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Study finds increases in child welfare reporting and racial inequities

Legislators have passed laws that police and regulate pregnant people's use of drugs and alcohol with the goal of protecting the health and safety of babies. These laws include reporting requirements to child welfare agencies that medical providers must follow. Researchers are learning that these targeted policies do little to improve infant health outcomes, and may, in some cases, create more harm.

Now, new data shows how rates of these child welfare investigations have doubled in the last decade, with racial inequities persisting as more than two times as many Black than White infants investigated.

Findings show:

Between 2010 and 2019, the rates of investigations stemming from medical professionals’ reporting doubled, while rates for other mandated reporters such as teachers and police remained stable.
The research underscores how racial inequities in these investigations persist with more than two times as many Black than White infants investigated.
Rates of these investigations varied greatly from state to state, with one state (Minnesota) having an increase of almost 80%.
Racial inequities in reporting persisted over the decade – in 2019, child welfare investigated 1 in 18 Black (5.4%) infants, 1 in 31 Indigenous infants (3.1%), and 1 in 42 white infants (2.5%) stemming from medical professionals’ reporting.


In a post-Roe era of heightened surveillance and criminalization of pregnant and birthing people, this research points to a troubling phenomenon, despite research showing that increased child welfare system involvement does not improve children’s health. Increased child welfare investigations may contribute to broader health inequities for Black birthing people and infants, as well as other groups.

“Medical professionals concerned about increases in reporting can review recent research on the impact of child welfare reporting, particularly in relation to parental substance use and reflect on the possible consequences of overreporting to child welfare, as well as what their roles might be in reducing overreporting."

The article, Medical Professional Reports and Child Welfare System Infant Investigations: An Analysis of National Child Abuse and Neglect Data System Data, is available in Health Equity.

Health professionals interested in reducing overreporting can take this free self-paced video course.