Transcript An Examination of California`s 2002 Birth

Predictors of Child Welfare Contact
Between Birth and Age Five:
An Examination of California’s 2002 Birth Cohort
Barbara Needell, MSW, PhD
Emily Putnam-Hornstein, MSW (lead author)
Center for Social Services Research
University of California at Berkeley
The Performance Indicators Project is a collaboration of the
California Department of Social Services and the University of California at Berkeley,
and is supported by the
California Department of Social Services and the Stuart Foundation
Presentation designed by Bryn King
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Using Birth Records (and other
Administrative Data Sources) to Examine
Opportunity and Equality
• Birth records and other administrative datasets may contain
valuable information—with variables that are associated with
substantial differences in outcomes
• Findings based on linkages of administrative data sources may
assist in targeting vulnerable populations
• The study presented today is an example of how linked
administrative data can inform our work
--what other data linkages might be useful?
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
California's 2002 Birth Cohort Study
• Utilized population-level birth data to describe those children
who may be at greatest risk of maltreatment during the first
five years of life
• Constructed a unique dataset by linking California’s
administrative child welfare data to statewide vital birth
records
• Employed a cohort study design to track contacts with child
protective services (CPS) for children born in 2002
• Analyzed twelve variables captured in the birth record to
determine predictive capability for later CPS contact
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Understanding the Variation Hidden
Beneath Summary Data
• Seeing the forest for the trees:
– Of the 531,035 children born in California in 2002, 14%
(N=74,182) were found to have been referred for possible
maltreatment before age 5.
– There was tremendous variation in rates of CPS contact
among a number of birth variables, including: birth
weight; level of prenatal care; maternal birth place, age
and education; paternity information; Medi-Cal
coverage; and race/ethnicity.
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Rate of CPS Involvement:
Birth Weight
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
187
137
low (<2,500 g)
normal (>=2,500 g)
0
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Rate of CPS Involvement:
Prenatal Care
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
0
489
254
223
123
none
third trimester
second trimester
first trimester
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Rate of CPS Involvement:
Maternal Birth Place
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
0
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
183
90
US-born
foreign-born
Rate of CPS Involvement:
Maternal Age at Birth
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
0
257
190
126
93
<20 yrs
20-24 yrs
25-29 yrs
30+ yrs
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Rate of CPS Involvement:
Maternal Education
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
0
201
179
114
34
<12th grade
12th grade
some college
college+
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Rate of CPS Involvement:
Paternity Information
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
0
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
344
124
missing
present
Rate of CPS Involvement:
Medi-Cal Coverage at Birth
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
0
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
212
85
medi-cal
other
Rate of CPS Involvement:
Maternal Race / Ethnicity
rate per 1,000
500
400
300
200
overall rate of 140/1,000
100
0
349
300
143
54
134
native am
black
hispanic
asian / pi
white
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Risk of CPS Contact (and 95% CI) by Race
and Medi-Cal Coverage at Birth
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Conclusion
• Birth records can be a useful source of information to view events and
outcomes from a public health perspective.
• Summary statistics (e.g., 14% of California’s children are reported to CPS
before age 5) can mask extraordinary important variation.
• Strong interactions may occur among variables of interest (e.g., race and
poverty).
• We must dig below the surface, and be wary of “facts” that hide the
information we really need to understand the populations we serve.
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley
Barbara Needell
[email protected]
510 290 6334
CSSR.BERKELEY.EDU/UCB_CHILDWELFARE
CENTER FOR SOCIAL SERVICES RESEARCH
School of Social Welfare, UC Berkeley