Income inequality and child welfare interventions in England and Wales

Background Previous research has identified a relationship between income inequality and child abuse and neglect in the USA. This association has received limited exploration outside the USA. Methods Administrative data on child protection (CP) in 172 English and Welsh local authorities between 2013 and 2018 were combined with data on deprivation, ethnic density and education from publicly available data sources. Commercial income data were used for Gini coefficient estimation. We tested whether similar evidence for three key findings from a US study could be found in England and Wales. These included whether there was evidence of a relationship between income inequality and child maltreatment, whether this relationship was non-linear and whether this relationship varied dependent on the level of poverty. Results There was a significant non-linear relationship between income inequality and state care rates in England and Wales. Predicted state care rates were higher as income inequality increased, up until around average levels where the effect flattens. However, there was no significant relationship for models predicting CP plan/register rates. Income inequality, income deprivation, ethnic density and higher education were able to explain around 75% of the variance in English and Welsh state care rates. Conclusions There is some evidence to support the claim of a relationship between income inequality and child maltreatment beyond the USA in England and Wales, and a case for further comparative research, but there are significant limitations in the comparability of data.</p

‘When you're sitting in the room with two people one of whom… has bashed the hell out of the other’:Possibilities and challenges in the use of FGCs and restorative approaches following domestic violence

Domestic violence continues to be a primary reason for referrals to state child welfare services in advanced industrialised countries. There is growing concern in many state child welfare services to develop responses to it that are both more effective and more humane. The use of restorative approaches, in particular Family Group Conferences (FGCs), has been suggested as one such response. This article draws from data gathered from an evaluation of a UK Government funded “Innovation Project” part of which extended the use of FGCs in an urban local authority area which was already making extensive use of them. This paper presents and explores a typology of FGCs used in situations of domestic violence: pragmatic, resolution-focussed and restorative FGCs, developed from the evaluation data and augmented by relevant literature. The study data revealed pragmatic FGCs to be the most used, restorative the least. It is suggested that each type of FGC brings potential benefits but only restorative FGCs offer the possibility of full restoration in the traditionally understood sense. It is argued that the present mother-centric, risk-adverse, child protection systems which currently operate in many countries provide a powerful resistor to the greater implementation of this restorative way of working.</p

Social work, poverty, and child welfare interventions

** From Crossref via Jisc Publications Router.The relationship between children's material circumstances and child abuse and neglect raises a series of questions for policy, practice, and practitioners. Children and families in poverty are significantly more likely to be the subject of state intervention. This article, based on a unique mixed‐methods study of social work interventions and the influence of poverty, highlights a narrative from practitioners that argues that, as many poor families do not harm their children, it is stigmatizing to discuss a link between poverty and child abuse and neglect. The data reveal that poverty has become invisible in practice, in part justified by avoiding stigma but also because of a lack of up‐to‐date research knowledge and investment by some social workers in an “underclass” discourse. We argue, in light of the evidence that poverty is a contributory factor in the risk of harm, that it is vital that social work engages with the evidence and in critical reflection about intervening in the context of poverty. We identify the need for fresh approaches to the harms children and families face in order to support practices that engage confidently with the consequences of poverty and deprivation.NO DIVISION23pub5171pub

Toward full integration of quantitative and qualitative methods in case study research: insights from investigating child welfare inequalities

Delineation of the full integration of quantitative and qualitative methods throughout all stages of multisite mixed methods case study projects remains a gap in the methodological literature. This article offers advances to the field of mixed methods by detailing the application and integration of mixed methods throughout all stages of one such project; a study of child welfare inequalities. By offering a critical discussion of site selection and the management of confirmatory, expansionary and discordant data, this article contributes to the limited body of mixed methods exemplars specific to this field. We propose that our mixed methods approach provided distinctive insights into a complex social problem, offering expanded understandings of the relationship between poverty, child abuse, and neglect

Contextualising the pervasive impact of macroeconomic austerity on prison health in England: A qualitative study among international policymakers

Background: Prisons offer the state the opportunity to gain access to a population that is at particularly high risk of ill-health. Despite the supportive legal and policy structures surrounding prison rehabilitation, the oppressive nature of the austerity policy in England threatens its advanced improvement.Methods: Using grounded theory methodology, this is the first interdisciplinary qualitative study to explore the impact of macroeconomic austerity on prison health in England from the perspective of 29 international prison policymakers.Results: The far-reaching impact of austerity in England has established a regressive political system that shapes the societal attitude towards social issues, which has exacerbated the existing poor health of the prisoners. Austerity has undermined the notion of social collectivism, imposed a culture of acceptance among prison bureaucrats and the wider community, and normalised the devastating impacts of prison instability. These developments are evidenced by the increasing levels of suicide, violence, radicalisation and prison gangs among prisoners, as well as the imposition of long working hours and the high levels of absenteeism among prison staff.Conclusions: This study underscores an important and yet unarticulated phenomenon that despite being the fifth largest economy in the world, England’s poorest, marginalised and excluded population continues to bear the brunt of austerity. Reducing the prison population, using international obligations as minimum standards to protect prisoners’ right to health and providing greater resources would create a more positive and inclusive system, in line with England’s international and domestic commitments to the humane treatment of all people

Incidence and phenotypes of childhood-onset genetic epilepsies:a prospective population-based national cohort

Epilepsy is common in early childhood. In this age group it is associated with high rates of therapy-resistance, and with cognitive, motor, and behavioural comorbidity. A large number of genes, with wide ranging functions, are implicated in its aetiology, especially in those with therapy-resistant seizures. Identifying the more common single-gene epilepsies will aid in targeting resources, the prioritization of diagnostic testing and development of precision therapy. Previous studies of genetic testing in epilepsy have not been prospective and population-based. Therefore, the population-incidence of common genetic epilepsies remains unknown. The objective of this study was to describe the incidence and phenotypic spectrum of the most common single-gene epilepsies in young children, and to calculate what proportion are amenable to precision therapy. This was a prospective national epidemiological cohort study. All children presenting with epilepsy before 36 months of age were eligible. Children presenting with recurrent prolonged (&gt;10 min) febrile seizures; febrile or afebrile status epilepticus (&gt;30 min); or with clusters of two or more febrile or afebrile seizures within a 24-h period were also eligible. Participants were recruited from all 20 regional paediatric departments and four tertiary children’s hospitals in Scotland over a 3-year period. DNA samples were tested on a custom-designed 104-gene epilepsy panel. Detailed clinical information was systematically gathered at initial presentation and during follow-up. Clinical and genetic data were reviewed by a multidisciplinary team of clinicians and genetic scientists. The pathogenic significance of the genetic variants was assessed in accordance with the guidelines of UK Association of Clinical Genetic Science (ACGS). Of the 343 patients who met inclusion criteria, 333 completed genetic testing, and 80/333 (24%) had a diagnostic genetic finding. The overall estimated annual incidence of single-gene epilepsies in this well-defined population was 1 per 2120 live births (47.2/100 000; 95% confidence interval 36.9–57.5). PRRT2 was the most common single-gene epilepsy with an incidence of 1 per 9970 live births (10.0/100 000; 95% confidence interval 5.26–14.8) followed by SCN1A: 1 per 12 200 (8.26/100 000; 95% confidence interval 3.93–12.6); KCNQ2: 1 per 17 000 (5.89/100 000; 95% confidence interval 2.24–9.56) and SLC2A1: 1 per 24 300 (4.13/100 000; 95% confidence interval 1.07–7.19). Presentation before the age of 6 months, and presentation with afebrile focal seizures were significantly associated with genetic diagnosis. Single-gene disorders accounted for a quarter of the seizure disorders in this cohort. Genetic testing is recommended to identify children who may benefit from precision treatment and should be mainstream practice in early childhood onset epilepsy