Child abuse rates dropped during COVID — the reasons point to economics

When the COVID-19 pandemic struck and America went into lockdown, child welfare systems across the country grew concerned. Calls to child abuse hotlines plummeted and child welfare leaders sounded the alarm, suggesting that the steep decline in reports was a sign that an unseen epidemic of abuse was spreading behind locked doors. As one reporter described it: “While much of the city has been staying indoors and ‘staying safe,’ for many children from troubled homes, the coronavirus pandemic has confined them to the most dangerous place they can be.” 

The shift to virtual schooling fueled these concerns. Education personnel is responsible for 20 percent of all child abuse hotline reports during the school year. And teachers no longer had the ability to see children in person and spot the signs of abuse and neglect that they are obligated to report.   

But then something unexpected happened. Child abuse and neglect rates did not go up across the United States. Research published by two of us in JAMA Pediatrics found that the rate of child abuse emergency department visits actually declined in the early months of the pandemic, from an average of 1,000 a month to a low of 400 a month in March 2020. Hospital admissions for child abuse declined sharply.  

Other researchers reported drops in hospitalizations of infants for abusive head trauma.  Reports to child welfare agencies fell by 40 to 60 percent, a far steeper drop than could be accounted for by school closures.  

What explains this missing child abuse epidemic? It’s simple: prevention works. 

The pandemic demonstrated the positive impacts of addressing family needs rather than removing children from their families after disaster strikes. When the pandemic began, many parents struggled to keep their families safe. Many faced job loss, health issues and the disruption of routines. In March 2020 and March 2021, Congress passed COVID relief bills that provided timely, meaningful support to offload this stress and lessen the impact on families. These investments reduced economic stress, which had a measurable impact on protecting children from both abuse and neglect.  

Research has found that spending on public benefit programs such as cash assistance, housing, child care, the Earned Income Tax Credit and Medical Assistance Programs is associated with a reduction in child welfare system involvement and child fatalities due to maltreatment. Chapin Hall’s analysis of the relationship between economic and concrete supports and child maltreatment and child welfare involvement confirms this, noting: “Research suggests poverty is a key driver of child welfare system involvement . . . even modest economic supports can stabilize families and alleviate the need for more intensive intervention.”

Which of the COVID-era supports made the biggest difference? A 2020-2021 survey of 9,000 U.S. parents found that nearly half of U.S. families received assistance with basic needs. Stimulus checks and child tax credits dramatically reduced childhood poverty. Unemployment insurance payments and eviction moratoriums stabilized housing for many. Communities and nonprofit organizations stepped up as well. School bus drivers delivered food to children who missed their school lunches. Nonprofits turned office space into food pantries. Teens helped get food to the elderly, and adults found ways to preserve their family ties. 

With these supports in place, families did not just make it through COVID, they got to enjoy time spent at home with each other. In the survey, parents reported that they read books, cooked, told stories, went for walks, played outdoors, watched TV, or played video games with their children. Even while acknowledging extraordinary stress, most families found that the pandemic brought them closer. 

The drop in abuse and neglect rates also illuminated the flaws in our system of mandatory reporting. The experience during COVID, when kids saw fewer mandated reporters such as teachers, shows mandatory reporting is not the end-all-be-all solution to child and family well-being. The evidence that racial disparities affect our current mandatory reporting process and child welfare system has been accumulating for years. One study shows that more than half of Black children and more than one-third of all children in America are the subjects of a child abuse or neglect investigation by the age of 18. In contrast, another study reports that Black adults are less likely to recall that they experienced child abuse than white adults. This racial disproportionality could be the result of our society’s tendency to blur the lines between abuse and neglect and economic instability.  

The charge of neglect, which accounts for the majority of families involved with child protective services (CPS), is driven by persistent poverty or, as was the case during the pandemic, temporary economic shocks, such as a job loss or health issues. Both of these conditions can lead to unaddressed substance abuse, mental health problems, domestic violence and other family stressors. Rather than CPS involvement and family separation, these families need resources that could enable them to weather the storm and keep their children safely in the home. 

We have an opportunity to put the lessons from this pandemic to work to reduce child abuse and neglect, reform child welfare and mandatory reporting and address systemic racial inequities.  

Three federal programs are due for reauthorization by Congress this year and can help to make community-based prevention more of a priority. They include the Child Abuse Prevention and Treatment Act (CAPTA), Title IV-B of the Social Security Act, and the Maternal Infant and Early Childhood Home Visiting (MIECHV) program. The Temporary Assistance to Needy Families Program (TANF), with its statutory goal of supporting needy families so that children can remain safely at home, is also due for reauthorization, and Congress could ensure families receive the resources they need upstream, prior to intrusive and costly CPS interventions. Other critical supports to families are the expanded Child Tax Credit, paid family and medical leave, behavioral health services and quality childcare.  

This pandemic has taught us that child adversity, such as abuse and neglect, is a public issue, a solvable issue and a preventable issue. We know that parents love their children and that families are our greatest asset in ensuring that children are safe and healthy. Concrete and economic supports can help even the most overloaded parents overcome adversity and help their children thrive. A child and family well-being system that supports all families in getting their needs met should be our goal. It is an achievable goal, a collective responsibility, and one we invite everyone, especially Congress, to join us in pursuing.

Robert Sege, MD, Ph.D. and Allison Stephens are part of the HOPE National Resource Center at Tufts Children’s Hospital and Tufts Medical Center and co-authors of the report, “Child physical abuse did not increase during the pandemic.” Sege is a senior fellow at the Center for the Study of Social Policy in Washington D.C. and professor of pediatrics and medicine at Tufts University School of Medicine. Stephens is director of networks, communications and policy at Tuft’s Center for Community-Engaged Medicine. Amy Templeman is director of Within Our Reach and director of Practice Excellence at Social Current. She previously served as executive director of the federal Commission to Eliminate Child Abuse and Neglect Fatalities.