EDITOR’S NOTE: This is Part One of a two-part series in the “Our Kids” reporting project. Our Kids is a project of the Broke in Philly reporting collaborative that examines the challenges and opportunities facing Philadelphia’s foster care system. (See also Part Two, “Can Racial Bias Be Corrected in the Child Welfare System?”)
Shortly after Christmas, Kyeesha Lamb’s baby boy fell out of bed. She and her boyfriend had co-slept with the four-month-old child that night and awakened to his crying.
Quickly, Lamb picked the child up from the hardwood floor, soothed him back to sleep, checked on him in the night, and by morning, the experience looked like an inexpensive lesson: the baby showed no ill effects at all. Over the next couple of days, however, Lamb noticed her son used his right arm very little and sometimes held it tightly to his side. “He didn’t seem to be in any pain unless we tried to move his arm around,” she says, “but I didn’t like it.”
Lamb, 24, was already raising another boy, just 16 months old, and knew to keep a close watch on the newborn, to see if he improved. But over the next few days, he continued favoring the arm and even went through an odd crying episode — a spell that convinced Lamb she needed to take him to the hospital.
The staff at Children’s Hospital of Pennsylvania asked her what happened, appeared supportive, and then informed her that the doctor had ordered a full skeletal x-ray.
Shortly after that, the tone of the visit changed. The radiologist discovered two possible injuries — a break in the baby’s arm, which appeared consistent with the fall Lamb described; and a possible second break in her baby’s leg, too, which looked older. Lamb could not explain that second potential injury. There had been no earlier accident.
Lamb expressed concern and took solace in the doctor’s admission that x-rays were sometimes uncertain.
“They said, sometimes, in babies, they see what looks like a fracture in the x-ray, still healing,” says Lamb. “But it could also be just how the baby’s bones are growing.”
To confirm a break, staff told her, a new set of x-rays would be taken in a few weeks. If the new images showed fresh bone growth around the supposed fracture site, they’d know the radiologist had discovered a bone in the process of healing. If no new growth appeared, they’d know there had never been a break at all.
The problem, hospital staff informed her, was that the suspected second break suggested possible child abuse, giving them no choice under the law but to report her to the Department of Human Services. Fear brewed in Lamb’s stomach as she defended herself. Then a DHS caseworker arrived, questioned her, and took both children into custody.
Now, months later, Lamb’s experience of the child welfare system continues. The second set of x-rays cleared her, showing no new growth at the suspected fracture site — proof that there was no break in the baby’s leg. Nevertheless, DHS informed her that they would keep her kids in custody until a full hearing could be held.
“I didn’t understand how this was possible,” says Lamb, recalling the moment she heard the news. “I was like, ‘I didn’t do anything wrong. You know that now, and you’re still keeping my kids?’”
Lamb’s story, however, isn’t that unusual. Built to err on the side of caution for kids, the child welfare system often manifests as a punitive and intrusive force, particularly toward Black families, who are statistically more likely to be referred for investigations and more likely to have their kids taken into foster care when compared to white families. As a result, reformers and abolitionists are demanding that the system be reformed, even wholly reimagined. They frame this cause in the language of the Black Lives Matter movement — a cry to preserve Black families against a system built to separate them.
Research Uncovers the Patterns of Bias
Last summer, worldwide news broadcasts of George Floyd’s murder by a white Minneapolis police officer triggered racial justice protests across all 50 states and around the globe. Child welfare advocates and activists were among many who felt the horror of those images personally.
“The foster community obviously has a disproportionate number of Black people in it,” says Constance Iannetta, founder of Foster Strong, which seeks to improve child welfare practices and raise public awareness, “and I knew that tragedy was really going to resonate across our community.”
Black people comprise about 13 percent of the total United States population and 25 percent of the youth in foster care. In Philadelphia, where Lamb lives, the disparity is likewise dramatic, showing Black people comprise 42 percent of the population and 65 percent of the youth in foster care.
For at least a decade, government officials and child social workers alike have been talking about how to address this disproportionality, which affects Indigenous and, in some states, Latino families as well. Of course, some still deny that the problem even exists. Elizabeth Bartholet, a Harvard law professor, has maintained over the years that Black people are more often involved in child welfare because “maltreatment rates” are higher in the Black population. Other researchers counter that this argument represents both magical thinking and circular reasoning.
“We’ve seen clear research throughout American society, not just in law enforcement but [in] banking and housing, that racism exists,” says Richard Wexler, executive director of the National Coalition for Child Protection Reform, which has been advocating for decades to drastically reduce the number of kids in foster care. “But social workers are somehow immune from that? It doesn’t make any sense.”
Further, Bartholet’s opponents point out that maltreatment rates are based on decisions that people make to report, investigate and judge families. Racially biased input will yield a racially biased output.
The papers showing evidence of racial bias in the system run deep. A paper published in January 2021 in Children and Youth Services Review surveyed the existing studies of child protective services investigations and race and determined that Black families are subjected to greater scrutiny and harsher judgment at virtually every stage of contact, including disproportionate reports to CPS, subsequent investigations and child removals.
Multiple studies also have shown that Black families are less likely than white families to receive in-home services, also called “preventive services,” which are intended to keep families together. A 2016 study published in Public Health Nursing suggested the reason why. The authors looked at 62,499 neglect or abuse cases across five states and found that child welfare professionals often regarded Black parents as less likely to change.
University of New Hampshire social work professor Vernon Brooks Carter looked at 418 substantiated cases of a lack of supervision; of the families represented in the study, 60 percent were white and 31 percent were Black. Carter found that white kids were more likely to be inadequately supervised by their parents — left at home alone, for instance, while mom runs to the store. But Black children under similar circumstances were more than three times as likely to be removed from their parent’s care.
Lamb’s particular case also fits the pattern of racial bias uncovered by past research.
In fact, a 2010 paper published in the journal Pediatrics that documented racial bias in the child welfare system focused on American hospitals. The study examined 3,063 cases of infants who suffered traumatic brain injuries at 39 different hospitals. The authors found that infants in Black families, and infants in families who did not have government health insurance, underwent greater testing — such as the skeletal survey ordered of Lamb’s child — than did white infants who suffered similar injuries.
Children in white families, however, were more likely to be determined victims of child abuse if a skeletal survey was ordered, suggesting that doctors engaged in heavier scrutiny of white families when it was truly warranted.
Dr. David Rubin, the paper’s senior author and a pediatric researcher at Children’s Hospital of Pennsylvania (CHOP), summed up the obvious conclusion at the time: “These results raise concerns that different thresholds for suspicion of child abuse were being used for children of different races and economic levels,” he said.