Summary: Researchers report that the Child Tax Credit not only reduced child poverty, but that the 2021 expansion’s monthly payments were associated with a short-term decline in child abuse and neglect-related emergency department visits.
Source: Georgia Institute of Technology
Previous research has shown that the 2021 expansion of the federal Child Tax Credit (CTC) lowered childhood poverty, improved food security, and helped families stabilize their finances.
A new study led by Lindsey Rose Bullinger, Assistant Professor at Georgia Tech’s School of Public Policy, adds to this evidence by finding that the expansion’s monthly advance payments were also associated with a temporary reduction in child abuse and neglect (CAN) cases presenting to emergency departments.
Published Feb. 16 in JAMA Network Open, this is the first study to examine how unconditional income—delivered as advance CTC payments—relates to changes in child abuse and neglect. The authors compared emergency department visits at Children’s Healthcare of Atlanta (CHOA) in the days immediately before and after the CTC disbursements and against the same calendar periods in years without such payments.
“This research strengthens the case that income-support policies—like an expanded child tax credit, broader tax credits, and higher minimum wages—help parents protect their children by reducing financial strain,” Bullinger said. “Policymakers and child advocates should consider these effects when designing benefits that support families.”
After payments, fewer emergency room visits
To reach their conclusions, Bullinger and co-author Angela Boy from CHOA’s Stephanie V. Blank Center for Safe and Healthy Children evaluated pediatric emergency department visits identified as related to child abuse and neglect. They focused on the fall of 2021, when the expanded CTC sent monthly advance payments—up to $300 per child—to an estimated 38 million U.S. families.
The study found that in the four days following each monthly payment, the hospital system recorded, on average, 1.13 fewer daily cases of child abuse and neglect compared with the two weeks preceding payments. In contrast, during the same periods in 2018 and 2019 (years without advance CTC payments), cases rose by about 0.65 per day as the month progressed.
Researchers have long linked financial hardship with a higher risk of child maltreatment. What this study contributes is evidence that unconditional cash transfers can have an immediate, measurable association with reductions in abuse and neglect cases—consistent with the idea that these payments eased material hardship, lowered parental stress, and temporarily improved family functioning.
The authors note, however, that the protective effect was short-lived: reported abuse and neglect visits generally returned to roughly pre-payment levels after about four days. Still, the study observed stronger reductions in the last three months of the six-month CTC expansion, which may reflect cumulative benefits from repeated monthly payments.
What policymakers need to know
This research adds to growing evidence—alongside studies on minimum wage increases and expanded access to food assistance—that modest increases in family income from direct benefit programs can reduce child maltreatment. The authors emphasize that changes to income-support policies can influence child safety even over short timeframes.
“Because child abuse and neglect impose substantial long-term costs on children, families, and society, even small policy improvements that reduce exposure to maltreatment could yield meaningful benefits over time,” Bullinger and Boy wrote.
They recommend that lawmakers consider child abuse and neglect prevention as an explicit objective when debating the design, duration, and permanence of unconditional payment programs such as the Child Tax Credit.
About this psychology and childhood abuse research news
Author: Press Office
Source: Georgia Institute of Technology
Contact: Press Office – Georgia Institute of Technology
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Original Research: Open access. “Association of Expanded Child Tax Credit Payments With Child Abuse and Neglect Emergency Department Visits” by Lindsey Rose Bullinger et al. JAMA Network Open
Abstract
Association of Expanded Child Tax Credit Payments With Child Abuse and Neglect Emergency Department Visits
Importance
Poverty is a well-documented risk factor for child maltreatment. Recent studies indicate that income-support policies can lower rates of abuse and neglect, but when income support is tied to employment it is difficult to isolate the effect of income itself from employment-related factors.
Objective
To estimate the short-term association between universal, unconditional income payments to parents and child abuse and neglect.
Design, Setting, and Participants
This cross-sectional study leveraged variation in the timing of the 2021 expanded CTC advance payments to assess whether receiving unconditional income was associated with changes in child abuse and neglect. Using a fixed-effects approach, the researchers compared CAN-related emergency department visits before and after payments in 2021 and contrasted those trends with the same calendar periods in 2018 and 2019, when no such payments occurred. Participants were pediatric ED patients identified as experiencing child abuse or neglect at a level I pediatric hospital system in the southeastern United States from July through December 2021. Data were analyzed from July to August 2022.
Exposures
Timing of disbursement of expanded CTC advance payments.
Main Outcomes and Measures
Daily emergency department visits classified as related to child abuse and neglect.
Results
During the study period there were 3,169 CAN-related ED visits. The 2021 advance CTC payments were associated with fewer CAN-related ED visits in the four days following disbursement, though the overall reduction was marginally non-significant (point estimate, −0.22; 95% CI, −0.45 to 0.01; P = .06). Significant reductions were observed for male children (point estimate, −0.40; 95% CI, −0.75 to −0.06; P = .02) and non-Hispanic White children (point estimate, −0.69; 95% CI, −1.22 to −0.17; P = .01). These declines did not persist beyond the short-term window after payments.
Conclusions and Relevance
The findings suggest that federal income supports delivered directly to parents are associated with immediate reductions in child abuse and neglect-related emergency department visits. These results are relevant to policy discussions about making temporary expansions of the Child Tax Credit permanent and inform broader debates about income-support programs designed to protect children and families.