Browsing by Subject "Child welfare system"
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Item Parental substance use and foster care entrance : trends, geographic variation, and predictors of reunification(2021-05-06) Stritzel, Haley; Crosnoe, Robert; Cavanagh, Shannon; Brayne, Sarah; Kirk, David; Raley, KellyParental substance use is a major risk factor for a child’s entrance into foster care and, in the context of the opioid epidemic, has contributed to an increasing proportion of foster care entrances. However, parental substance use exists on a spectrum of severity and risk to a child’s safety and well-being. Whether or not a child with substance-using parent(s) is removed to foster care and returns to their parents’ home following foster care depends on the extent to which professionals, caseworkers, judges, and other authorities perceive parental substance use as maltreatment and whether it can be reconciled with a child’s safety and wellbeing. Decision-making in the child welfare system largely depends on the personal judgments of caseworkers, judges, and other child welfare workers, which are in turn influenced by external factors varying over time and place. Regarding time, the primary narrative regarding substance abuse has shifted dramatically from one emphasizing criminality and the need for punishment during the 1980s crack cocaine epidemic to one emphasizing public health and the need for treatment during the current opioid crisis. How this new narrative is reflected in child welfare decision-making, however, has not been adequately explored. Regarding place, the policies, availability of services, and more general sociodemographic and health environment of counties and states are known factors in child welfare decision-making, but have yet to be applied specifically to cases involving parental substance use. This dissertation links data from the Adoption and Foster Care Analysis and Reporting System with various county- and state-level data sources to address these gaps in the literature. The first study shows how sociodemographic variation in substance use-associated foster care entry rates over time reveal changes in where and for whom the child welfare system allocates resources. The second study demonstrates how county-level policy, health, and sociodemographic characteristics explain geographic variation in these rates. In the third study, I show how Medicaid expansion and program generosity interact in nuanced ways to predict reunification among children removed from the home due to parental substance use. All three studies illustrate the ongoing connections between the opioid epidemic and child welfare.Item The effect of maltreatment and trauma on health risk behaviors among adolescents involved with the child welfare system : the role of psychological symptoms(2016-08) Walsh, Elizabeth Grace; Carlson, Cindy I., 1949-; Keith, Timothy Z; Drum, David; Stark, Kevin; Loukas, AlexandraChildhood maltreatment, including abuse and neglect, remains a pressing social problem in the United States, with retrospective studies finding that up to 40% of adults report having experienced some type of maltreatment during their youth (Finkelhor, Turner, Shattuck, & Hamby, 2013). The consequences of maltreatment are widespread and long lasting, and can include post-traumatic stress disorder, depression, anxiety, aggression, delinquency, substance abuse, and suicidality (Gilbert et al., 2009). Although the effects of various individual forms of maltreatment and of a composite “adverse childhood experience” (ACE) score on rates of individual health risk behaviors in adolescence and adulthood have been documented, the pathway whereby childhood maltreatment leads to later engagement in risk behavior is still not well understood (Anda et al., 2007; White & Widom, 2007), and relatively little is known about the psychological factors that link childhood maltreatment to engagement in health risk behaviors. This study used a subsample of adolescents from the second National Study of Child and Adolescent Well-Being (NSCAW II), a longitudinal study of youth involved with the child welfare system, to examine: 1) the effects of child maltreatment and trauma symptoms reported at baseline on engagement in health risk behaviors measured 36 months later, and 2) whether depressive symptoms and future expectations, measured 18 months after baseline, mediate the effects of maltreatment on health risk behaviors. Using structural equation modeling, this study found that both maltreatment and trauma symptoms were risk factors for later adverse outcomes, but that maltreatment was more consistently and strongly associated with behavioral outcomes (i.e. substance use and sexual behavior) while trauma symptoms were more consistently associated with psychological outcomes (i.e. depressive symptoms and future expectations). Results overall did not support the hypothesis that the psychological constructs examined mediated the effects of maltreatment and trauma on later health risk behaviors. Findings also identified early substance use as a critical risk factor for youth exposed to maltreatment, as substance use at baseline mediated the effects of maltreatment not only on later substance use but also on sexual risk behavior, as well as increasing risk for subsequent depression.