Poverty and Child Abuse

And now for something depressing.

Jill Lepore has a long essay in the latest New Yorker about, on the one hand, two sensational murders of young children in Boston, and, on the other, the long-term problem of child abuse. The best thing about the article is that Lepore knows how long we have been wrestling with this problem; public policy swings between removing children from troubled families and trying to keep troubled families together have been going on since at least the 1860s. One reason we don't hear more about the problem, except when there is a sensational murder, is that everyone is tired of what seems to be an unending, hopeless crisis. The major newspapers all have articles and editorials from decades ago that they could re-run with only the names of the officials changed.

Lepore and the people she interviews all seem to think that fighting child abuse in the way we do is hopeless, because the real problem is poverty. And there is a sense in which this is true. According to the Children's Defense Fund,

Poverty is the single best predictor of child abuse and neglect. Children who live in families with an annual income less than $15,000 are 22 times more likely to be abused or neglected than children living in families with an annual income of $30,000 or more.

That number is misleading in some ways, as I will explain, but I can tell you that I just spent the past hour searching for information on the question and found a whole lot of numbers from many sources that say pretty much the same thing.

The question is, why? What is the actual causal link between poverty and child abuse?

First, the number I cited lumps together "abuse" and "neglect," two quite different categories. The separate numbers are that very poor children are 14 times more likely to be abused and 44 times more likely to be neglected. "Neglect" is sometimes a word for being too poor to meet our standards of family life; for example, parents can be charged with child neglect for being homeless. When single mothers can't find or afford child care and leave their children at home alone, the children can be considered "neglected" and taken away from them. (Even if they have been ordered to get jobs by state welfare officials.)

So part of the disparity does arise simply from lack of resources to give children things our society thinks they ought to have. On the other hand "abuse," meaning physical harm, is still vastly more common among the very poor. Perhaps this is partly because of reporting differences, in that middle class families are better able to keep their problems private, but child murder is a lot harder to conceal and it shows the same disparity.

So why are very poor Americans more likely to abuse their children?

The most obvious answer to me is mental illness, along with associated drug abuse. In America there is a very strong association between mental illness and poverty, and crazy, drug-addled people are more likely to hurt their children. People who have been in prison are also more likely to hurt their children, and prison is also strongly associated with drug abuse and mental health problems.

Stress is another factor. When single mothers get jobs they become more likely to abuse their children, even though their economic situations improve, and I suppose this is because being a working single mother is just very stressful.

Which gets me to another factor that I wonder about, even though I haven't found any studies that show it is a problem: loneliness. In traditional societies new mothers get lots of help with their babies from relatives and neighbors, but in our atomized world many parents seem to be pretty much alone. That has to make it much harder for them to cope and much more likely that they will abuse or ignore their children. The only sort of intervention that has been shown to decisively reduce child abuse is very long term family visitation, beginning during pregnancy and continuing for more than two years. People involved in Yale's Mind the Baby program say that the key is helping mothers communicate with their babies, something one assumes is done by relatives for people who have them around.

All Americans know how hard it has been to break up the multi-generational cycle of poverty, child abuse, addiction, and prison. One thing we know is that these problems often start young; children who have had any sort of contact with child protective services, even the briefest visit, are more than twice as likely to end up in prison. For what we spend keeping drug users in prison, we could easily provide every poor mother in America with monthly home visits by a pediatric nurse. If we are serious about the pathologies of American poverty, that is the kind of intervention we need to focus on.