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Study Links Poverty & Fatal Child Abuse

Around one in five children in the United States lives in a family with an income that falls below the poverty line. Growing up in poverty has long been associated with a laundry list of negative outcomes for kids: poor health, lower test scores and graduation rates, increased risk of involvement with the juvenile justice system, and lower earning potential once they reach adulthood, to name some of the worst. But new research published by the American Academy of Pediatrics suggests that living in a poor neighborhood may have serious implications for children’s basic safety. Boston University researchers have released a study linking poverty and fatal child abuse — with some babies facing a risk of not surviving infancy as much as three times higher than their peers in wealthier neighborhoods.

It's disheartening. But while even one child dying at the hands of a caregiver is one too many, using these data to draw conclusions about poor families only serves to vilify them —and ignores decades of outside research about the systemic nature of poverty itself.

For starters, the study itself wasn’t focused on poor families. Published in the May issue of Pediatrics, the researchers pulled available data on community living conditions rather than those in individual households. The researchers examined whether living in an impoverished community — neighborhoods where 20 percent or more residents earned poverty-level incomes — was associated with a change in the rate of children suffering fatal abuse.

What the study found was alarming: Between 1999 and 2014, a total of 11,014 children died as a result of child abuse. Nearly half of them (45 percent) had not yet made it to their first birthday. Fifty-six percent were boys, and 58 percent were white. As for the relationship between concentrated poverty and fatal child abuse, they found that counties with the most poor residents had more than three times the rate of child abuse fatalities compared with richer counties.

But because the research focused on the entire neighborhood, rather than the individual households, it’s impossible to know whether the incidences of fatal child abuse happened in the poorest households. Did the children who died in the study actually live in low-income families? Or could the rates of abuse be driven by other factors — poor community resources, low employment prospects, high parent stress and maternal depression levels — that speak to the climate in the entire community, not just their homes? It’s simply not clear.

Other research suggests that disparities in the whole environment are behind why so many poor infants are at greater risk of infant death. In short, the brutal levels of stress associated with living on the economic edge — including the high levels of housing instability, the substandard medical care that women of color get in pregnancy, and the high rates of maternal depression in poor communities — have combined with unequal treatment at an institutional level to create a dangerous environment for poor infants and a health crisis for poor infants of color in the United States The overall result is that the United States remains one of the most dangerous countries in the world for infants.

Because babies are so vulnerable and require such care, we tend to gauge how our society is doing by how our infants our faring. And by all measures, America is falling behind. The National Center for Health Statistics reported that in 2013, around six out of every 1,000 babies died at birth or in the first year of life in the U.S. — triple the rate of Norway or Japan and double the rate of Ireland, Israel or Italy. And sadly, as many as five children die each day from abuse or neglect, according to the Child Welfare Information Gateway.

But while the simple narrative might be to point to pick apart individual families to explain why so many babies are at risk, poverty isn’t so simple. Just as this latest study shows, to understand why so many babies are in danger, we have to look at our whole community. Blaming individual families doesn't help anyone — and it doesn't protect babies.