Poverty and Family Reunification for Mothers with Substance Use Disorders in Child Welfare
Although prior research has established that maternal substance use disorders (SUDs) are associated with poor foster care outcomes, few earlier studies have sought to differentiate between families with maternal SUDs who reunify and those who do not reunify. This study applied the intersectional social determinants of a health framework to examine the effect of socioeconomic status (SES) risks on the likelihood of reunification for 325 mothers with SUDs and their children in foster care. Multivariate Cox regression models assessed four SES risk factors separately and cumulatively: single parent; income less than $15 000; unemployment; and severe housing issues. The study results reveal that none of the SES factors alone reduced the chances of reunification, but did so in combination. Compared to cases with one risk, cases with three risks were 39.1 per cent less likely to reunify and four‐risk cases were 49.3 per cent less likely to reunify. Cases with zero, one and two risks did not significantly differ. The primary implication of this study is that families with maternal SUDs in child welfare are a heterogeneous group whereby reunification depends on SES risk severity. In practice, these findings suggest that improving reunification for families with maternal SUDs may be aided by reducing the total number of socioeconomic risk factors, rather than eliminating specific risks. © 2018 John Wiley & Sons, Ltd. ‘Examine[s] the effect of socioeconomic status risks on the likelihood of reunification for 325 mothers with substance use disorders and their children in foster care’ Key Practitioner Messages Families affected by parental SUDs in child welfare are a heterogeneous group whose outcomes vary based on the severity of socioeconomic risk. Mothers with SUDs in child welfare are significantly worse off socioeconomically compared to fathers with SUDs. The impact of SES on reunification outcomes depends on the accumulation of risk, rather than individual factors. Substance abuse treatment must be augmented with efforts to reduce the cumulative SES burden on families.