November 17, 2020

When families are dealing with stress over housing insecurity, there is a greater risk of child maltreatment and Child Protective Services (CPS) becoming involved. These findings come from three researchers at the UNC-Chapel Hill Gillings School of Global Public Health.

Dr. Meghan Shanahan

Dr. Meghan Shanahan

Dr. Anna Austin

Dr. Anna Austin

Caroline Chandler

Caroline Chandler

Their article, “Association of Housing Stress With Child Maltreatment: A Systematic Review” was published online by the journal Trauma, Violence, & Abuse. In the article, Department of Maternal and Child Health doctoral student Caroline Chandler, MPH — along with assistant professors Anna Austin, PhD, and Meghan Shanahan, PhD — share results from a review of existing literature that links housing stress with increased likelihood of child abuse and neglect.

“The family stress model hypothesizes that economic pressures, including material hardships such as housing insecurity, create stress that can contribute to harsh or neglectful parenting,” say the study authors.

Child maltreatment is a major public health issue in the United States. In 2018, CPS received more than 4 million reports of suspected maltreatment. Child maltreatment is associated with an increased likelihood of depression, anxiety, substance use disorders, chronic pain, less education and low socioeconomic status from childhood into adolescence and throughout adulthood.

Previous research has established that poverty is a risk factor for CPS confirmed maltreatment, with children in low-income homes being three times as likely to experience abuse and seven times as likely to experience neglect. However, policies that promote financial stability can improve these outcomes.

“We need a stronger safety net that adequately supports families and prevents them from experiencing material hardships, such as housing insecurity,” Chandler says. “Previous research has demonstrated that population-level policies that increase financial stability — such as Medicaid expansion, increases in minimum wage, paid parental leave and more generous welfare benefits — reduce the risk of child maltreatment. It is likely that other policies that help families meet their basic needs and reduce financial stress will have similar results.”

This review is the first to evaluate the literature specific to housing stress as a tangible manifestation of poverty and a novel way to capture the direct impacts of poverty on daily life. The researchers define “housing stress” broadly as including homelessness, eviction, overcrowding, unsafe housing conditions, frequent moves and unaffordable housing costs.

The team identified 21 peer-reviewed articles that used nine distinct measures of housing stress. Overall, these studies demonstrated an association between various measures of housing stress and an increased likelihood of caregiver or child self-reported maltreatment, CPS reports, investigated and substantiated CPS reports, out-of-home placements and maltreatment death.

Now, the researchers call for additional studies to explore which specific types of housing stress — homelessness versus unsafe housing conditions, for example — have the strongest connection with specific types of child maltreatment, such as neglect versus physical abuse. These details could inform future public health interventions and partnerships between CPS, housing and homeless service systems, and other social services in an effort to prevent child maltreatment.

“Families with children make up one third of the population of people experiencing homelessness in the U.S.,” the authors share. “This review demonstrates that housing insecurity is one form of material hardship that families experience that increases the risk of child maltreatment. We hope that this review supports calls for evidence-driven housing policy reforms that build a stronger safety net and allow families to thrive.”

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