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Racial Disparities in Child Welfare and Infant Health: An Examination at the County-Level


The goal of this study is to contribute to an important gap in research on Black infants in the child welfare system. Black infants represent a high-risk population at the center of both health and child welfare disparities. Using both the child welfare and public health disparities knowledge base as a foundation, this research aims to better understand how health, when analyzed as an attribute of place, may function as an ecological risk or protective factor by influencing patterns of child welfare outcomes among infants. Birth indicators are well established as individual-level risk factors for child maltreatment, yet whether this relationship exists at the county-level and its potential impact on current levels of disparity among infants has not been explored. County-level studies in child welfare can contribute to the scope of research needed to answer imperative questions regarding how local community factors, social service system characteristics, and service availability may influence disparate outcomes across geographies. As such, this study 1) examines variation and changes over time in levels of low birth weight and infant allegation disparity across California counties 2) uses Poisson regression models to determine whether low birth weight is associated with increased incidence of infant maltreatment allegations and 3) examines the relationship between a county’s rate of low birth weight disparity and its rate of infant allegation disparity.

Results of this study identified wide ranges of maltreatment allegation and disparity rates across California counties. A number of statistically significant differences in mean infant allegation disparity rates were observed for counties that were grouped and compared according to select contextual measures of interest. Findings from the Poisson regression modeling indicated that the model for Black infants was the only case in which county low birth weight was a significant predictor of maltreatment allegations. The effect of county low birth weight on maltreatment allegations for racial groups combined and for White infants were negligible and did not reach statistical significance. Results support the case for multi-level studies that incorporate more sophisticated measures of ecological health to explore the potential relationships between developmentally relevant, health-related factors and child welfare outcomes.

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