Contact With Child Protective Services Common Among US Kids

Emily Willingham

July 22, 2021

The median rate at which children have contact with Child Protective Services (CPS) across the 20 most populous US counties is 41.3%, according to findings published July 19 in the Proceedings of the National Academies of Science. Black children are at greatest overall risk of having encounters with CPS, at 60%.

CPS contact is "ubiquitous, especially for children from families that don't have a lot of socioeconomic resources," says senior author Christopher Wildeman, PhD, a professor of sociology at Duke University, Durham, North Carolina, and the director of the National Data Archive on Child Abuse and Neglect.

"Clinicians should be aware that high levels of CPS contact, especially to the degree that leads to foster care or termination of parental rights, may also end up being clinically relevant," he continued.

The findings are "quite staggering" and show an effect of place in addition to other factors on CPS contacts and outcomes, says Kelley Fong, PhD, assistant professor of sociology at the Georgia Institute of Technology, Atlanta, Georgia, who was not involved in the study. "I hope that [the results] encourage more attention to this issue," she said.

Wildeman and his co-authors used national databases to determine the cumulative prevalence of CPS contact in the 20 counties. Most of the counties were located in California, Texas, and Florida. The investigators found "extremely high" rates of CPS investigations in most of the counties and "large" disparities by race or ethnicity in several of them.

Overall, the median cumulative prevalence of CPS investigations was 41.3%. Rates were highest for Black children, ranging from 43.2% to 72.0% in the counties studied.

Hispanic children in Bexar County, Texas, and all children in Maricopa County, Arizona, except Asian/Pacific Islander children experienced what the authors say are "extreme rates" of "later-stage" CPS interventions, including placement in foster care and termination of parental rights.

The researchers single out Maricopa County as having "uniquely high rates" of such interventions, at almost 3% for termination of parental rights and almost 10% for placement in foster care. In contrast, the median rates for all counties combined were 0.7% for termination of parental rights and 3.5% for placement in foster care. The ratio of parental terminations in Maricopa compared with New York was 17.5 to 1.

The toll is heaviest for Black children, whose maximum cumulative risk for foster care placement was 20.1% in Los Angeles County. The maximum risk for termination of parental rights was in Maricopa County, at 5.6%. Rates of investigations also were highest for Black children, topping out at 72% in Los Angeles County and exceeding 60% in 11 of the 20 counties examined. By contrast, investigation rates among Hispanic and White children ranged mostly from 20% to 50%.

The fact that rates of CPS contact were similarly high across counties but that investigational outcomes differed — from no steps being taken to termination of parental rights — suggests a strong local influence, says Fong. "A child growing up in one place might land in foster care, while in another place might never come to the attention of CPS," she said.

Clinicians working with marginalized populations "should absolutely be aware that in many cases, they're coming into contact with children who have had encounters with CPS," said Fong. Even if an investigation is closed quickly, she says, these encounters can be really stressful for the family. "Lower-level encounters are important to pay attention to," she said.

Wildeman concurs. "I also study the criminal justice system and how that affects families, and this is another institution contact that families experience that clinicians absolutely have to ask about," he said. "It's essential for physician's to understand this core piece of a child's history."

Wildeman and Fong report no relevant financial relationships.

Proc Natl Acad Sci U S A. Published online July 27, 2021. Full text

Emily Willingham, PhD, is a science writer and author of Phallacy: Life Lessons From the Animal Penis (Avery) and The Tailored Brain: From Ketamine, to Keto, to Companionship, A User's Guide to Feeling Better and Thinking Smarter (Basic Books). Find her on Twitter @ejwillingham.

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