Research In Action
Research In Action
Child maltreatment and child welfare involvement disproportionately impact families of color, with overrepresentation of Black and Native American children in the percentage of cases that are reported, substantiated, and result in child removal from the home compared to their percentages in the general population. In Philadelphia, Black children represent 66% of all children in foster care, despite making up only 42% of children in the city. Both individual- and system-level biases are thought to play a part, in addition to overlapping risks, such as poverty and unemployment that are concentrated in families of color as a result of decades of structural racism.
As a general pediatrician and research fellow in the National Clinician Scholars Program, my mission is to advance equity by reducing racial disparities among system-involved youth. In partnership with the City of Philadelphia Department of Human Services and with the mentorship of Dr. Joanne Wood, director of research for CHOP's Safe Place, and Dr. Eugenia South, faculty director of the University of Pennsylvania’s Urban Health Lab, I am excited to examine how place-based interventions and community reinvestment impact child maltreatment and child welfare involvement.
Legacies of Redlining
Structurally racist policies such as redlining (racially discriminatory housing and lending practices), mass incarceration, and police violence have also led to disparities in neighborhood resources and exposures. Consider the following:
- Historically redlined neighborhoods with racialized segregation have increased exposures to pollutants and gun violence and decreased access to quality housing and greenspace.
- Studies have shown that neighborhood disinvestment and racial segregation are correlated with increases in child maltreatment.
- Here in Philadelphia, a study conducted by the City of Philadelphia Department of Human Services, the University of Pennsylvania, and Casey Family Programs found that the neighborhoods with the highest rate of child maltreatment reporting were the same ones burdened by residential segregation, economic disinvestment, and oversurveillance by police and child welfare systems.
This points to an opportunity to address child maltreatment risk through place-based interventions.
The Promise of Greenspace
One such intervention is greening, or the planting of grass, trees, and other vegetation to create parks or community gardens. Dr. South, who is an emergency medicine physician at the University of Pennsylvania and faculty director of the Urban Health Lab, has led several studies demonstrating that greening interventions result in clear benefits to the neighborhood, including reductions in violent crime, feelings of depression and stress, and improvements in social cohesion.
Our study, generously supported by CHOP's PolicyLab and the Center for Pediatric Clinical Effectiveness Pilot Grant Awards program, aims to evaluate the impact of greening interventions on the neighborhood risk of child maltreatment in Philadelphia. This study will be the first to examine the association between greening and child maltreatment, and may identify mechanisms to address child maltreatment risk through place-based interventions.
We will first conduct a serial, cross-sectional study to evaluate the association between residential tree canopy, or the percent of block area covered by tree canopy, and neighborhood risk of child maltreatment. We will then measure the impact of greening and trash pick-up interventions on child maltreatment risk leveraging data from a completed randomized control trial of vacant lot greening that was performed from 2011 to 2014. This data compared child maltreatment outcomes in neighborhoods near vacant lots that underwent a greening or trash pick-up intervention with neighborhoods near vacant lots that did not undergo any intervention.
Repair Neighborhoods to Treat Communities
As providers who care for children, we can advocate for investment in neighborhoods to better care for the children and families that live in them. Interventions that address the built environment, such as tree-planting and other greening, can not only treat whole communities, but also represent an opportunity to center racial equity by investing in historically excluded and marginalized neighborhoods.