Child Tax Credit Payments Linked to Reduced Child Abuse and Neglect

Summary: Child tax credit not only helped to reduce childhood poverty, but the expansion of monthly payments also helped to reduce child abuse and neglect, a new study reports.

Source: Georgia Institute of Technology

Research has shown that the 2021 expansion of the federal Child Tax Credit (CTC) significantly reduced childhood poverty, put food in kids’ stomachs, and helped families secure their finances.

Now, a new study led by School of Public Policy Assistant Professor Lindsey Rose Bullinger shows the expansion’s monthly payments also helped reduce child abuse and neglect—at least temporarily.

The study was published on Feb. 16 in JAMA Network Open and is the first to examine the link between unconditional payments such as the tax credit and changes in child abuse and neglect (CAN). It found that child abuse and neglect-related emergency room visits to Children’s Healthcare of Atlanta temporarily declined in the days following tax credit payments compared to those leading up to the disbursements and to similar periods in years with no such remittances.

“This research adds to the evidence showing that income-support public policies such as the child tax credit expansion, more generous tax credits, and minimum wage increases support parents in keeping their kids safe and secure,” Bullinger said.

“This is important research for policymakers, child advocates, really anyone who is committed to keeping kids healthy and safe.”

After payments, fewer emergency room visits

To reach their conclusions, Bullinger and co-author Angela Boy of CHOA’s Stephanie V. Blank Center for Safe and Healthy Children analyzed visits to the system’s emergency rooms before and after the implementation of the credit, which provided approximately 38 million U.S. families with monthly payments of up to $300 per child in the fall of 2021.

They found that in the four days following payments, the hospital system saw 1.13 fewer daily cases of child abuse and neglect than in the two weeks before payments. During the same periods in 2018 and 2019—when there were no payments—cases rose by 0.65 per day.

Researchers know that financial stress too often results in abuse and neglect of children. Still, it hasn’t been clear how parents might use unconditional payments and what impact they might have in reducing maltreatment.

While not definitive, the numbers in the study paint a picture of strapped families finding financial relief from the monthly payments in 2021 compared to 2018 and 2019 when they were under increasing stress as the month went on and their funds dwindled.

“Because experiencing material hardship is associated with child maltreatment, we expect these CTC payments to also be associated with child abuse and neglect in the short run by potentially reducing material hardship, reducing parental stress, and improving family functioning,” Bullinger and Boy wrote in their paper.

The researchers also found the apparently-protective effect of the payments wore off over time, with abuse and neglect cases returning to roughly pre-payment levels after just four days.

This shows a sad looking child
It found that child abuse and neglect-related emergency room visits to Children’s Healthcare of Atlanta temporarily declined in the days following tax credit payments compared to those leading up to the disbursements and to similar periods in years with no such remittances. Image is in the public domain

However, the research did show greater reductions in abuse and neglect cases in the final three months of the six-month program, potentially due to the cumulative effects of the payments.

What policymakers need to know

The research adds to a growing body of evidence—including work by Bullinger on the impact of increasing the minimum wage and increased accessibility to food benefits—that raising family incomes, including through direct benefit programs, can significantly reduce child abuse and neglect.

“Together, these studies suggest how child maltreatment can be influenced by even modest changes in income benefit schedules,” the researchers wrote.

Bullinger said lawmakers should consider child abuse and neglect (CAN) prevention when thinking about enacting or extending unconditional payment programs such as the child tax credit.

“Child abuse and neglect is very costly, both to individual children and families, and also to society. If we can reduce exposure to this adverse experience with small improvements to policies here and there, the benefits are likely large in the long run,” she said.

About this psychology and childhood abuse research news

Author: Press Office
Source: Georgia Institute of Technology
Contact: Press Office – Georgia Institute of Technology
Image: The image is in the public domain

Original Research: Open access.
Association of Expanded Child Tax Credit Payments With Child Abuse and Neglect Emergency Department Visits” by Lindsey Rose Bullinger et al. JAMA Network Open


Association of Expanded Child Tax Credit Payments With Child Abuse and Neglect Emergency Department Visits


Poverty has long been associated with a higher risk for child maltreatment, and recent research suggests that income support policies are associated with reduced child abuse and neglect. However, income supports tied to employment cannot separate the associations of income from those of employment.


To estimate the short-term association of universal and unconditional income payments to parents with child abuse and neglect.

Design, Setting, and Participants  

In this cross-sectional study, variation in the timing of the 2021 expanded child tax credit (CTC) advance payments was used to determine whether receiving unconditional income is associated with child abuse and neglect. A fixed-effects approach was used to compare child abuse and neglect before and after payments were made in 2021. The study compared 2021 trends with the same period in 2018 and 2019, during which no CTC payments were made. Participants were pediatric emergency department (ED) patients identified as experiencing child abuse or neglect at a level I pediatric hospital system in the Southeastern US from July through December 2021. Data were analyzed from July to August 2022.


Timing in the disbursement of the expanded CTC advance payments.

Main Outcomes and Measures  

Daily child abuse and neglect-related ED visits.


During the study period, there were 3169 ED visits related to child abuse or neglect. The 2021 advance payments of the expanded CTC were associated with fewer child abuse and neglect-related ED visits. There was a decrease in these ED visits in the 4 days following the advance CTC payments, although the reduction was not significant (point estimate, −0.22; 95% CI, −0.45 to 0.01; P = .06). There were significant reductions in such ED visits among male children (point estimate, −0.40; 95% CI, −0.75 to −0.06; P = .02) and non-Hispanic White children (point estimate, −0.69; 95% CI, −1.22 to −0.17; P = .01). These reductions did not persist, however.

Conclusions and Relevance  

These findings suggest that federal income supports to parents are associated with immediate reductions in child abuse and neglect-related ED visits. These results are important for discussions of making the temporary expansion of the CTC permanent and are applicable to income support policies more broadly.

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