We know what puts North Carolina children at risk of neglect. But can we fix it?

North Carolina children experience more than twice as much neglect as physical and sexual abuse, and poverty is a big risk factor, child welfare advocates say.

But the solutions are not simple.

In 2022, over 400,000 N.C. children under the age of 18 lived below the federal poverty line, or about 17%, according to the U.S. Census. Roughly a third were under age 6, which state and federal data shows is a group most at risk of abuse, neglect and related fatalities.

NC Child, a nonprofit child advocacy organization, estimates the number of poor or low-income children may be closer to 43% of the state’s population, since the federal poverty threshold is based on outdated 1960s measures. The National Center for Children in Poverty cites research showing children and families need at least two times the current poverty threshold to meet their basic needs.

The 2024 federal poverty threshold for a family of three is about $12.41 an hour for one working parent.

However, the Massachusetts Institute of Technology living wage calculator shows $36.68 an hour will meet the basic needs of a single working parent with one child in North Carolina. Two working parents with one child can get by on $20.53 an hour each, it shows.

That’s well above what the average worker earns in most N.C. counties. In 2023, only four N.C. counties reported hourly wages higher than the national average of $33.35 an hour, the federal Bureau of Labor Statistics reported.

About 63% of the state’s children who live below the federal poverty limit are Black or Hispanic, and most live in rural counties, NC Child has reported.

The hardship of not having adequate food, housing and other basic resources can cause toxic stress, worsening domestic violence and child neglect as well as hindering cognitive development, experts say. Parents involved in the criminal justice system, abusing alcohol or drugs, or struggling with serious mental health issues can also leave children facing poverty and stress.

Child welfare officials and advocates, citing a landmark study on adverse childhood experiences, say North Carolina won’t make significant progress without better addressing poverty.

Poverty is part of a bigger problem

But subsistence programs are not enough, because most children are not placed in foster homes because their families are poor, said Emily Putnam-Hornstein, a UNC-Chapel Hill School of Social Work professor and lead investigator for the Lives Cut Short project.

“Poverty is a very constant backdrop, but when children are removed, it’s always because (there is) either poverty plus a serious parental substance use disorder, poverty plus serious family violence and domestic violence, or poverty plus a very serious parental mental health disorder,” Putnam-Hornstein said.

”If we don’t diagnose the root cause and the right problem, then we potentially tackle it in the wrong way,” she added.

In 2023, the state legislature approved spending $835 million on programs that child welfare advocates and N.C. Department of Health and Human Services officials say could make a dent in the behavioral health crisis that started with the 2020 pandemic and continues to fuel depression and anxiety, isolation, rage, substance abuse and post-traumatic stress disorders.

The funding includes $80 million for better access to mental health and substance use services for children and families, $130 million to expand the state’s behavioral health crisis response system and $100 million to expand services for people in the criminal justice system, including re-entry programs that address substance use, mental health and family issues that contribute to child abuse and neglect.

It also funded pilot programs aimed at the state’s opioid epidemic and more community-based services that keep children at home.

The money starts to address problems that cost taxpayers more in the long term, said Sharon Hirsch, president and chief executive officer of Positive Childhood Alliance North Carolina.

Over $4,000 a minute is spent now dealing with future consequences of abuse and neglect, from health care to criminal justice and lost productivity in the workplace, she said. The N.C. Budget & Tax Center reported a similar finding in 2017.

“We know that if we spent more money on prevention, we could prevent a whole host of of problems and have more children growing up safe, and nurtured and loved getting positive experiences that we know will make a difference for their health, and for our bottom lines as a society moving forward,” Hirsch said.

More funding to reduce child abuse, neglect

The latest spending and the state’s updated early childhood action plan, which emphasizes food security, childcare access and better wages for childcare workers, are steps forward for families, Hirsch said.

“Anything that we can do to help families put food on table, pay for diapers, pay for rent, making it easier for them to get transportation to and from work, get access to living wage jobs, always results in reductions in child maltreatment, because that financial stress on families is a big risk factor,” Hirsch said.

Child advocacy groups are now urging the state to raise the minimum wage of $7.25 an hour, which was set in 2009, and implement other programs and changes that could help families statewide, including:

• Replacing the federal child tax credit expansion that cut child poverty by 40% during the pandemic but has expired. The nonpartisan N.C. Budget and Tax Center has recommended giving parents a $1,900 tax credit for each child under age 6 and $1,600 for each older child.

• More child care subsidies for families. The News & Observer has reported the loss of $1.3 billion in federal COVID money in June could close a third of the state’s child care centers or force parents to pay even more. Over 60,000 families now use the state’s child care subsidies, NC Child has reported. Roughly 30,000 more are on a waitlist.

• Support for Gov. Roy Cooper’s budget proposal for $745 million for early childhood initiatives, including grants to provide more child care subsidies for families, and support child care centers, Smart Start and pre-K programs that provide early childhood education and care to preschool children.

Every $1,000 invested in public benefits, whether for medical care, housing, food or child care, causes a 7.7% reduction in child fatalities, a 4.3% reduction in abuse and neglect reports, and a 2.1% reduction in foster care placements, the Positive Childhood Alliance NC concluded in a report based on University of Chicago research studies.

Investing in children and families is “a recognized strategy to prevent child maltreatment,” said Kella Hatcher, executive director of the N.C. Child Fatality Task Force.