Keeping Kids Safe: Addressing the Upstream and Downstream Drivers of Child Well-Being

About 10 years ago, when I first moved to the Washington, D.C., area, there was a mix up with my 8-year-old son’s afterschool care. Instead of going to his afterschool karate program, the school put him on a bus headed home. My husband and I were at work, at least 30 minutes away, but we dropped everything and rushed home to meet him. 

On my way there, I called the non-emergency police line and asked them to send a patrol car to look for our son and keep him safe until we could get there. After hanging up with the police, I felt slightly less worried about our son roaming the neighborhood, scared and unsupervised. My husband, on the other hand, panicked.

He assumed that the police would call child protective services and that would launch an investigation into why we did not properly care for our son. When my husband was growing up as a Black man living in poverty in the Bronx, New York, involvement by child protective services was common and feared. The fear and distrust of systems charged with protecting children stayed with him decades later.
 

Complex Drivers, Abundant Challenges

In my family’s case, everything worked out—a police officer sat with my son until my husband arrived. Still, I can’t help but wonder what the outcome would have been had we lived in a different neighborhood, or had not proactively asked for help, or had to leave our son alone because of an unavoidable gap in child care. Data and the experiences of so many families of color suggest that our story could have ended differently had any of these circumstances been true.

The factors that lead to involvement in the child welfare system are complex, and many of them are related to socioeconomics. Most child-welfare systems involvement is because of neglect, rather than abuse. State agencies commonly define neglect in ways that reflect the challenges of living in poverty, such as lack of access to food, clothing, and housing, otherwise known as upstream factors. I see similar parallels in my work in the health sector where social determinants of health play a significant role in a person’s well-being. Access to preventive, health promoting resources versus emergency care is often determined by the distribution of resources in and across communities. Lack of access to resources makes it difficult for people to thrive, contributes to health inequities, and increases stigma experienced by patients living in poverty in the health care system. 

At the same time, the challenges facing the child welfare system are abundant. Children and families of color are disproportionately over-represented in the child welfare system, and they have disparate outcomes. The conflation of poverty and neglect contributes to this disproportionate over-representation, which stresses the scarce resources in the child welfare system and contributes to high staff turnover. Other challenges include finding ways to expand the use of prevention strategies; expediting permanent, stable living situations; and adequately addressing the complex needs of children and families.

Panelists in a recent AIR webinar agreed that addressing the complex drivers of child welfare involvement can often be outside of the scope of well-intentioned, expert leaders and staff diligently working to keep kids safe. They also noted a growing recognition in the field that improving socioeconomic conditions is a strategy to prevent child abuse and neglect. In other words, strengthening the services of child welfare agencies or health care providers (i.e., downstream services) can have an effect on child and family well-being, but it will be limited without also focusing on upstream factors.

Simultaneously Working Downstream, and Upstream

AIR’s research and technical assistance efforts recognize the value of pursuing parallel upstream and downstream strategies to promote well-being for children and families.

Upstream efforts address the factors that may lead children to become involved in the child welfare system. For example, experts in our health and human services divisions developed training modules that communities can use to identify and implement evidence-based and promising upstream approaches that promote child and family well-being. Modules cover approaches such as conditional cash transfers, social safety nets, and increasing access to health care and early childhood education. AIR experts also evaluate programs that fund cash transfers, mentoring, social support, and career readiness training as strategies to prevent, and transition families from, involvement with the child welfare system.

On the other hand, downstream efforts are focused on the child welfare system itself. For example, AIR is providing support to the Los Angeles County Department of Children and Family Services in developing a manual for its Community Cultural Broker Program. The program pairs eligible African American families with a community cultural broker who helps families navigate the child welfare system and community resources to mitigate risk to child safety and build protective factors. Developing the manual for this program will allow other jurisdictions to adopt the program and brings the Department of Children and Family Services one step closer to becoming eligible to receive federal funding for the program.

This work aims to make it easier for families to care for their children by providing equitable, efficient, and evidence-based services to children who are truly at risk for severe adverse outcomes. It gives me hope for a future where we keep kids safe, stable, and with their families, where they can thrive.