Challenges in areas ranging from education to the environment, gender to governance, health to housing don’t exist in a vacuum. Each month, Abt experts from two disciplines explore ideas for tackling these challenges in our monthly podcast, The Intersect. Sign up for monthly e-mail notifications here. Catch up with previous episodes here.
The signs are there long before children enter the child welfare system, so how can we keep kids safe and families together? In this episode of The Intersect podcast, Abt’s Ginger Pryor (former head of child welfare in both L.A. County and the state of Georgia) and Whitney Rostad explain how real solutions to systemic failures can emerge from disaggregated data, community input, and silo-busting collaborations.
- Reaching Equity: Data, Collaboration, and the Social Determinants of Health
- Data & Racial Equity: How Do We Eliminate Bias from AI, Machine Learning, and More?
- Kids First: Systems, Health and Family Well-being
Read the Transcript
Eric Tischler: Hi, and welcome to The Intersect. I'm Eric Tischler. Abt Associates tackles complex challenges around the world, ranging from improving health and education to assessing the impact of environmental changes. For any given problem, we bring multiple perspectives to the table. We thought it would be enlightening and maybe even fun to pair up colleagues from different disciplines so they can share their ideas and perhaps spark new thinking about how we solve these challenges.
Today, I'm joined by two of those colleagues, Ginger Pryor and Whitney Rostad. Ginger works to create systemic solutions that help children and families avoid the need for deeper-end social services, such as child protection. Prior to joining Abt, she managed Los Angeles' child welfare system and, before that, the entire state of Georgia's.
Whitney is a researcher, using community-level data to show people the connection between social determinants of health and child welfare, and addressing how we can have more equitable outcomes.
Ginger Pryor: Thank you.
Whitney Rostad: Thanks for having me.
Eric: So, typically, we pair colleagues who work in seemingly disparate fields. But today we're going to talk about child welfare in the context of social determinants of health, which obviously encompasses a lot of different aspects of the work that Abt does. But more specifically, in this case, the two of you both provide technical assistance that, in theory, are at very different levels. There's that macro systemic level and then also what I'm going to call “micro” data level. So I'm looking forward to connecting all these dots. And I'm going to start with you, Ginger. Do you want to talk a little bit about the risks of child welfare involvement and what we're trying to solve for here?
Ginger: I think that there are a variety of factors that cause children to come to the attention of the child welfare system. When people think of child protection, they think of severe physical and sexual abuse. But the majority of children that come to the attention of our child welfare systems really are for neglect. And those issues stem around severe poverty, housing issues; those things that cause families to go deeper into our systems.
Really quickly, child protection agencies, they receive about 3.9 million referrals for child maltreatment, involving about 7.1 million children. And that's more than 19,000 children every day. Most of those reports are screened out and no further action is necessary. So data for both the front end and within the deep end of the child welfare system, some children are just much more at risk of child welfare involvement.
Again, when you get into deep aspects of deep poverty that causes families to become homeless; food insecurities, where children may be malnourished. So things like lack of supervision, families who are really dealing with issues around employment. They can't find appropriate daycare. You would think a parent is going out and they're trying to make sure that they can feed their child, but if you leave your child unsupervised, and then we get a call to our hotline, you're going to get a visit from the child welfare system, talking about lack of supervision and those things.
The last thing I would say is that, when we think about the families that come to the attention of our system, there's something that we talk significantly about, and that's disproportionality. And really what that means, is that we have lots of children, Black and brown children, that are disproportionately represented in a child welfare system.
So, for example, African American children make up about 14 percent of the child population in the United States, but they make up well over 20 percent of those entering into our child welfare system. So that's what we call disproportionality, because it's not equally represented across the general population. And the same with our Latino or Latinx children being disproportionately represented. And Native American children, while many feel that the population may be small and they represent 1 percent, they're double, twice that, in the child welfare system.
So these are some of the things that we need to think about with regard to disproportionality and what biases are steeped inside our system, what inequities are steeped in our system around race and poverty that play a role in removing children from their homes, and how these decisions really negatively impact the life trajectory of our youngest children who are more likely to come into the system than older children.
Eric: Right. So we're talking about equity here, and you just threw out a lot of figures that illustrate that. So we're also talking about data. Whitney, when you're hearing all this, this is obviously where you come in.
Whitney: So Ginger touched on a couple things that bring families to the attention of child welfare, in addition to potential decision-making bias that's present in the child welfare system. As somebody who takes a public health approach to child maltreatment and different types of violence prevention, if I were sitting down with Ginger, looking at her child welfare data, it would lead us to, I think, a question about: is it something about Black and brown families or parents that are putting them at risk of child welfare system involvement? Or is it something about the conditions in which Black and brown families are raising their children?
When we're looking at the data, the data is very clear that Black and brown families are entering the system disproportionately, compared to their white counterparts. So if we're in that traditional child welfare mindset, which has been about fixing parents, it might lead us to this question: well, what is it about Black and brown parents that put their children at risk? When, really, we want to shift that question to: what is it about the conditions in which they're raising their children? Because Black and brown families are more likely to be poor. They're less likely to own homes so they're more likely to experience housing instability. They're more likely to be involved with government programs.
This is driven by history. This is driven by historic policies set out by the government that have driven Black and brown families into areas of concentrated poverty, which has limited their ability to own homes, which then, again, puts them at risk of experiencing housing instability. All of which then put them at risk of being surveilled by all of these different government systems who are mandated reporters. And that leads them to the door of child welfare. And then child welfare is responsible for meeting needs that child welfare has never been prepared to meet, around poverty, housing, employment, things like that, education.
So, as somebody who has a background in public health and social determinants of health, I would want to look at the community-level data from which these families are primarily coming. So often, with child welfare data, we see that there are hotspots of where families are being reported from, where child welfare is doing a lot of investigations, where we see a lot of the removals. So, if we go and dig into the data in those communities, those communities often look very similar. There's a lot of poverty. There's a lot of housing issues, such as families spending a lot of their income on housing. They're more likely to be accessing different types of benefits, like SNAP and housing vouchers and other programs.
So, if I was a child welfare leader, what I would want to know is: how do I bring those partners to the table so that we serve families more upstream? Child welfare cannot do this alone, we need collective approaches to preventing child welfare involvement. And that means we need to bring our partners to the table.
So, if I were looking at a neighborhood, and Ginger told me, "This is a neighborhood where we do a lot of investigations ..." And as Ginger mentioned, a lot of those in investigations don't result in any services. Most of them tend to be screened out. Only about 20 percent of cases are typically screened in and actually receive services. So, if I was looking at that neighborhood where we're seeing a lot of investigations happening, I'm looking at the poverty rate. And then I want to know: what about SNAP? What are the SNAP uptake? What is the housing voucher uptake in that community?
Before I pass it on, I just want to also mention Ginger mentioned a lot about disproportionality. A lot of our community-level data can also be disaggregated by race and ethnicity. And we should be disaggregating our data because neighborhoods can overall look okay, the poverty rate might not be that bad, it doesn't seem like people are paying too much for housing, but when you break that data down by race and ethnicity it can really mask what's going on for certain groups. So some groups and neighborhoods can be faring worse than others.
Ginger: As a leader that has ran systems, what I found, the power of data and what it's showing me, is that Black and brown families are coming into the system at an exceptionally higher rate than their white counterparts. I need to be able to get underneath the hood to ask the question as to why. And oftentimes, when you look at the trajectory of a white family versus an African American family or a Latino family, Latinx family, an Asian American family--because there's the flip as well, too, in Asian communities, they're underrepresented in the system, and that has implications as well, too--is that: do we have what we call bias or implicit bias that's happening, where we say that, "Well, this African American family, they need to come in," because somewhere in our minds we may have a bias that somehow Black and brown families don't raise their children in the same way because we're looking at it through the litmus or what we call the white gaze on families?
So we talk about that a lot and use that language around what is happening with Black and brown families, and is there a difference? And when you get underneath the hood, there is no difference. When you look at the same neglect cases, what we're finding ... because the power really rests in the decision of a human. So yes, the call gets screened, decisions are made, checklists are gone through. But at the end of the day it's the individual that's knocking on that family's door, that's doing an assessment. And we are all carrying our bias with us. It doesn't matter, white, Black, brown, whatever, we all have bias that we can ... and are we putting that on families?
And what I've found, in my 30 years of working in child welfare, is that I've tracked trajectory. I used to be the president of Black Administrators in Child Welfare. And we track the trajectory of children. We track white families and we track Black families. Same allegations, but, interestingly enough, white families were receiving services in their homes and Black children were being bought into the system. But yet, there was no differentiation between the allegation.
So, as a leader, you're left with: well, why is that then? If there's no difference in the allegation and they are even coming from similar neighborhoods, why is the white family getting services in the home but you're bringing that Black child in? So it's this issue of housing instability and economic instability is sweeping across this country, and it is affecting families astronomically. But again, we are still finding that, even with similar conditions, Black and brown families are still coming into the system disproportionately than their white counterparts.
Eric: Thank you both, that's a great example of both the context in which we're operating and the need for data. It's also an example, then, of how the system can work or not work. We just talked about bias in data and bias in terms of the people who are meant to be operating this system, and how does that bias play out within the implementation of the system. And then Whitney was talking about housing vouchers and SNAP. So we're talking also about different systems that operate in and around the child welfare system and how they are or aren't coordinating together. So I'm going to go back to you again, Ginger, if you don't mind, and ask how do we get systems to work together? How do we improve the implementation of systems?
Ginger: Sure. There's a saying, in my other life at Casey and other places: there's no data without stories and no stories without data, right?
Eric: Mm-hmm (affirmative).
Ginger: So using data is powerful. As a leader, you need it. You want to be able to have this understanding of what is happening in the communities that you're called to serve. At the same time, you need to incorporate the power of folks that have lived experience, that are living that, and educating them about, "This is what the data is saying. And let's talk about what is happening in your respective community. How do we work collectively, together?" I always like to say, "What is the opportunity that we're solving for?" I think sometimes it's framed as a problem. But I like to frame it as an opportunity because I think that, as a leader, we have this moment where people can own their own transformation. I think that's when you start to see systems move.
I'll give an example. Oftentimes, as a leader, people will think that I can just make a technical solution: we'll just hire more people and this will happen. It's a swipe of the pen. As long as you sign on, this transformation is going to happen, and you can make this data different if you do that. But then there are these adaptive things that are more behavioral issues, in terms of, as we talked about earlier, how people think about individuals who come to the attention of the system. Am I equipping my workers in a way to activate behavioral change when they're out there doing the practice? And then what's happening in communities where, if a family has grown up with generations and generations of poverty, then what are going to be some of the adaptive solutions that we need to work on together to change that trajectory so that we can break that cycle of poverty, so that when we move forward, we can mitigate the next generation of children coming into the system?
So, with that, when I was in Georgia I was able to work with folks like Whitney to take the data that we had, work in partnership with the community. Also, I had the privilege, when I was in Georgia, that I ran both the systems. So I not only ran protection, but I ran supplemental nutrition assistance program as well as temporary assistance for needy families. And we found that the majority of the families that were coming into the protection side were already sitting in the SNAP and TANF side. So we created something called State of Hope, where I went to all 159 counties that sit within Georgia and really started designing, together, solutions that each of the communities wanted to own.
With that, we found that there were really four levels that families were focused on and concerned about: quality parenting and caregiving. They were focused on education. They were focused on economic stability, as well as housing stability. So, with that, we designed solutions that the families with lived experience were requesting. Then we provided seed grants and funding to help accelerate those solutions or opportunities that families wanted to lift up. And we called that a State of Hope. And that is something that still exists today, in Georgia.
The last thing I'll say is that one of the very specific things that came out of it was in Rome, Georgia. So Whitney talked about housing and this issue of poverty. What we were noticing from the data was that there was an exorbitant amount of calls coming from this one area in Rome. And that area was the area where there were two public housing sites. So when the families came together and talked about what their needs were, there really needed to be ... you can call them a family resource center, this collective one-stop shop where families could get services around food insecurity. So there was a food bank, where we took an abandoned school, we provided the resources for the abandoned school, and all of the entities co-located there. Protection co-located there. CASA--Court Appointed Special Advocates-- were housed there. Food banks was housed there. Clothing banks were housed there. As a result of that, we saw a significant reduction of calls coming into our system. I think, when we do that kind of work and we have folks with lived experience and others coming to table to do collective impact, this is how we can change a trajectory of people going deeper into systems.
Eric: That sounds like the upstream solution that Whitney was talking about earlier. And Whitney, it looked like you were going to say something?
Whitney: I want to just respond to ... Ginger's example is great, that's what I was getting at, that I often can look at neighborhoods and their community-level data, and 90 percent of the time I can predict what the child welfare data looks like for that. Because it's just so predictable, because poverty is such a huge driver of child welfare and other government systems' involvement. But then there are neighborhoods where the data doesn't look great, but yet the child welfare data looks okay. There's actually not a lot of reports. There's not a lot of investigations happening there. And that's because there's a lot of social support and resources in those communities that maybe the publicly available data can't speak to.
I want to give an example, because I love Ginger bringing up “no data without stories and no stories without data.” This community-level data represent the experiences in a neighborhood. So we want to use that data to really target our resources. But then once we know what neighborhoods we think would benefit from resources, additional resources, we need to go into those neighborhoods and ask the families what they want. What do they need? Where would they like to access services? Because if we go in and locate services at a child welfare office or some other kind of social service system that they don't really want, the stigma of accessing those offices, they don't want to be seen accessing those offices, we're never going to have the service uptake that can potentially have huge benefits to our downstream systems, like child protection.
So in Florida, for example, they've used community-level data to think about what neighborhoods would benefit from a family resource center. They identify those neighborhoods and then they go into those neighborhoods and they ask families, "Where would you want to access services?" And those families said, "Libraries." They said, "That's somewhere that our family spends a lot of time.” It's not stigmatizing to be accessing a library. And it's very convenient for those services to be co-located there for families to access. If they had just gone in to that neighborhood, they bought a building or they put services somewhere, like a TANF office for example, they probably wouldn't have seen the uptake of services like they did when they co-located them at libraries.
Eric: So we're talking about lived experience, and we're talking, again, about data, and we're talking about making changes to the system at the community-level. So how do we think about making systemic changes upstream, using that community-level data and approach?
Ginger: I think when you are at the local level, each time you go to a local community the learnings and the transformation that happens there then rolls up to a larger opportunity to make decisions around systems-level change, policies and things that are negatively impacting families. But sometimes, as a leader, you think you're making the right decision, you take a regulatory law that comes down from the Feds. You still have to interpret the spirit of that law and how you're going to implement it right in practice. And you think that you're doing the right thing, and then you inadvertently are negatively affecting families. But how you learn about changing that is transformation happening locally. What's the statement? “Think globally, but act locally.” So it's like, as a leader, I'm thinking at the systems-level, but I also have to think about whatever transformation I'm trying to make at the larger systems-level. I have to start locally, because I have to test it, I have to know if it's going to work. And I have to have that continuous quality feedback loop from community. So I do things like making sure that folks with lived experience are a part of how we move policies forward. No policy in Georgia moved forward without the vetting of those with lived experience. They were a part of that before we issued policy out. I took that and moved that to L.A. as well. I do think you have to make those small tests of change and then elevate that back up at the 30,000 foot, and then ask yourself: how is that going to change, again, policy? Translating that to practice. And then translating that, ultimately, to hopefully positive outcomes for the families that you're trying to serve.
Eric: So we're talking about leveraging lived experience, we're talking about co-locating services. What are some other best practices that we might want to talk about?
Whitney: As I mentioned, I'm a public health person. So when I'm thinking about: how do we serve families and children most effectively and how do we reach as many families and children as possible? we're not going to see the huge movement that we need to see in the child welfare system if we don't move completely upstream. Economic supports are essential; the earned income tax credit, the child tax credit. We've seen a lot of economic supports in response to COVID. And we know that those types of supports have huge implications for families' economic stability, which we know is a huge protective factor for child welfare system involvement.
People think of child protection and they think of child and sexual abuse, when the majority of our cases are neglect. And we haven't seen rates of neglect change in 30+ years. And that's because, as a society and as a country, we've never demonstrated the political will to address poverty issues. So the best anti-poverty policies we have, we know that they're effective at reducing child welfare involvement. We don't know whether they're equally effective for all subgroups because we just haven't done those types of evaluations yet.
We really need a lot more research around what policies and programs support the conditions that promote health and wellbeing and prevent child welfare involvement. We know a little bit about economic support policies. But a lot of the economic supports we saw in response to COVID, those provided a lot of very interesting natural experiments, [from] which I think we're going to see a lot of interesting research come out in the next coming years.
I'll also say, Ginger's talked about transformation a couple times. I do want to make sure we lift up that there is really a reckoning happening in child welfare. There's been a lot of talk about this unprecedented opportunity we have in response to COVID to really change how we serve children and families. Systems are increasingly trying to adopt a public health approach, and that means they need to partner with other systems. And that also includes families with lived experience. We really want them leading these solutions and we want them to tell us what they need and how to best meet those needs. So I think it's a really exciting time to be working in child welfare, but there's a lot we still need to know about how best to serve children and families in their communities.
Eric: So you mentioned partnering with systems again, partnering between systems, which I think brings us right back to Ginger again. Ginger, how about you? Whitney you just talked about how we need more data, we need to learn more things. What do you feel like you need to do on your side of the fence to grow more and implement more solutions?
Ginger: Yeah. I think obviously, again, yes, the data is critical, research is important. And that research has to be turned into action. We can't be paralyzed by navel-gazing the situation, we need that, but then we have to turn that into action. So, with regard to the practice components, I think that there are a couple of things. In L.A., looking at research and things that have been done, lots of conversation and studies and data around equity. But then, what do you do with that? So one of the things that we did in L.A., was we took a look at the data and what was happening. There were about eight of our regions in LA that had the most significant disproportionality. I mean, I'm talking about Black children coming into the system six times more than their white counterparts, where it was stark.
So, with that, we decided to create this step in-between when you receive the call and before we are activating families coming in, that we were creating these multidisciplinary teams that were really checking even the smallest amounts of bias. So if a worker says, "Well, we need to do this because that mom is not compliant." Okay, well, how is she non-compliant? Let's sit down and talk about: what does that mean to you? And is that really non-compliance or we not taking into account that you did just knock on this parent's door and you do have the ability to remove this mother or this father's child? Could it be that the mom or the father is in distress? And how do we help workers take a beat before we just react and make decisions about removing children unnecessarily? And really start breaking down: why are we saying a thing? Why are we labeling families in certain ways? And really walking through that practice and then partnering supervisors with these multidisciplinary teams before final decisions were made.
We implemented that practice in L.A. and, within less than six months, we saw a 60 percent reduction in the number of African American children coming into those eight regional offices.
Ginger: So those are the types of things. Now, can it be sustained? I can't answer that question yet. But what I can say is that, in that moment, by shifting the way we practice, by being informed by the research and doing something about it, we significantly changed the trajectory of children coming into the system.
I really think the biggest issue is that we’ve got to share a space. You can't keep bringing children into protection and then telling child welfare systems to handle it, when the very reason that the child is coming into the system is because of what Whitney's talking about. Housing has a role to play in this, TANF and all of those other systems have a role to play in this.
When families have food insecurity or they're living in service deserts, and those things like that, protection was designed to do just that: severe allegations of neglect and severe abuse and sexual abuse cases. They were not designed to provide those type of supports that should be happening in communities because those other systems were set up. So how do we share that space and share that ownership so that we can make collective decisions around the things that can transform the way in which people experience living in their communities, developing more assets in communities, so that protection systems can really then focus on the most egregious of child abuse or neglect cases?
But right now, our system is flooded. So it's almost like we focus on one thing and then we forget about all the other things. It's Maslow's hierarchy of need, you can't do other things if families don't have a house and they can't eat and they can't clothe their kids, we can't start talking about other levels of transformation. So I think those are the things that we have to start dealing with and having this collective impact and sharing power, making those deeper connections, mobilizing effort. And then those are the things that lead to ultimate transformation of systems.
And there are small systems across the country where those things are happening: Nebraska, L.A., San Diego, Georgia, just to name a few, are some systems that are doing that collective impact work or that boundary spanning leadership that's really changing the trajectory for families, because they're dealing with all of the social determinants of health that will then ultimately mitigate deeper involvement in systems.
Whitney: There's so much I want to talk about in response to Ginger's comments, because she's articulating a public health approach so well. It's not about just having housing, it's also about having the supports to sustain that housing, ensure that housing is safe, and budgeting. There are so many other things; I talked about the earned income tax credit and economic supports--it's not about just giving families money either, it's about having comprehensive community services that are available to these families. Money certainly helps, but it's not everything. A public health approach is a both/and. We need policies and programs that create supportive conditions so families can do their best at raising their children. And when they are struggling, we also need individual programs that can reach those families before they dive deeper into crisis.
I think there's so much that goes into a public health approach that's so relevant to child welfare. And I think it really starts with changing how we view individuals who live in poverty. We really need to shift from an individualist perspective to a more collectivist perspective, like Ginger commented, around collective impact. And a lot of these federal initiatives, like Community Collaborations, Thriving Families, Safer Children, Essentials for Childhood, they all embrace a collective impact because they understand that public health can't do it alone, child welfare can't do it alone, housing can't do it alone. We really all need to be coordinating our activities and working together to deliver what families and children deserve and what they need. And that's good quality services.
We've talked a little bit about equity. I don't think we've probably said “equity,” but we're definitely talking about equity issues. We have to think about the implementation of policies and whether they're achieving equitable outcomes. So for the child tax credit, to be eligible for the previous version of the child tax credit you had to have an earning threshold. Again, because of historical policies that have made black and brown families more likely to live in poverty, they're less likely to have access to these economic supports as well. Even though those are the families these policies are intended to serve, they don't do a great job of it. But the expanded trial tax credit did, because it reached all of those families, it reached the lowest income families who needed it the most. So it was really quite remarkable what that one policy alone was able to do. I just wanted to touch on that. Like I said, I could talk about this stuff all day and get really into the nitty-gritty of it.
Eric: Well, we'll definitely have to have you guys back, because I've got to produce this every month. But it was really great to talk about this, we bridged the macro and the micro. It's not just data, it's not just systems, it's people; it's the people in those systems and the people running those systems, so this has been a wonderfully holistic conversation and I'm glad we all got to have it together. Thank you both for joining me.
Ginger: Thanks, Eric.
Whitney: Yeah, thank you for having me.
Eric: And thank you for joining us at The Intersect.