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Introduction The U.S. Affordable Care Act Medicaid expansion, which allowed states to expand Medicaid coverage to low-income adults beginning in 2014, has reduced the risk factors for child neglect and physical abuse, including parental financial insecurity, substance use, and untreated mental illness. This study examines the associations between Medicaid expansion and the rates of overall, first-time, and repeat reports of child neglect and physical abuse incidents per 100,000 children aged 0–5, 6–12, and 13–17 years. Methods The 2008–2018 National Child Abuse and Neglect Data System was analyzed using an extension of the difference-in-differences approach that accounts for staggered policy implementation across time. Owing to evidence of nonparallel preperiod trends in the 6 states that expanded Medicaid from 2015 to 2017, the main analyses included 20 states that newly expanded Medicaid in 2014 and 18 states that did not expand Medicaid from 2008 to 2018. Analyses were conducted in 2020–2021. Results Medicaid expansion states were associated with reductions of 13.4% (95% CI= −24.2, −9.6), 14.8% (95% CI= −26.4, −1.4), and 16.0% (−27.6, −2.6) in the average rate of child neglect reports per 100,000 children aged 0–5, 6–12, and 13–17 years, per state-year, relative to control states. Expansion was associated with a 17.3% (95% CI= −28.9, −3.8) reduction in the rate of first-time neglect reports among children aged 0–5 years and with 16.6% (95% CI= −29.3, −1.6) and 18.7% (95% CI= −32.5, −2.1) reductions in the rates of repeat neglect reports among children aged 6–12 and 13–17 years, respectively. There were no statistically significant associations between Medicaid expansion and the rates of physical abuse among children in any age group. Conclusions Insurance expansions for low-income adults may reduce child neglect.

Family violence, including child maltreatment (CM) and intimate partner violence (IPV), plagues far too many American families, particularly those in low-income communities. CM and IPV are intertwined and impose a significant emotional, health and financial burden on children and families and an economic burden on our country. Although these and other forms of violence are influenced by shared risk factors across the socioecological spectrum, prevention efforts typically intervene on a single type of violence at a microsystem level via individual or family intervention. Research is needed to identify policies operating at macrosystem levels that reduce, at scale, multiple forms of violence affecting children. In this paper, we propose a three-step theory of change through which health insurance expansions might reduce rates of CM and IPV, using Medicaid expansion as an exemplar. The proposed framework can inform research examining the link between health insurance and the primary prevention of CM and IPV.

Purpose The aim of this study was to improve understanding of long-term socioeconomic consequences of teen parenting for men and women. Methods Analysis is based on the Woodlawn Study, a longitudinal study of an African-American cohort from a socially disadvantaged community in Chicago; data were collected at childhood (N = 1,242), adolescence (N = 705), young adulthood (age 32 years, N = 952), and midlife (age 42 years, N = 833). This analysis focused on the 1,050 individuals with data on teen parenting. We used propensity score matching to account for differences in background characteristics between teenage parents and their peers and used multiple imputation to account for differential attrition. Results The regression models after propensity score matching showed that at the age of 32 years, in comparison to nonteen mothers, teenage mothers were more likely to be unemployed, live in poverty, depend on welfare, and have earned a GED or completed high school compared to finishing college. At the age of 32 years, teen fathers were more likely to be without a job than nonteen fathers. At the age of 42 years, the effect of teen parenting for women remained statistically significant for education and income. There were no significant associations between teen parenting and outcomes for men at the age of 42 years. Conclusions Socioeconomic consequences of teenage parenting among African-Americans from disadvantaged background seem to be primarily concentrated in women and persist throughout adulthood. In addition to promoting the delay of parenting after the teenage years, it is critical to provide programs at early stages in the life course to mitigate the negative socioeconomic consequences of teenage motherhood as effects for women are broad.