The way that children are treated in the US is a scandal. Despite all the talk of family values and Christian morality, the reality is that many children are treated poorly. One measure is that Infant mortality rates in the US are terrible given its wealth. Other indicators of concern for children are measures of pre-natal and post-natal care for mothers and children and the availability of low-cost quality day care.
In the United States, the most common causes of infant mortality are congenital malformations and disorders associated with low birth-weight and short gestation.
The fact that the United States has the highest infant mortality is not because of a lack of specialists or facilities for neonatal births; on the contrary, America has more neonatologists and neonatal intensive care beds per person than Australia, Canada, or the United Kingdom.
As with other health metrics, America’s relative performance is declining. In 1960, the United States had the twelfth lowest infant mortality rate in the world. By 1990, we had dropped to twenty-third, and we sank to thirty-fourth in 2008. Our high infant mortality rate evidences the economic, ethnic, and racial disparities referred to earlier. For example, in 2005, African-American infants suffered a death rate of 13.63 per 1,000 births, more than twice the national average. The CDC’s 2004 world rankings indicate that an African-American baby would have a better chance of survival if born in Russia or Bulgaria than in the United States.
The problem in the US is, of course, that people cannot afford to access these services because politicians don’t really give a damn about providing poor people with good health care.
The continuing cuts in funding for health care and in aid to needy families have had serious adverse effects on the welfare of children. So it was a welcome change to read Aída Chávez and Ryan Grim’s account of something that passed in Congress with little notice because it was tucked into the recent legislation to keep the government open that changed the existing system in which children are taken away from their families (where their situation was not good) and placed in foster care group homes (where it might be even worse).
They describe the problem that case workers faced in which they had to choose between two unpalatable options.
Imagine the situation from the perspective of a caseworker: you see a parent struggling with her housing situation, holding down several low-paying jobs and perhaps you suspect some substance abuse issues. There are pamphlets you can hand out, organizations like food pantries or diaper banks you can recommend for some elementary services, but beyond that, what can you do?
The sole significant action available is to break the family up and put the child in foster care, stuffing them in a group home. If you don’t and something goes wrong, it’s on you. If you do put the child in a group home and something goes wrong, well, that’s the fault of the group home.
The new law balances that incentive by giving case workers some meaningful things they can actually do. Now they’ll be able to offer addiction treatment and counseling, parenting support services or moving the child in with close family. The latter option — allowing the child to live for a time with grandparents or aunts and uncles — has long been the most common sense approach, but has never been truly supported or encouraged by public policy. Now, with the Family First law, it is.
The law also takes some practical steps not to set up new disincentives. Much of government action on the ground level is driven by how it influences funding flows. In order for a state to recoup federal money for foster care services, for instance, there are income thresholds involved. (Not many rich children wind up in foster care, but it’s part of the law nonetheless.) The new law says that if a child’s relatives attempt to take the child in and for whatever reason it doesn’t work, the child is still eligible for federal support. If that weren’t made clear, case workers might be reluctant to let a grandparent try to take a child in, for fear that the time spent with a relative with a higher income would make them ineligible for federal help down the road. Those are the kinds of backwards incentives that had long been a blight on the country’s foster care system, but are finally being addressed.
Children are taken from their families in cases of abuse but more often than not, Sandy Santana, executive director for Children’s Rights said, kids enter the foster care system because of neglect that stems primarily from issues of poverty or substance abuse.
“With the opioid epidemic, more and more kids are coming into the system because their parents are dependent on opioids,” Santana said. “For the government now to redirect funding for substance abuse and preventative services to keep those kids that are at risk of entering foster care with their families is a big, big deal.”
The Family First law also incorporates rigorous assessments to make sure that a child actually has a continuing need to be in a group facility and if not, the child is sent back to a family foster home so they don’t languish in group care.
Of course there was opposition to this measure from the institutions, some of them Christian, that run group homes.
The Baptist Children’s Home of North Carolina, along with other providers across the country, voiced objections this time around too. Most of the resistance to foster care reform came from group home networks — the legislation would reduce the number of kids entering the system, therefore, interfering with their revenue model of stowing away children.
It is nice that once in a while, the government does something good for people other than themselves and their rich friends.
It would be even better if Congress did something to prevent so many people from being put in prison when their crimes pose no danger to society, such as the possession of small amounts of marijuana for personal use, because the incarceration of these people has devastating effects on the families they leave behind. That is another system that, like the children foster group homes, favors the interests of private businesses, in this case the private prison complex.