Child maltreatment is a pressing public health issue in the United States, with over three million children referred to child protective services in 2021 alone. Infants are particularly vulnerable to victimization. Policy interventions that aim to support families economically, such as the earned income tax credit, housing assistance programs, subsidized childcare, and higher state minimum wages, have been shown to reduce child maltreatment. Socioeconomic disadvantage and financial instability increase family stress, which raises the risk of harsh or neglectful parenting practices and, ultimately, child maltreatment. Therefore, these policies help alleviate parental stress, improve financial stability, provide access to resources, and enable a better balance between work and family obligations. Paid family leave (PFL) is also a potentially helpful policy, as it offers economic support to families during crucial periods, such as the birth of a child. By allowing employees to take time off work while still receiving a portion of their wages, PFL eases financial strain and reduces the risk of maltreatment. This dissertation expands on this existing scholarship by examining the impact of state-level paid family leave policies on infant maltreatment, considering variations by maltreatment type and caregiver demographics. The first study (Chapter 2), conducted as a scoping review following the PRISMA framework, explores how PFL affects families at different social-ecological levels. The review synthesizes evidence demonstrating the positive effects of PFL on child outcomes, parental outcomes, family outcomes, and labor market outcomes. The second study (Chapter 3) employs a quasi-experimental design to analyze the relationship between state-level PFL policies and rates of infant maltreatment. The findings suggest a significant association between PFL implementation and a decrease in reports of infant neglect, highlighting the role of economic stability in family well-being. However, an unexpected increase in reports of emotional abuse reveals the complexity of child maltreatment and the necessity for comprehensive prevention strategies. The final study (Chapter 4) investigates the moderating effects of caregiver demographics on the relationship between PFL and substantiated cases of infant neglect. The results indicate a significantly lower rate of infant neglect in states with PFL policies, with significant interactions observed among PFL access for female, male, and white caregivers. These findings emphasize the protective influence of PFL on rates of infant neglect and underscore the importance of inclusive policies that meet the needs of diverse caregiver demographics. Collectively, these studies contribute to our understanding of the role of PFL policies in promoting family well-being and preventing early childhood maltreatment. This dissertation contributes valuable insight into the relationship between state-level PFL policies and infant maltreatment. The studies conducted in this dissertation utilize rigorous study design and analysis methods to reveal nuanced findings about the protective effects of PFL on child welfare outcomes. This work contributes to the academic literature and has practical implications for policy development, social work practice, and future research. The decrease in infant neglect, along with the significant relationship between caregiver demographics and policy access, highlights the vital role of PFL in fostering safe and healthy environments for families during early childhood.
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