Spotlight on Disproportionality and Disparities among Families in Child Welfare and Substance Use Treatment
Families of color and other diverse groups affected by child abuse or neglect and substance use disorders (SUDs) often face a complex set of challenges. The prevalence of SUD 1 and challenges associated with disproportionality and disparities in service systems varies by gender, 2, 3 race and ethnicity, 4, 5, 6 socioeconomic status, 7 as well as among other important groups.
Disproportionality is the underrepresentation or overrepresentation of a group compared to its percentage in the total population, 4, 5, 6 socioeconomic status, 8 such as the overrepresentation of racial or ethnic groups in child welfare.
Disparity is defined as “all things being equal—including need, eligibility, and preferences—one group systematically fares worse than another.” 9 For instance, the rate of opioid misuse among Blacks is similar to the general population and yet drug overdose deaths between 2015–2016 among Blacks increased by 40%, compared to the general population increase of 21%; and, exceeded all other racial and ethnic groups. 10 Contributing factors include substantially lower access to SUD treatment 11 and limited access to medication-assisted treatment for opioid use disorders. 12
Both disproportionality and disparities exist at each of the decision points across the child welfare service continuum. 13 In 2018, Black children composed approximately 23% of children in foster care, while they were approximately 14% of the total U.S. child population. 14 In the same year, American Indian/Alaska Native children accounted for over 2% of children in foster care, while composing less than 1% of the total U.S. child population. 15 Racial and ethnic minority children are:
- More likely to experience lengthier placement in out-of-home care
- More likely to experience group placement
- Less likely to reunify 16
Assessing risk to child safety and well-being in the context of socioeconomic factors—such as housing and financial insecurity—has been a long-standing challenge in the child welfare system. Families with low socioeconomic status are more likely to be referred to child welfare services for severe neglect and have a higher unmet need for housing services and medical care. 17 A cross-system collaborative approach that is attuned to and actively addresses institutional inequities in services and differences among populations is necessary to meet the complex needs of families.
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Policy and Practice Resources
Child Welfare Information Gateway, 2021
This webpage has resources on issues such as overrepresentation in the child welfare system, underrepresentation in support services, inequitable investigations for suspected cases of maltreatment, and disparities in decision-making. It also provides resources on pursuing racial and LGBTQ (lesbian, gay, bisexual, transgender, and questioning) equity in child welfare.
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Disproportionality Rates for Children of Color in Foster Care Dashboard
National Center for Juvenile Justice, 2021
Interactive dashboard with national and state disproportionality rates for children of color in out-of-home care.
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Cultural Competency Resources
Substance Abuse and Mental Health Services Administration, 2021
Access resources and online training on cultural competency from SAMHSA and other agencies and organizations.
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Office of Behavioral Health Equity
Substance Abuse and Mental Health Services Administration, 2020
The Office of Behavioral Health Equity oordinates SAMHSA’s efforts to reduce disparities in mental and/or substance use disorders across populations. The website includes key federal health equity resources such as data on health disparities and health care quality among diverse populations, information about health policy, cultural and linguistic competency, health literacy, and more.
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Is It Possible to Modify Neighborhood-Level Characteristics to Reduce the Rate of Child Maltreatment?
Casey Family Programs, 2020
This study tests an approach in which children are considered within the context of their community—regardless of their individual and family-level characteristics—to determine whether neighborhood-level characteristics can be modified to reduce or prevent child maltreatment.
Visit Website Is It Possible to Modify Neighborhood-Level Characteristics to Reduce the Rate of Child Maltreatment?
Identifying Racial and Ethnic Disparities in Human Services: A Conceptual Framework and Literature Review
(PDF 2.5 MB)
Office of Planning, Research and Evaluation 2017
This publication summarizes existing research on racial and ethnic disparities access, services and treatment, and outcomes within the six selected Administration for Children and Families (ACF) human services programs and offers a conceptual framework for distinguishing racial and ethnic “disparities” from “differences.”
View Document Identifying Racial and Ethnic Disparities in Human Services: A Conceptual Framework and Literature Review
Child Welfare Practice to Address Racial Disproportionality and Disparity
Child Welfare Information Gateway, 2016
This issue brief explores the prevalence of racial disproportionality and disparity in the child welfare system. It also describes strategies that can assist child welfare administrators, program managers, and policymakers with addressing these issues in general and at specific decision points in the child welfare process (e.g., prevention, reporting, investigation, service provision, out-of-home care, permanency). Examples of State and local initiatives that address disproportionality also are highlighted.
Visit Website Child Welfare Practice to Address Racial Disproportionality and Disparity
Working With Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) Families in Foster Care and Adoption
Child Welfare Information Gateway, 2016
This bulletin is designed to help child welfare and adoption professionals expand their cultural competence and skills when working with LGBTQ individuals and same-sex couples. It also examines laws and policies and provides tips to effectively engage this vital and distinct community.
Visit Website Working With Lesbian, Gay, Bisexual, Transgender, and Questioning (LGBTQ) Families in Foster Care and Adoption
Disparities and Disproportionality in Child Welfare: Analysis of the Research
Annie E. Casey Foundation, 2011
This report discusses the major underlying causes and theories on disproportionality and disparity in child welfare.
Visit Website Disparities and Disproportionality in Child Welfare: Analysis of the Research
Addressing the Underlying Issue of Poverty in Child-Neglect Cases
American Bar Association, 2014
This article discusses poverty in child maltreatment cases and includes information on State approaches to address the issues. Approaches are grouped into three categories: (1) increased availability of and access to financial services, (2) increased parental self-advocacy, and (3) differential/alternative response.
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Related Online Trainings, Videos, and Webinars
State and Local Examples
National Data Archive on Child Abuse and Neglect (NDACAN)
NDACAN manages and distributes various child welfare administrative datasets, including the Adoption and Foster Care Analysis and Reporting System and the National Child Abuse and Neglect Data System . Communities can use these datasets to examine various demographic variables such as age, race, and gender as compared to the general child population to assess equitable child welfare practice as it relates to substantiations, referrals, service access, permanency decisions, and other child welfare factors.
Visit Website National Data Archive on Child Abuse and Neglect (NDACAN)
National Network to Eliminate Disparities in Behavioral Health (NNED)
NNED is a network of community-based organizations focused on the mental health and substance use issues of diverse racial and ethnic communities. NNED supports information sharing, training, and technical assistance.
Visit Website National Network to Eliminate Disparities in Behavioral Health (NNED)
Addiction Technology Transfer Center Building Health Equity and Inclusion Webpage
This webpage is a compilation of resources including those for training and technical assistance, national Culturally and Linguistically Appropriate Services standards, cultural humility, and considerations. There are also resources for specific groups such as African Americans, Latinx populations, Native Americans, women, LGBTQ people, and youth.
Visit Website Addiction Technology Transfer Center Building Health Equity and Inclusion Webpage