinical-level internalizing or externalizing behavioral problems from 0-12.

Results: In model 1, poverty predicted Exposure to Risky Situations (β = .14, SE = .05, p = .009) and Permitting Misbehavior (β = .17, SE = .05, p = .001). Housing instability predicted Inattention to Basic Needs (β = .12, SE = .05, p = .009). In model 2, caregiver depression additionally contributed to Inattention to Basic Needs (β = .12, SE = .05, p = .010) and Exposure to Risk Situations (β = .13, SE = .06, p = .012). In model 3, child behavioral problems contributed to all neglect types: Inattention to Basic Needs (β = .23, SE = .04, p < .001), Permitting Misbehavior (β = .16, SE = .05, p = .001), Exposure to Risky Situations (β = .13, SE = .05, p = .005), Inattention to Monitoring (β = .12, SE = .04, p = .007) and Inadequate Support (β = .16, SE = .05, p = .001). Child clinical-level behavioral problems usurped effects of caregiver depression, but not poverty and housing instability (RMSEA= .034 [.033, .036], TLI=.958, SRMR = .053).

Conclusions: Housing instability and poverty predicted adolescent neglect in this high-risk cohort, net of family and child health risk. Family financial hardship, however, did not specifically predict monitoring and support neglect. Child behavioral problems may overwhelm caregivers, contributing to the neglect of adolescents. Policy and practice should support family’s financial and housing security and child behavioral health.