Poverty and child abuse: never the twain shall meet?

The latest child poverty monitor makes for grim reading (Simpson et al., 2015). It shows an increase to 29% of New Zealand children now living in poverty, or nearly a third of all children in this land of milk and honey living below the poverty line. There have been various disclaimers that this measure is inaccurate, that it’s somehow ‘artificial’ as it’s obtained due to the median income and housing costs rising, while the incomes of poorer people remain the same. But that’s the point really – that if median incomes and costs rise, and the incomes of poorer people remain constant, then a greater proportion of those families will be unable to purchase basic necessities. This is poverty.

We also know that poverty and child abuse have an association. We are sometimes hesitant to spell it out, perhaps due to a desire to resist a ‘blame the poor’ mentality. It is true that the vast majority of poor children won’t be abused. A quick ‘back of the envelope’ calculation, for example, gives us some idea of the proportions: 305, 000 kids in poverty, about 16, 000 distinct children substantiated for abuse in 2014, and 85% of children substantiated for abuse are also ‘seen’ in the benefit system (Child Youth and Family, 2015; Vaithianathan et al, 2012). So, let’s say 85% of those 16, 000 are in poverty of some kind, that’s 13,600 (although this is a VERY rough proxy – we also know a substantial proportion of working families are in poverty, while not everyone seen on a benefit is necessarily in poverty). As a percentage of the 305, 000 kids in poverty, 13, 600 is 4.5% of all poor children substantiated for abuse, meaning 95.5% are not. BUT this rate of abuse (as a rate) is still much higher than for children from wealthier backgrounds – something a plethora of national and international studies have confirmed (for better stats, see studies cited below, plus Pelton (2015), for a good international overview).

Recognising the association between poverty and child abuse isn’t about blame, it’s about recognising the interrelated nature of all the factors across the ecological spectrum that influence human behaviour. As much abusive behaviour is either caused or exacerbated by stressors of various kinds, it makes sense theoretically that if you can’t afford the basics, can’t afford good housing, can’t afford decent food or the range of health and childcare supports that wealthier families can, then abuse is one possible outcome. The child poverty monitor technical report confirms this, as the rate of hospital admission for injuries arising from abuse and neglect in deprivation deciles 9 – 10 was more than 8 times the rate of those in deciles 1 -2 (using NZdep13 – see below) (Simpson et al., 2015, p.54).

Evidence from other countries is also convincing. So why is the conversation about the connections between child abuse and poverty so absent in our political discourse? If, similarly to other public health issues, there exists a socio economic gradient in people’s experiences of child abuse, then why is there not a serious policy strategy around addressing the gradient as one aspect of a multi-pronged approach to child abuse prevention? We are not alone in this dearth. A recent wide-ranging evidence review of the links between poverty and child abuse and neglect (CAN) for the Joseph Rowntree Foundation (Bywaters et al., forthcoming 2016) concluded that:

• “There is a lack of joined up thinking and action about poverty and CAN in the UK
• There is a limited UK evidence base, both in terms of official data and research
• That lessening family poverty across the population is likely to have a positive effect in reducing both the extent and severity of CAN in childhood and on the socio-economic consequences of CAN in adult life” (Bywaters et al., 2016).

They go on to note that one of the main strategic policy goals emanating from these conclusions is:

“to secure widespread recognition of the strong association between families’ socio-economic circumstances and children’s chances of being subject to abuse or neglect. It is essential that this association is framed as a public issue, a matter of social inequity, not as a further source of shame and pressure on individual disadvantaged families … to develop and apply effective anti-poverty policies, to connect such policies with policies aimed at reducing inequities in child health, education and to explicitly incorporate a focus on their relevance for CAN” (p. 3).

Meanwhile, here in Aotearoa, the place of poverty in regards to the child abuse and neglect debate is invisible, at least in official discourse. Here, a much more simplistic, moralising discourse about child abuse pervades officialdom, and it runs something like this: child abuse is perpetrated by bad individuals, and if only we could identify them and share information about them more effectively, we could prevent child abuse. Hence the rather manic focus on police checking and child protection policies (as if no one had them before the Vulnerable Children Act 2014). Child abuse is, via these policy developments and their associated discourses, framed as the inexcusable and morally repugnant actions of individual parents, actions entirely dislocated from the social contexts that families live in. In fact, recognition of the impact of social contexts and parental life histories on parenting parted ways with these reforms at the time of the White Paper, and the two have not been seen together since. The Minister at the time of the White Paper pointedly separated the role of poverty and other social issues with this comment:

“We know there are families suffering financial hardship, and that is particularly concerning when it is persistent…Though I acknowledge the pressure that financial hardship puts on families, that is never an excuse to neglect, beat, or abuse children. Most people in such circumstances do not abuse their children, and I cannot tolerate it being used as justification for those who do” (Paula Bennett, Minister for Social Development 2012, White Paper on Vulnerable Children, 2012: 2).

The introduction went on:

“Most children grow up happy, healthy, and loved by their families, whänau, and caregivers. But too many don’t have adults who keep them safe and put their needs first. There are many reasons for this, but parental capacity, poverty, welfare dependency, drug and alcohol abuse, and mental health issues are frequently blamed. We must work together to find those children who are vulnerable to abuse and neglect, and keep them safe…This isn’t just about breakfast in the morning or poverty, as important as those things are. It is about finding the children we are really concerned about before they are hurt, then acting to ensure they have a brighter future.” (Ministry of Social Development, 2012: 3).

In these ways, poverty and other issues influencing parenting are constituted as flimsy ‘excuses’, as simplistic, selfish and dishonest reasons for parents whose children are deemed ‘at risk’, and the aim of child abuse prevention is framed as one of identifying children and rescuing them from these irresponsible parents ‘before it’s too late’. Such a pointed severance of parental behaviour from the social and personal contexts of their lives ignores the wide-ranging evidence on the causes and correlations of child abuse. Following this train of logic also leads nowhere in a pragmatic sense, as ‘telling off’ bad parents, framing child protection as investigation and punishment, and removing children, are the only possible responses when the problems are framed in this manner.

Child abuse prevention involves attention to lowering the prevalence of factors that make parenting harder – specifically poverty, poor housing and low social supports – combined with offering services that actually engage with parents around their needs, the impacts of their own life histories, their aspirations, and understanding their relationships with their children. Without greater attention to resourcing this intensive family work, within a broad poverty alleviation strategy, we will continue to flounder. One intensive family preservation service in Australia, for example, recommends a caseload of two. That’s right, just two families at any one time for each social worker. Unless we get our heads around the range of supports and services required, and the high level resourcing of services required to truly prevent child abuse, the outcome is likely to be more abuse, more removals, and more cost for children, their families and the state, rather than prevention of harm for all. While we await the final report of the CYF review, it’s worth reiterating that the role of CYF can only be one part of a broader set of reforms needed if we want to prevent child abuse. This will require a radical change in policy direction, embedded in a fresh and progressive political vision that deals in social reality not ideological myth-making.

References

Bywaters, P., Bunting, L., Davidson, G., Hanratty, J., Mason, W., McCartan, C. and Steils, N. (2016). The relationship between poverty, child abuse and neglect: An evidence review. Coventry: Joseph Rowntree Foundation.

Cram, F., Gulliver, P., Ota, R. and Wilson, M. (2015). Understanding overrepresentation of indigenous children in child welfare data: An application of the Drake risk and bias models. Child Maltreatment, 20(3), 170-82. doi: 10.1177/1077559515580392.

Ministry of Social Development (2012). White Paper for vulnerable children: Children’s action plan -Identifying, supporting and protecting vulnerable children. Wellington: NZ Government.

Pelton, L.H. (2015). The continuing role of material factors in child maltreatment and placement. Child Abuse & Neglect, 41(0), 30-9

Simpson, J., Duncanson, M., Oben, G., Wicken, A. and Pierson, M. (2015). Child Poverty Monitor 2015 Technical Report. Dunedin: NZ Child & Youth Epidemiology Service, University of Otago.

Vaithianathan, R. (2012). Can administrative data be used to identify children at risk of adverse outcomes? Auckland: Business School, Department of Economics, University of Auckland.

Wilson, M.L., Tumen, S., Ota, R. and Simmers, A.G. (2015). Predictive modelling: Potential application in prevention services. American Journal of Preventive Medicine, 48(5), 509-19.

Note on the New Zealand deprivation index

The NZ deprivation index is a way of categorising deprivation based on a variety of census responses. It’s used to map the whole country spatially into ‘meshblocks’ – small areas – and rate them from 1 (least deprived) to 10 (most deprived). This is the opposite to school decile rankings! See this nifty map and info.