Richard Wexler’s Child Neglect in America article uses a Swedish child neglect study to make sweeping claims about “American child neglect and poverty,” even though childhood conditions in the two countries are radically different. In the Nordic welfare states, far fewer children live in deep poverty and families receive broad supports like child benefits, paid leave, subsidized childcare, and universal health care, while U.S. child poverty is roughly twice as high and basic needs often go unmet without thin, means‑tested programs. When Swedish researchers describe “neglect,” they are usually studying families whose housing, food, and medical care are already guaranteed, but in the U.S. “neglect” overwhelmingly tracks unemployment, low wages, and missing safety‑net protections—so treating these baselines as equivalent hides the fact that American parents are often punished for poverty in ways Swedish parents are largely shielded from.​

It is misleading to lift a powerful Swedish neglect study on foster care mortality and drop its findings wholesale into the American debate without first acknowledging how radically different the two child‑welfare universes are. The Swedish sample comes from a universal welfare state with far lower child poverty, guaranteed income supports, housing, health care, and child allowances, where “neglect” is less tightly bound to material deprivation and where out‑of‑home care is a small, highly selected slice of all child‑welfare involvement. In the United States, by contrast, neglect is strongly and consistently correlated with deep poverty, welfare cuts, and economic marginalization; multiple studies find that when cash, housing, and basic benefits improve, neglect reports fall, precisely because so much of what is labeled “neglect” is structural hardship rather than parental malice.

KARA agrees with Wexler that poverty is over‑penalized, but his neglect rhetoric is unlikely to increase America’s safety net for children (especially in the short term) and minimizes the independent danger of chronic neglect, especially for children experiencing extended neglect, medical, or educational neglect that is not solved by cash alone.​ The federal government has slashed many child and family friendly programs in good financial times and will slash many more as budgets tighten – SEE THEM IN THEM READ MORE below.

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False equivalence between Swedish and U.S. “neglect”

Wexler treats Swedish and American “neglected children” as interchangeable, but cross‑national work makes clear that who enters the system and why varies enormously across wealthy countries. Sweden’s universal benefits substantially reduce material hardship, so the children entering its care system are, on average, more filtered for complex adversity (parental mental illness, substance use, violence) rather than simply poverty; in the U.S., by contrast, an enormous share of maltreatment reports and removals are triggered by conditions that track directly with low income, welfare policy, and lack of supports. Importing a mortality estimate from one context to another without adjusting for these selection differences risks implying that American foster youth and Swedish foster youth are drawn from the same risk pool, when the evidence strongly suggests they are not.​

Comparing foster care to an imaginary alternative

Wexler is right that most studies compare foster care to “services as usual” rather than to a generous package of guaranteed housing, income, treatment, and child care, but he then commits the same sin from the opposite direction: he reads the Swedish findings as if the real‑world alternative to U.S. foster care is a fully funded Nordic‑style support system that does not exist for American families. In reality, cross‑national data show that the U.S. has among the weakest social safety nets and highest child‑poverty rates in the rich world, and that raising benefits and stabilizing families measurably reduces neglect reports and CPS involvement; the right lesson is that America should build those supports, not that U.S. foster care can be judged solely against a hypothetical, fully resourced in‑home model that lawmakers have never been willing to fund. Treating “foster care versus a robust welfare state that American children do not have” as the operative comparison quietly stacks the deck and obscures that U.S. policymakers have systematically chosen to respond to poverty with surveillance and removal instead of income, housing, and services.​

Ignoring civil rights, system‑level variation and selection effects

America is the only nation in the world not to have ratified the United Nation’s RIGHTS OF THE CHILD TREATY of the 1980s. Because of this, American children have no standing in court, voice in the media, State House, or their homes. This List of laws protecting children shows the stark differences in how children are valued around the world.

The broader comparative literature on 44 high‑income countries shows enormous variation in investigation rates, substantiated maltreatment, and entry into out‑of‑home care that reflects regional and sociocultural patterns more than any single universal mechanism. Nordic systems remove a smaller share of children, rely more heavily on family‑service approaches, and reserve long‑term care for a narrower, more damaged subset of cases, which by definition raises the average risk profile—and thus mortality risk—of children who are actually placed; U.S. systems, by contrast, combine higher poverty with broader, often racially skewed surveillance, sweeping in many children whose only “risk factor” is deprivation. When Wexler strings together studies from different eras, populations, and welfare regimes as if they all point in a single direction, he collapses these selection effects and invites readers to blame “foster care itself” for outcomes that are at least partly driven by which children are removed, AND MOST IMPORTANTLY, what supports exist before removal, and how long they are left to drift in under‑resourced systems.​

What the Swedish findings actually argue for

The Swedish mortality study and related Nordic research do underscore something profoundly important: once the state removes a child, it assumes a non‑delegable duty to provide safe, stable, therapeutic care—and when it fails, the consequences include suicide and premature death. Rather than proving that children “typically” do better left in dangerous homes, these findings are at least as consistent with a different indictment: that both Swedish and American systems have tolerated harmful residential placements, peer contagion, and instability instead of investing in small, well‑supported, rights‑respecting family settings and in the poverty‑reduction measures that would prevent many removals in the first place.

A more honest reading of the evidence is that policy should (1) sharply reduce removals driven by poverty, (2) massively expand voluntary, well‑funded family supports, and (3) radically improve the quality and oversight of foster and residential care for the smaller group of children who truly cannot be safely maintained at home—goals that require building something that looks more like the Nordic social safety net for all American children, not simply condemning foster care in isolation. KARA argues that until America massively expands voluntary, well‑funded family supports, and radically improves the quality and oversight of foster and residential care for neglected children, those children will suffer and die if “neglect” is diminished or removed from Child Protection.

AUTHOR’S NOTES:

KARA was cofounded by David Strand, a 3M executive who wrote his PHD thesis (NATION OUT OF STEP a statistical and program comparison between nations)​ after spending 10 years making public policy on children’s issues in Finland and Northern Europe. His work, is available on request by sending an email to: info@invisiblechildren.org  

This recent study done by Minnesota’s Safe Passage for Children, along with ACEs studies, and this from Texas show how children die and suffer lifelong damage by being left in abusive and neglecting homes. The crime statistics in the graph above support former MN Supreme Court Chief Justice Kathleen Blatz statement that “the difference between that poor child and a felon is about eight years”. It also makes understandable the 80% recidivism in American prisons at 9 years. Maintaining the punishment system doesn’t help, but leaving children in toxic homes with no rights or voice to save themselves is terribly dangerous and unfair.

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Additional information and studies about this topic in the Read More below.

Science Direct Study: No consistent evidence of significant difference in offending behavior among maltreated youth receiving in home or out of home care.

Powerful Social Worker podcast interview about overwhelmed CPS and children not receiving services

Removing children from truly abusive, dangerous homes is sometimes the only way to keep them alive and give them a chance to recover, and there is research and policy backing that hard reality. A quasi‑experimental U.S. study titled “The Causal Impact of Removing Children from Abusive and Neglectful Homes” used variation in investigators’ removal tendencies and found that removal significantly improved educational outcomes for young girls, including higher test scores and lower grade repetition, compared with similarly maltreated children left at home (https://www.ericchyn.com/files/BCHM_2021_Removals.pdf).

Other work on intensive, evidence‑based foster‑care models, such as Multidimensional Treatment Foster Care and KEEP, shows that when foster homes are carefully selected, trained, and supported, children have fewer behavior problems, more placement stability, and lower arrest rates than comparable youth in business‑as‑usual care, indicating that removal into high‑quality care can be protective when home conditions are toxic (https://pmc.ncbi.nlm.nih.gov/articles/PMC3505234/).

Policy frameworks in the U.S. explicitly recognize that the state must sometimes separate children from caregivers to prevent “imminent danger” or “serious physical harm,” including the federal Child Abuse Prevention and Treatment Act (CAPTA), which conditions state grants on laws that authorize emergency removal when there is reasonable cause to believe a child is suffering or at risk of serious maltreatment (https://www.childwelfare.gov/topics/systemwide/laws-policies/can/capta/).

State statutes, often summarized in Child Welfare Information Gateway digests, similarly require agencies and courts to act when safety cannot be assured in the home, using standards like “clear and convincing evidence” of abuse or neglect plus documented failure of less intrusive interventions (https://www.childwelfare.gov/topics/systemwide/laws-policies/state/). At the same time, federal policy in the Adoption and Safe Families Act (ASFA) requires agencies to prioritize child safety as the “paramount concern,” to seek termination of parental rights more quickly when parents have committed certain egregious acts (such as severe abuse, torture, or murder of a sibling), and to move children toward permanent family placements when returning home would leave them in ongoing danger (https://www.childwelfare.gov/topics/systemwide/laws-policies/federal/asfa/).

 

The following are recent cuts to child and family friendly programs in America:

 

Child welfare and protection programs

• ProPublica overview of DOJ, HHS, and other federal cuts hitting child care, Head Start, child welfare, and related programs: https://www.propublica.org/article/how-trump-budget-cuts-harm-kids-child-care-education-abuse​

• DOJ funding cuts affecting youth programs, child advocacy centers, court training, and victim services: https://counciloncj.org/doj-funding-update-a-deeper-look-at-the-cuts/​

• Child welfare leaders’ alarm over Trump’s call to freeze social services and child welfare–related spending: https://imprintnews.org/child-welfare-2/child-welfare-leaders-stunned-by-trumps-call-to-freeze-social-services-spending-legal-action-could-slow-implementation/268157​

• NCSL briefing on how proposed safety‑net changes affect states and child‑related programs, including SSBG: https://www.ncsl.org/events/details/how-proposed-changes-to-federal-safety-net-programs-could-affect-the-states​

Early childhood, education, and after‑school supports

• ProPublica reporting on Head Start regional office closures, rescinded funds, and reduced oversight of children’s safety in centers: https://www.propublica.org/article/how-trump-budget-cuts-harm-kids-child-care-education-abuse​

• EdWeek analysis of how changes in Trump’s 2025 budget bill (Medicaid, SNAP) affect schools and student services: https://www.edweek.org/policy-politics/how-medicaid-snap-changes-in-trumps-big-budget-bill-could-affect-schools/2025/07​

Nutrition, income support, and health care

• USDA overview of SNAP provisions in the “One Big Beautiful Bill” Act of 2025: https://www.fns.usda.gov/snap/obbb-implementation​

• KFF tracking of Medicaid provisions in the 2025 budget bill: https://www.kff.org/medicaid/tracking-the-medicaid-provisions-in-the-2025-budget-bill/​

• Commonwealth Fund analysis of how Medicaid and SNAP cutbacks would trigger job and service losses: https://www.commonwealthfund.org/publications/issue-briefs/2025/jun/how-medicaid-snap-cutbacks-one-big-beautiful-bill-trigger-job-losses​

• First Focus “Children’s Budget 2025” fact sheet summarizing projected federal cuts to children’s Medicaid and other programs: https://firstfocus.org/resource/fact-sheet-childrens-budget-2025/​

Programs for children with disabilities and special needs

• First Focus update on Trump administration actions targeting children with disabilities and their benefits: https://firstfocus.org/update/recent-actions-by-the-trump-administration-target-children-with-disabilities/​

• Children’s budget overview, including SSI/Medicaid implications for disabled children: https://firstfocus.org/resource/fact-sheet-childrens-budget-2025/​

Protections for immigrant and unaccompanied children

• KIND timeline of rollbacks to protections for unaccompanied children under the second Trump administration: https://supportkind.org/resources/a-timeline-tracking-how-the-second-trump-administration-is-rolling-back-protections-for-unaccompanied-children/​

• PDF timeline detailing specific policy changes (detention, legal services, screening) affecting unaccompanied children: https://supportkind.org/wp-content/uploads/2025/10/25_Trump-Admin-Rollbacks-Timeline.pdf​

• Related timeline and resources at the Center on Immigration and Child Welfare: https://cimmcw.org/a-timeline-tracking-how-the-second-trump-administration-is-rolling-back-protections-for-unaccompanied-children/​

• KIND commentary calling one rollback among the most damaging in its timeline: (Facebook post) https://www.facebook.com/supportkind/posts/one-of-the-most-damaging-rollbacks-in-kinds-timeline-began-in-march-the-administ/1244725666524921/​

Cross‑cutting impact on children

• ProPublica’s synthesis of the cumulative effect of cuts across HHS, DOJ, Education, and other agencies on children: https://www.propublica.org/article/how-trump-budget-cuts-harm-kids-child-care-education-abuse​

• First Focus “Children’s Budget 2025”: https://firstfocus.org/resource/fact-sheet-childrens-budget-2025/​

• NCSL event/resources on federal safety‑net changes and state impacts: https://www.ncsl.org/events/details/how-proposed-changes-to-federal-safety-net-programs-could-affect-the-states​

KIDS AT RISK ACTION/KARA/INVISIBLE CHILDREN