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CALIFORNIA’S MOST VULNERABLE PARENTS: WHEN MALTREATED CHILDREN HAVE CHILDREN Emily Putnam-Hornstein, PhD Bryn King, MSW Julie Cederbaum, PhD Barbara Needell, PhD Children’s Data Network University of Southern California California Child Welfare Indicators Project University of California, Berkeley The Research and Training Network: A Child Welfare Evidence- Informed Webinar January 2014

California’s Most vulnerable parents: When Maltreated Children have children

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California’s Most vulnerable parents: When Maltreated Children have children. The Research and Training Network: A Child Welfare Evidence-Informed Webinar January 2014. Emily Putnam-Hornstein, PhD Bryn King, MSW Julie Cederbaum, PhD Barbara Needell, PhD Children’s Data Network - PowerPoint PPT Presentation

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Page 1: California’s Most  vulnerable parents: When Maltreated  Children have children

CALIFORNIA’S MOST VULNERABLE PARENTS:

WHEN MALTREATED CHILDREN HAVE CHILDREN

Emily Putnam-Hornstein, PhD

Bryn King, MSWJulie Cederbaum, PhDBarbara Needell, PhD

Chi ldren’s Data NetworkUniversity of Southern Cal i fornia

Cal i fornia Chi ld Welfare Indicators ProjectUniversity of Cal i fornia, Berkeley

The Research and Train ing Network:

A Chi ld Welfare Evidence- Informed

Webinar

January 2014

Page 2: California’s Most  vulnerable parents: When Maltreated  Children have children

ACKNOWLEDGEMENTSTHANKS, THANKS, THANKS

This research was funded through a grant from the Conrad N. Hilton Foundation. We are deeply appreciative of the Foundation’s investment and support.

Thank you to our colleagues at the California Child Welfare Indicators Project (CCWIP) and the California Department of Social Services (CDSS) – and for CCWIP infrastructure support from CDSS and the Stuart Foundation

This study arises from the *new* Children’s Data Network – a data collaborative funded by First 5 LA

Student partners: Jaclyn Cleveland, Andrea Lane , and Kasey Gilbert

Page 3: California’s Most  vulnerable parents: When Maltreated  Children have children

Nationwide, teen pregnancy rates have declined by more than 40% during the last two decades, rising briefly in 2006/2007 before dropping to a historical low in 2011

Yet, significant risk differences persist across groups, with variations by state, race, socioeconomic status, and other characteristics

Research suggests that female youth involved with the child protection system have heightened teen birth rates…

BACKGROUNDWHAT WE KNOW…AND WHAT WE DON’T

Page 4: California’s Most  vulnerable parents: When Maltreated  Children have children

Limited epidemiological data available from which we can ascertain teen parenting rates/dynamics among youth involved with child protective services in California

These data are needed so that we can: Document the public health burden of teen births for this

population Monitor trends and evaluate the efficacy of pregnancy prevention

efforts for this population Determine the nature of services that are needed for young

mothers and children Develop programs that are responsive to what may be unique

parenting needs for youth who have been maltreated or are in foster care

OBJECTIVESKNOWLEDGE GENERATION

Page 5: California’s Most  vulnerable parents: When Maltreated  Children have children

THE LIMITATIONS OF ANY ONE SOURCE OF DATA…THE CONTINUING PROBLEM OF SILOS

Government Agencies

University and Foundation Partners

Ongoing Collaboration

Page 6: California’s Most  vulnerable parents: When Maltreated  Children have children

Child Protective Services/Foster Care records from the California Department of Social Services (1998-2012)

Vital Birth records from the California Department of Public Health (2000-2010) concerning births to teen mothers

Statewide and Los Angeles County-specific analyses

Birth information concerning all teens who had a live birth

CPS information concerning teen mothers (retrospective) and the children they gave birth to (prospective)

DATARECORD LINKAGE

Page 7: California’s Most  vulnerable parents: When Maltreated  Children have children

(Vol.1-1) Population-level examination of past CPS involvement among teen mothers

Teen birth rates among girls in foster care (Vol.1-4) Cross sectional (Vol. 1-2) Longitudinal

(Vol. 1-3) Intergenerational CPS-involvement

(Vol. 1-5) Infant health consequences

OVERVIEWTOPICS COVERED TODAY

Page 8: California’s Most  vulnerable parents: When Maltreated  Children have children

BRIEF VOL. 1-1A POPULATION-BASED EXAMINATION OF MALTREATMENT HISTORY AMONG ADOLESCENT MOTHERS

Births 2009

1998

Maternal History of CPS involvement

conception

Page 9: California’s Most  vulnerable parents: When Maltreated  Children have children

POPULATION PROFILE 35,098 teens (born in CA) gave birth in 2009 in California 12-15 yrs (5.3%); 16-17 yrs (28.6%); 18-19 yrs (66.1%) Latina (70.2%); Black (11.0%); White (15.7%) Prenatal Care initiated after 1 st Trimester (32.6%)

HISTORY OF ALLEGED MALTREATMENT

HISTORY OF SUBSTANTIATED VICTIMIZATION

HISTORY OF FOSTER CARE

KEY FINDINGHISTORY OF ALLEGED & SUBSTANTIATED MALTREATMENT IS COMMON AMONG TEEN MOTHERS

44.9%20.8% 9.7%

conservative estimates

Page 10: California’s Most  vulnerable parents: When Maltreated  Children have children

DESCRIPTIVE INFORMATIONHISTORY OF CHILD PROTECTION INVOLVEMENT

Page 11: California’s Most  vulnerable parents: When Maltreated  Children have children

KEY FINDINGEVER REPORTED / EVER SUBSTANTIATED

Page 12: California’s Most  vulnerable parents: When Maltreated  Children have children

BRIEF VOL. 1-4A CROSS-SECTIONAL STUDY OF BIRTH RATE TRENDS AMONG GIRLS IN FOSTER CARE

2006 2007 2008 20102009

In Foster Care 15-17 Years of Age

Birth Rate Birth Rate Birth Rate Birth Rate Birth Rate

Page 13: California’s Most  vulnerable parents: When Maltreated  Children have children

Over t ime, birth rates for the general populat ion are decreasing, but there is no analogous decl ine for the foster care populat ion

Across al l five years, average birth rates for the general populat ion are 2.0 per 100 vs. 3.2 per 100 for the foster care population

On a relative basis, birth rates among youth in foster care are higher than in the general population (~60% on average)

Yet, on an absolute basis, only a smal l percentage of gir ls in foster care give birth in any given year (≤ 3.5%)

KEY FINDINGFOSTER CARE VS. GENERAL POPULATION

2006 2007 2008 2009 20101.0

1.5

2.0

2.5

3.0

3.5

4.0

2.2 2.2 2.11.9

1.6

3.33.5

3.13.3

3.0

General Population Foster Care Population

Rate

per

100

Page 14: California’s Most  vulnerable parents: When Maltreated  Children have children

Foster Care vs. General Population Latina: 1.2 Black: 1.3 White: 3.1

General Population Racial Disparities Latina vs. White: 5.5 Black vs. White: 3.6

Foster Care Racial Disparities Latina vs. White: 2.2 Black vs. White: 1.5

KEY FINDINGRACIAL/ETHNIC DIFFERENCESFOSTER CARE VS. GENERAL POPULATION

Latina

Black

White

4.3

3.0

2.0

3.5

2.3

0.6

General Population Foster Care Population

Page 15: California’s Most  vulnerable parents: When Maltreated  Children have children

KEY FINDINGTIMING OF BIRTHS

foster care

foster care

foster care

Path 1

Path 2

Path 3

Page 16: California’s Most  vulnerable parents: When Maltreated  Children have children

Among girls who were in foster care and gave birth – less than 50% were in a placement when they became pregnant

KEY FINDINGTIMING OF CONCEPTION

Page 17: California’s Most  vulnerable parents: When Maltreated  Children have children

Risk factors? Highest birth rates observed among girls: In care for less than 12 months Experienced extreme placement instability (9+) Reentered care Placed in non-relative foster care (although initially higher in

congregate care) Removed for neglect

Protective? Substantially lower birth rates observed for girls: In care for 60+ months In guardian/other placement

KEY FINDINGBIRTH RATES ACROSS FOSTER CARE PLACEMENT EXPERIENCES

Page 18: California’s Most  vulnerable parents: When Maltreated  Children have children

BRIEF VOL. 1-2CUMULATIVE TEEN BIRTH RATES AMONG GIRLS IN FOSTER CARE AT AGE 17

In Foster Care at Age 17

2003-2007

first birth before age

18

first birth before age

19

first birth before age

20

first birth before age

21

repeat teen birth

Page 19: California’s Most  vulnerable parents: When Maltreated  Children have children

KEY FINDING #1CUMULATIVE RISK OF TEEN BIRTHS IS HIGH

Page 20: California’s Most  vulnerable parents: When Maltreated  Children have children

KEY FINDINGS #2 HIGH RATES OF REPEAT BIRTHS

41.2%

31.0%

Second Teen Birth by Age at First Birth

Page 21: California’s Most  vulnerable parents: When Maltreated  Children have children

BRIEF VOL. 1-3ADOLESCENT MOTHERS AND INTERGENERATIONAL CHILD PROTECTIVE SERVICE INVOLVEMENT

Birth 2006 / 2007

Child’s 5th birthday

Mother’s 10th birthday

reported

substantiated reportedsubstantiated

Page 22: California’s Most  vulnerable parents: When Maltreated  Children have children

010

2030

40

1 2 3 4 5birth 1 2 3 4 5birth

Children Reported by Age 5 Children Substantiated by Age 5

No Reportof Maternal Victimization

Unsubstantiated Reportof Maternal Victimization

Substantiated Reportof Maternal Maltreatment Victimization

Cum

ulativ

e Pe

rcen

tage

/ Ra

te p

er 1

000

1020

3040

1 2 3 4 5birth 1 2 3 4 5birth

Children Reported by Age 5 Children Substantiated by Age 5

No Reportof Maternal Victimization

Unsubstantiated Reportof Maternal Victimization

Substantiated Reportof Maternal Maltreatment Victimization

Cum

ulativ

e Pe

rcen

tage

/ Ra

te p

er 10

0

KEY FINDINGHIGH RISK SUGGESTS NEED FOR ENHANCED SUPPORTS TO BREAK CYCLE OF ABUSE & NEGLECT

010

2030

40

1 2 3 4 5birth 1 2 3 4 5birth

Children Reported by Age 5 Children Substantiated by Age 5

No Reportof Maternal Victimization

Unsubstantiated Reportof Maternal Victimization

Substantiated Reportof Maternal Maltreatment Victimization

Cum

ulativ

e Pe

rcen

tage

/ Ra

te p

er 10

00

1020

3040

1 2 3 4 5birth 1 2 3 4 5birth

Children Reported by Age 5 Children Substantiated by Age 5

No Reportof Maternal Victimization

Unsubstantiated Reportof Maternal Victimization

Substantiated Reportof Maternal Maltreatment Victimization

Cum

ulativ

e Pe

rcen

tage

/ Ra

te p

er 1

00

Page 23: California’s Most  vulnerable parents: When Maltreated  Children have children

VOL. 1-3, TABLE 1

[other covariates not shown]

children maltreated at twice the rate

Page 24: California’s Most  vulnerable parents: When Maltreated  Children have children

BRIEF VOL. 1-5INFANT BIRTH WEIGHT AND MALTREATMENT OF ADOLESCENT MOTHERS

Birth 2007-2009

substantiated

Low Birth Weight (< 2500g)

Mother’s 10th birthday Normal Birth Weight (≥

2500g)

Page 25: California’s Most  vulnerable parents: When Maltreated  Children have children

Documenting the prevalence of past abuse and neglect among adolescents who give birth and understanding its role in pregnancy decisions is critical to the development of informed prevention programs.

Recognizing that a history of maltreatment characterizes many adolescent mothers may be relevant to the development of interventions that enhance parenting capacity and protect against abuse and neglect in the next generation.

Monitoring the incidence of first and repeat births among girls currently and formerly involved with CPS is critical to evaluating the efficacy of pregnancy prevention efforts and determining the nature of services that are needed for young mothers and children. 

IMPLICATIONS?A START TO AN IMPORTANT CONVERSATION

Page 26: California’s Most  vulnerable parents: When Maltreated  Children have children

Data from the present study indicate that more than 1 in 4 young women in the foster care system at age 17 is parenting during her teens (this will be 1 in 3 before age 21).

The extension of foster care to youth over the age of 18 means that the nature of the state’s parenting obligations will expand and will increasingly include the next generation of children.

Maternal maltreatment may not only have consequences for the victim but also may contribute to next-generation health outcomes and maltreatment risk

OTHER THINGS TO CONSIDER…POLICY AND PROGRAMS

Page 27: California’s Most  vulnerable parents: When Maltreated  Children have children

[email protected]

MORE INFORMATION?http://www.hiltonfoundation.org/teenpar

ents