Elsevier

Aggression and Violent Behavior

Volume 65, July–August 2022, 101639
Aggression and Violent Behavior

A scoping review of economic supports for working parents: The relationship of TANF, child care subsidy, SNAP, and EITC to child maltreatment

https://doi.org/10.1016/j.avb.2021.101639Get rights and content

Highlights

  • A scoping review of economic support programs was conducted.

  • EITC, TANF, and childcare subsidy may reduce maltreatment.

  • Evidence on SNAP is mixed.

  • Take-up of benefits ranges considerably hindering their potential impact.

Abstract

Background

Poverty is associated with greater risk for child maltreatment. Understanding the impact of anti-poverty strategies in the United States has been the subject of many research studies, but to date there has been no comprehensive review of research on the relationship of economic supports for working parents to child maltreatment.

Objectives

Following PRISMA standards, we examine the existing literature on four key economic support programs in the United States and their relation to child maltreatment: Temporary Assistance to Needy Families, Supplemental Nutrition Assistance Program (SNAP), child care subsidies, and Earned Income Tax Credit.

Sources of evidence

We review studies published between 1996 and 2020 through searches of Web of Science, Academic Search Complete, and JSTOR. We used Google Scholar to conduct backward and forward searches of citations.

Results

We find evidence that these four programs may provide some preventive benefits against child maltreatment, although the limited evidence on SNAP is unclear. The overall take-up of benefits ranges considerably across the four programs, hindering their potential beneficial impacts.

Conclusions

Investments in economic supports for parents may significantly reduce child maltreatment.

Introduction

The United States social safety net consists of a variety of economic support programs with varying goals, requirements, eligibility criteria, and application processes. Compared to other industrialized nations, economic support programs in the United States are less generous and more administratively complex, often creating barriers for families in receiving the benefits to which they are entitled or otherwise eligible. Despite these challenges, a growing body of evidence suggests certain economic support programs may be especially helpful to families and have a protective role against child maltreatment (Fein & Lee, 2003; Lee & Mackey-Bilaver, 2007; Rostad et al., 2020; Yang et al., 2019).

Four important economic support programs for working parents of low-income include Temporary Assistance to Needy Families (TANF), child care subsidy, Supplemental Nutrition Assistance Program (SNAP), and Earned Income Tax Credits (EITC). Although a variety of studies have investigated individual economic support programs (e.g. Fein & Lee, 2003; Lee & Mackey-Bilaver, 2007; Rostad et al., 2020; Yang et al., 2019), a comprehensive scoping review of the relationship of these four most commonly accessed economic support programs in the US and their relationship to child maltreatment is needed. In this article, we briefly discuss the problem of child maltreatment and its relationship to poverty, and provide an overview of the each of the four economic support programs. We then present the scoping review methods and findings, followed by a discussion with implications for research and policy.

Child maltreatment is a critical public health problem with significant consequences for children including internalizing and externalizing symptoms such as depression, anxiety, conduct disorder, and aggression; learning problems; and problems relating to peers (National Research Council, 2014). Into adulthood, individuals who were maltreated have increased risk for behavioral health issues including substance use and psychiatric problems; medical issues, and lower socioeconomic status (National Research Council, 2014). In federal fiscal year 2018, 678,000 children were considered official victims of child maltreatment in the US (United States Department of Health & Human Services, 2020). However, this number only reflects children with official determinations of child abuse and neglect following a child protective services (CPS) investigation, and therefore vastly underestimates the problem of child maltreatment in society.

A large body of literature demonstrates linkages between child maltreatment and poverty (Berger, 2004, Berger, 2005; Berger et al., 2017; Drake & Jonson-Reid, 2013; Drake & Pandey, 1996; Font & Maguire-Jack, 2020; Garbarino, 1977; Kim & Drake, 2018; Pelton, 1978; Slack et al., 2004, Slack et al., 2017). A variety of reasons explain this linkage, including factors about the individual that may increase their likelihood for experiencing both poverty and child welfare involvement and factors about the communities and societies in which individuals live. Two important theoretical frameworks relevant to understanding the linkage between economic support programs and child maltreatment are the family stress model and the family investment model. The family stress model (FSM; Conger & Elder, 1994) suggests that economic stress affects parental mental and behavioral health, which in turn influences parenting capacity and capability and child adjustment. The family investment model posits that when parents are provided with additional money from economic support programs, parents will invest this money into their families resulting in better child outcomes (see Conrad et al., 2020). Taking these two models together, we hypothesize that by improving household resources among working families of low-income, economic support programs have the potential to reduce child maltreatment.

In the US, there are a number of economic support programs that seek to improve household resources among working families of low-income. As opposed to one single program sufficient to lift individuals out of poverty, there are multiple federal and state programs specific to tax refunds, income support for help people transition into the workforce, unemployment benefits, child care assistance, food supports, and others. The variety of programs can be cumbersome for participants to navigate, as each program has unique eligibility requirements, varying recertification periods, and different mechanisms for providing benefits. Despite these limitations, there is evidence of effectiveness for certain programs, alone and in combination, in reducing poverty. For example, the Center on Budget and Policy Priorities (CBPP), a nonpartisan research and policy institute, estimates that the poverty rate (using a supplemental poverty measure which counts income from SNAP, rental assistance, refundable tax credits, Social Security, and unemployment) has fallen by about ½ since 1967, due in large part to economic security programs in the United States (Trisi & Saenz, 2019). The supplemental poverty measure used by Trisi and Saenz (2019) includes non-cash programs (e.g. SNAP), tax credits (e.g. EITC), and cash benefits (e.g. Social Security) in its definition of “income.” Trisi and Saenz's (2019) estimates suggest that economic security programs in the United States lift 43% of people who would have fallen below the federal poverty level above that line in 2017. They compare this figure to only 4% of individuals being lifted about the federal poverty level in 1967 (Trisi & Saenz, 2019). A recent report prepared for the U.S. Congress suggests that combinations of social policy packages, including means-tested (programs provided to individuals who meet certain income requirements) and universal supports (programs provided to all people) for working families, could be effective in reducing child poverty by an additional 50% while increasing employment among families of low-income (National Academies of Sciences, 2019).

In the paragraphs that follow, we discuss four of the major economic support programs for working families and their potential for reducing child maltreatment in the context of the family stress/family investment models.

In 1996, the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) created Temporary Assistance to Needy Families (TANF), a state administered benefit conditioned on work, to replace the federal anti-poverty entitlement program known as Aid to Families with Dependent Children (AFDC). TANF evolved from a series of state-level AFDC waiver experiments conducted in the early 1990s that granted states flexibility in specified aspects of AFDC program administration. PRWORA extended and formalized the era of AFDC waivers by giving states a high level of discretion in achieving TANF goals through an annual $16.5 billion federal block grant program. TANF's behavioral goals are reflected in its four purposes: (i) to provide assistance to needy families so that children can be cared for in their own homes or in the homes of relatives; (ii) to end the dependence of needy parents by promoting job preparation, work, and marriage; (iii) to prevent and reduce the incidence of out-of-wedlock pregnancies; and (iv) to encourage the formation and maintenance of two-parent families (United States Department of Health and Human Services, 2012). TANF grants states considerable flexibility to achieve these goals through discretionary eligibility rules, maximum benefits, work requirements, program restrictions, behavioral requirements, family caps, time limits, earnings disregards, drug testing, and others. At the most basic level, TANF cash assistance provides parents of low income with the means to address their child's basic needs for survival including food, diapers, housing, medical care, and safe and appropriate child care. However, one of the effects of welfare reform, and later, the Deficit Reduction Act of 2005, has been to reduce the average number of families with children in poverty who receive cash assistance from 82% in 1979 under AFDC to 22% in 2018 (Meyer & Floyd, 2020).

The majority of children with substantiated reports of child maltreatment suffer solely from neglect (60.8%) (USDHHS, 2020). The Centers for Disease Control and Prevention (CDC) classify neglectful behavior as failure to provide or meet the basic physical, emotional, or educational needs of the child; failure to supervise or ensure a child's safety within and outside the residence given a child's emotional and developmental needs; and exposure of the child to violent environments (Leeb et al., 2008). Therefore, the extent to which parents are unable to provide for their child's basic needs may inform their likelihood of contact with child protection agencies. Multiple studies also provide evidence in support of indirect pathways hypothesized in the FSM whereby economic hardships generate economic pressures that threaten the well-being of children via the psychological distress that arises among caregivers in response to the day-to-day experience of economic instability and insecurity (Masarik & Conger, 2017).

With the establishment of TANF, the federal government established the Child Care Development Fund (CCDF) in the mid 1990s, to remove barriers to work for low-income parents. The CCDF is a partnership between federal and state governments and is authorized under the Child Care Development Block Grant. Over $5 billion in federal funding is set aside for CCDF from the Administration for Children and Families' Office of Child Care. States have flexibility in the ways in which the program is delivered, but it must be used to provide financial assistance to low-income families to access child care so that they can work or attend a qualified job training or educational program.

Although the policy intent of child care subsidies was to remove barriers to work for low-income parents, they might also be related to a number of other positive outcomes for families, including child maltreatment prevention. Child care subsidies have been found to decrease work disruptions (Forry & Hofferth, 2011; Press et al., 2006; Weinraub et al., 2005). Given the link between poverty and child maltreatment (Drake & Jonson-Reid, 2013), child care subsidies ability to reduce work disruptions may lead to reductions in maltreatment. Further, a variety of child care stressors are associated with greater risk for maltreatment. Specifically, instability in arrangements is related to increased self-reported physical and psychological abuse, while not having someone available for emergency child care needs is associated with self-reported neglect (Ha et al., 2015). To the extent that child care subsidies improve the reliability of child care, maltreatment may be reduced. Take-up rates for child care subsidies are low, with an estimated 8% of potentially eligible children receiving subsidies based on federal income eligibility limits and an estimated 12% of potentially eligible children based on state income eligibility limits (Ulrich et al., 2019).

The Supplemental Nutrition Assistance Program (SNAP; formerly the Food Stamp Program) is a legal entitlement program administered by the U.S. Department of Agriculture (USDA) in cooperation with states. The largest food assistance program in the United States, SNAP is a key component of the USDA's strategy to reduce hunger and malnutrition among Americans of low-income and decrease food insecurity, a lack of physical and economic access to sufficient quantities of affordable and nutritious food (Coleman-Jensen, 2011). In 2019, the program served an average of 35.7 million persons per month or 11% of the U.S. population (USDA Economic Research Service, 2020). Unlike TANF, which has been capped at $16.5 billion since its inception, as a federal entitlement, SNAP is typically responsive to changing economic conditions. In 2018, the federal government spent $68 billion on SNAP and other related food assistance programs, and approximately 85% of eligible individuals received SNAP in fiscal year 2016 (Center on Budget and Policy Priorities, 2019). Whereas states only spend 21% of federal and state TANF funds on basic cash assistance, 92% of federal SNAP spending is spent on food (Burnside & Schott, 2020). Basic eligibility requirements and benefit formulas for SNAP are nationally uniform with the exception of Alaska and Hawaii where maximum benefits are higher to adjust for higher food prices. However, PRWORA and the 2002 Farm Bill gave states considerable discretion in program features that influence accessibility through a number of statutes, regulations, and waivers (see Ganong & Liebman, 2018).

Food insecurity has been associated with increased probabilities of CPS investigations, specifically for child neglect (Yang, 2015) and a number of established risk factors for child maltreatment including poverty, unemployment, family violence, poor parental mental health and child behavioral problems. However, in well-designed studies, SNAP has been found to improve the food security, health, and economic well-being of SNAP participants when compared to SNAP-eligible, non-participants (Swann, 2017; Ratcliffe, McKernan, & Zhang, 2011). Conversely, SNAP participants who experience reductions or cut offs from benefits experience increases in food insecurity, economic hardship, and maternal depressive symptoms when compared to participants with consistent benefits (Ettinger de Cuba et al., 2019).

Earned income tax credit (EITC) is an economic support in the United States provided to low- and moderate- income people who are working. Parents receive a much larger benefit compared to working adults who are not parents. EITC was originally put in place in 1975 under President Gerald Ford, as part of the Tax Reduction Act. The credit was intended to be a temporary credit for low-income workers to help offset Social Security payroll taxes and rising energy prices (Hungerford & Thiess, 2013). It was made permanent by the Revenue Act of 1978 and was greatly expanded by President Ronald Reagan. In the years that followed its original creation, it has been lauded as a successful anti-poverty program in the United States that increases labor force participation of single mothers (Hungerford & Thiess, 2013). In 2020, the maximum credit for families with one child is $3584 and $6660 for families with 3 or more children (Tax Policy Center, 2020). Across the United States, EITC participation was 78% in 2016, among those who are deemed possible eligible (Internal Revenue Service, 2019). Barriers to receiving EITC include lack of awareness of the benefit, concerns about citizenship, concerns about taxes not having been filed properly in the past, stigma surrounding receiving government help, lack of knowledge or motivation in signing up for the credit (Phillips, 2001).

EITC is primarily believed to be related to child maltreatment through its impact on poverty. (Klevens et al., 2017). Through increasing work among parents, the credit has the potential to create lasting improvements in economic conditions. In addition to the reductions in economic hardships, EITC has been found to have positive impacts for parents, including reduced mental health problems and stress (Evans & Garthwaite, 2014). Given prior research suggesting a link between mental health conditions and child maltreatment and stress and maltreatment (Stith et al., 2009), these reductions may have impacts on improved parenting and reduced maltreatment.

Given the connection between poverty and child maltreatment (Berger, 2004, Berger, 2005; Berger et al., 2017; Drake & Jonson-Reid, 2013; Drake & Pandey, 1996; Font & Maguire-Jack, 2020; Garbarino, 1977; Kim & Drake, 2018; Pelton, 1978; Slack et al., 2004, Slack et al., 2017) and the evidence of effectiveness of certain economic support programs in reducing poverty (Trisi & Saenz, 2019), we examine research regarding the relationship of TANF, child care subsidy, SNAP, and EITC to child maltreatment. The specific questions addressed within this scoping review are: (1) How many articles examine the relationship between the economic support program (TANF, child care subsidy, SNAP, and EITC) and child maltreatment? (2) What measures of child maltreatment are used? (3) What methods are used to assess the relationship? and (4) What are the main take-aways from the body of work? These questions are currently unanswered within the literature and are critical for advancing child maltreatment prevention.

Section snippets

Methods

We followed PRISMA standards to conduct this scoping review. Prior to beginning our search for articles, the co-authors met to develop a protocol for reviewing studies. This protocol is not available online but summarized here. To conduct our review of the relationship between TANF, child care subsidy, SNAP, EITC and child maltreatment, we searched the following academic databases: Web of Science, Academic Search Complete, and JSTOR. Inclusion criteria included peer-reviewed articles that were

Overview

Immediately following welfare reform, a plethora of new research was published on the effects of TANF on a range of employment and educational outcomes (Ziliak, 2015). However, relatively few studies examined the effects of TANF programs and participation on child maltreatment outcomes. Through our search strategy, we were able to identify 15 articles. Two additional studies were originally identified but excluded as they focused on reunification rather than child maltreatment per se (Kang et

Discussion

The purpose of this scoping review was to examine the literature on four economic support programs and their relation to child maltreatment: Temporary Assistance to Needy Families, Supplemental Nutrition Assistance Program (SNAP), child care subsidies, and Earned Income Tax Credit. These programs comprise an important safety net for working families of low-income. Overall, the body of research is suggestive that providing cash (or near cash) assistance may be promotive in families and may play

Funding

The authors had no funding to conduct this study.

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