Children in Temporary Assistance for Needy Families (TANF)
Child-Only Cases with Relative Caregivers

Chapter III:
Secondary Analysis

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Contents

To further explore the characteristics of children in TANF child-only cases with relative caregivers, researchers analyzed data from two national surveys: the National Survey of Child and Adolescent Wellbeing and the Survey of Income and Program Participation. The extensive measures available in the two surveys offer generalized, quantitative estimates of service needs and well-being for this population and comparisons with other children supported by TANF and other children in out-of-home care.

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3.1 Analytic Approach

Secondary analyses compare children in TANF child-only cases with relative caregivers to other children supported by TANF, and to other children in out-of-home care.

To further explore the types of services and needs that children in TANF child-only cases with relative caregivers may have, the study team conducted the secondary analysis to examine child well-being measures for these children relative to other reference groups. The study staff explored two dimensions with these comparison groups: the first relates to income differences, and the second to the type of caregiver.

Researchers examined income differences by comparing child-only cases, families receiving TANF, and low-income children who are not receiving TANF. The study staff also examined different caregiver arrangements by comparing child-only cases living with a relative caregiver to child-only cases living with a parent, children in non-TANF kincare, or children in foster care. Although there are many other unobservable differences between the groups, the underlying rationale for focusing on the two dimensions of income and caregiver arrangements was that these two factors, together and separately, influence service needs, service use, and child well-being.

Some of the key research questions that are answered by this analysis are:

For each survey, the following report sections provide a general overview of the data sources, a description of how researchers used survey measures to identify children in TANF child-only cases with relative caregivers and relevant comparison groups, the sample sizes of each group, and analyses. The discussion section summarizes what the two surveys can - and cannot - tell us about the well-being and service needs of children in TANF child-only cases with relative caregivers.

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3.2 The National Survey of Child and Adolescent Well Being

3.2.1 Data Overview

The National Survey of Child and Adolescent Well-Being (NSCAW) makes available for the first time longitudinal data on children and families involved in the child welfare system. Data are collected from first-hand reports from children, parents, and other caregivers, as well as reports from caseworkers, teachers, and data from administrative records. This is the first national study that examines child and family well-being outcomes in detail and seeks to relate those outcomes to their experience with the child welfare system and to family characteristics, community environment, and other factors. The NSCAW sample, which represents the population of children and families that encounter the child welfare system, includes more than 5,400 children (ages 0 to 14) from 97 child welfare agencies nationwide.

Because NSCAW's sample is drawn from children who have been investigated for maltreatment, it does not represent the larger population of children supported by TANF.

It is important to note that children in TANF child-only cases with relative caregivers in the NSCAW sample are not representative of all such children, since many children in TANF child-only cases with relative caregivers have no contact with the child welfare system. However, for those children represented by this sample, NSCAW data allow analyses of child performance on standardized measures of well-being, and the interaction of these children with other service systems, such as the TANF program, Medicaid, housing assistance, and others.

3.2.2 Identifying Child-Only Cases and Comparison Groups

A number of possible comparison groups were available to researchers in these data. The comparison groups examined are described in Table 3-1. These groups provided a wide continuum of characteristics and a context for understanding the service use, needs, and well-being of children in TANF child-only cases with relative caregivers in relation to their peers.

Table 3-1.
Descriptions of Comparison Groups
Comparison Group Description
TANFCOR Children who are receiving TANF child-only benefits and living with relative caregivers
TANFCOP Children who are receiving TANF child-only benefits but living with a parent
TANFHH Children living in households that receive TANF
LOWINC Children who are in low-income households but not receiving any TANF benefits
KINCARE Children living with relatives who are not receiving TANF
FOSTER Children living with nonrelatives in foster care
OTHER All other children (children living with parents in higher-income households that do not receive TANF)

The study staff used an algorithm developed by a member of the NSCAW analysis team to identify children in TANF child-only cases with relative caregivers from the NSCAW data. Researchers used an item on the interview of the child's current caregiver that asked for whom the TANF or AFDC benefits that were received by the household were provided. Project staff asked this question only of caregivers who indicated in a previous item that someone in the household presently receives TANF or AFDC. Possible responses regarding who received TANF or AFDC were (1) child and other household members, (2) child only, and (3) other household members only. Researchers then limited the child-only cases to those living with a primary or secondary caregiver who is a nonparental relative. The results indicated that at Wave 1 (baseline), 13 percent (weighted) of the cases that received TANF received them for the child only.

The algorithm for the creation of the comparison groups relied on information about whether children are living in their home or outside of their home, their relationship to their caregiver, whether their caregiver receives foster care payments, and who in the household receives TANF benefits. Study staff created categories hierarchically to be mutually exclusive, so if children met the criteria for being classified as child-only TANF living with a relative caregiver, they were excluded from subsequent categories for which they might qualify, such as KINCARE. The logic and order of comparison group creation are presented in Table 3-2.

Table 3-2.
Logic and Order of Comparison Group Creation
In Own Home Caregiver Foster Care Payments TANF Our Category N
Unweighted Weighted
N Relative N Child TANFCOR 54 13,954
Y Parent N Child TANFCOP 95 36,587
Y Parent N Household TANFHH 763 356,901
Y Parent N None LOWINC 1196 657,933
N Relative Some Some KINCARE 456 92,247
N Other Y N FOSTER 565 78,506
        OTHER 1,724 904,983

Children who are part of households receiving TANF benefits were identified from the same set of questions as the child-only cases, only this group comprises those children whose households reported that the household and child, or just the household, receives TANF benefits.

Researchers relied on a different set of questions to identify other children in out-of-home care with relative caregivers, or with nonrelative caregivers. Using a series of questions on the child's living arrangements, staff identified children living out of their homes and then examined the type of out-of-home care. The response categories specify kincare and foster home. For kincare, researchers required that the primary caregiver be related to the child but not a biological, adoptive, or step parent. For the foster care category, staff required that the parent reported receiving foster care payments. Because of small numbers in the kin foster care category, staff defined kincare as including both kin foster care and kin care without foster care payments. Some of these relative caregivers receive TANF for the entire household, as described in Section 2.2.1. Children living with nonrelatives receiving foster care payments were classified in the foster care group. Researchers did not include children who are in residential programs or group homes in either category.

To identify the comparison group that included children in households that were low income but not receiving TANF, staff used a categorical variable that asks respondents to choose an income category that reflects the total combined income of all members of the household over the past 12 months. Study staff created an algorithm that related household size, Federal Poverty Level (FPL), and reported income. Researchers used the NSCAW income increment that was closest to the FPL for a given family size, as shown in Table 3-3, and households that were at or below the FPL were included in the analysis.

3.2.3 Analysis

Demographics

The study team examined the demographic characteristics of the children in each group, focusing on the variables included in Table 3-4. More than half the children in each group (except OTHER) are 5 years of age or less; the low mean age suggests that this group is highly skewed toward children aged 2 or less.

Table 3-3.
Definitions of TANF Eligibility by Income Range and Household Size
Household Size Federal Poverty Level
for Household Size		 NSCAW Maximum
for Income Category		 Difference
1 8,350 4,999 3,351
2 11,250 9,999 1,251
3 14,150 12,500 1,650
4 17,050 17,500 (450)
5 19,950 17,500 2,450
6 22,850 22,500 350
7 25,750 22,500 3,250
8 28,650 27,500 1,150

Table 3-4.
Demographic Characteristics of Children by Group(a)
(all numbers percentage except mean age)
TANFCOR TANFCOP TANFHH LOWINC KINCARE FOSTER OTHER
Male 0.60 0.55 0.53 0.47 0.35* 0.55 0.52
Mean Age (Years) 2.35 2.29 2.56 2.70 2.42 2.24 2.72
Less than 1 Year 31.48 36.84 21.63 17.73 24.34 35.99 14.62
1 to 5 31.48 38.95 32.24 33.61 32.46 23.94 32.54
6 to 10 20.37 14.74 27.79 29.10 23.90 24.11 27.61
11 and Over 16.67 9.47 18.35 19.57 19.30 15.96 25.23
Substantiated Investigation 0.52 0.21 0.31 0.29 0.57 0.71 0.28
White 0.55 0.43 0.25** 0.47 0.44 0.41 0.56
Black 0.31 0.34 0.42 0.25 0.33 0.34 0.22
Hispanic 0.06 0.06 0.25*** 0.20 0.16 0.18 0.16
Other 0.08 0.17 0.08 0.07 0.07 0.08 0.06
In Home 0.32 1.00*** 1.00*** 0.98 0.22 0.00*** 1.00
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the National Survey of Child and Adolescent Well-Being (NSCAW), a national survey of children who have been investigated for abuse or neglect.

KINCARE children tend to be female, while the other groups tend to have a fairly even balance between male and female. TANFHH children are less likely than TANFCOR children to be white and more likely to be Hispanic. TANFCOP and TANFHH children are more likely to be at home, while FOSTER children are less likely. Children in nonkin foster placements are more likely to have substantiated child welfare investigations than children in the other groups.

Variables Related to Child Well-Being

NSCAW collects a number of measures of child well-being that include the following areas of function: cognitive status, neurodevelopmental impairment, communication, school achievement, school engagement, relationships with peers, protective factors, and parental monitoring. Because each of these instruments has a specified age range, some measures are not available for some groups of children. This analysis uses the measures shown in Table 3-5, which were selected to maximize data on various aspects of child well-being across the sample age range.

Table 3-5.
Summary of Child Well-Being Measures by Age(a)
Measure Age
0 1 2 3 4 to 5 6 7 to 10 11 to 15
Social Skills Rating System       X X X X X
Child Behavior Checklist     X X X X X X
Children's Depression Inventory             X X
Preschool Language Scale-3 X X X X X      
Battelle Developmental Inventory X X X X        
Youth Self-Report               X
Total 2 2 3 4 4 3 4 5
(a): Data from the National Survey of Child and Adolescent Well-Being (NSCAW), a national survey of children who have been investigated for abuse or neglect.

Table 3-6 shows that TANFCOR children tended to have the highest percentile scores and standardized scores for social skills in preschool. For standardized scores, TANFCOR children scores were significantly higher than those of children in the KINCARE, FOSTER, and TANFHH groups. Children in the TANFCOP, LOWINC and OTHER groups had scores that were not significantly different from those of the TANFCOR children. In the measures of well-being that address social skills and developmental status, higher scores are better scores. For problem-focused measures, such as the Child Behavior Checklist, the opposite is true.

Children in TANF child-only cases with relative caregivers score somewhat higher on developmental indicators, but also have some indicators of behavioral and mental health problems.

The TANFCOR group scored very well on the perceptual discrimination section of the Battelle Developmental Inventory, relative to the other children. TANFCOP children and TANFHH children both scored lower on this part, with a significance difference at the 10 percent level. No significant differences were observed among the various categories of children for the other sections of the Inventory, such as memory, reasoning and academic skills, and conceptual development. TANFCOR children also scored well on the reasoning and academic skills section and the conceptual development section, though no significant differences were noted. Furthermore, while there were no significant differences across the groups, TANFCOR children had the highest rating for their language skills.

On the child behavior checklist, where higher scores reflect more behavior problems, younger children in the TANFCOR group had significantly higher scores than the TANFHH and KINCARE groups. Although there were no significant differences between percentile scores for child behavior among the different groups of older children, a different pattern was observed. FOSTER children scored the highest, and the TANFCOR children scored the lowest except for the OTHER children.

Similarly, no significant differences were observed among the children's depression levels or their trauma symptoms, although TANFCOR children had relatively high scores on depression and trauma symptoms compared to other children. On the behavior section of the Youth Self Report, where again higher scores indicate more problems, TANFCOR children scored relatively well. The TANFCOP, FOSTER, and LOWINC children all reported higher scores than the TANFCOR children. The KINCARE group scored significantly higher at the 10 percent level, and the TANFHH group scored significantly higher at the 1 percent level from the TANFCOR children.

Table 3-6.
Measures of Well-Being(a)
  TANFCOR TANFCOP TANFHH LOWINC KINCARE FOSTER OTHER
Social Skills Rating System
PS: Social Skills Percentile-Preschool 50.74 23.87*** 28.24 34.60 32.26 23.53 32.89
PS: Social Skills Standard-Preschool 100.53 87.18 87.68*** 91.28 89.43*** 85.34*** 90.45
Battelle Developmental Inventory
BD: Perceptual Discrimination-Percentile 46.09 14.34* 18.99* 23.07 26.17 28.35 24.54
BD: Memory-Percentile Score 23.74 28.87 28.90 25.43 27.61 30.76 28.12
BD: Reason and Academic Skills-Percentile 34.92 19.51 19.47 24.75 26.13 31.50 19.44
BD: Conceptual Develop.-Percentile 40.55 24.87 21.09 26.13 18.70 30.22 26.62
Preschool Language Scale
CO: Total Langu (Aud/Express) Std. Score 98.91 85.91 86.28 87.54 91.71 88.43 89.72
Child Behavior Checklist
TC: Total Percentile (0-4) 82.17 75.09 69.94*** 59.65 64.17*** 82.88 53.44
BC: Total Percentile Score (4-18) 68.62 73.25 73.03 69.49 69.55 82.00 67.25
Children's Depression Inventory
CD: Depression: Total CDI Raw 11.20 8.31 9.68 11.37 8.59 11.18 9.14
Trauma Symptom Checklist
TR: Trauma: PTS Raw Score 13.46 9.07 8.40 8.61 8.28 9.89 8.32
TR: Trauma: PTS T Score 57.85 49.40 49.32 49.50 48.93 52.03 49.00
Youth Self-Report
YB: Behavior Probability: Total Raw Score 29.46 37.40 48.10*** 46.59 43.59* 41.83 45.73
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the National Survey of Child and Adolescent Well-Being (NSCAW), a national survey of children who have been investigated for abuse or neglect.

Overall, the one area that seems problematic for the TANFCOR group is in reports of depression and trauma, although these differences are not statistically significant. In terms of social skills, problem behavior, and development, TANFCOR children scored as well or better than the other groups of children.

Variables Related to Service Use

NSCAW provides a wide range of data on services received by the child (Table 3-7) and by the caregiver (Table 3-8). Data on services received through the child welfare system are included in subsequent waves of data collection and are not reported here.

Children in TANF child-only cases with relative caregivers were less likely to use emergency health care than other children.

For many of the service use categories, no significant differences were reported by different groups of children. These service categories include seeing a dentist; taking a vision test; going to the ER or urgent care unit for an illness; requiring a nurse or doctor to treat an injury, accident, or poisoning; and being tested for learning problems. TANFCOR children did well in rates of hearing tests, with children in the FOSTER group using this service significantly less. TANFCOR children also had a relatively low rate for overnight hospital admissions for an illness or injury, while KINCARE, FOSTER, and TANFHH children had significantly more admissions. FOSTER and TANFHH children were more likely to be currently enrolled in a daycare program than TANFCOR children, at a significance level of 5 percent. FOSTER children were also more likely to be diagnosed with a learning problem or disability by a professional than TANFCOR children. TANFCOR children were significantly less likely to be receiving special education services or enrolled in special education classes compared to children in the KINCARE, FOSTER, TANFCOP and TANFHH groups.

There were no great differences in WIC coverage across the different groups of children. TANFCOR children were more likely to receive food stamps than FOSTER children, but less likely than TANFCOP children. These differences were statistically significant. KINCARE and FOSTER children were less likely to be receiving TANF funds or other public assistance, whereas TANFCOP and TANFHH children were more likely to receive housing support than TANFCOR children. TANFCOP children were significantly (p < 0.10) more likely to be in a household that receives SSI; not surprisingly, since this would qualify the household for child-only TANF benefits. Similarly, KINCARE and FOSTER were more likely to receive foster care payments.

Table 3-7.
Child-Reported Service Use(a) (for Children over age 11 during the past year)
  TANFCOR TANFCOP TANFHH LOWINC KINCARE FOSTER OTHER
Child saw dentist/hygienist 64% 43% 60% 53% 58% 51% 59%
Child had vision test 55% 65% 74% 71% 56% 48% 72%
Child had hearing tested 70% 57% 77% 78% 55% 51%* 76%
Child admitted to hospital overnight for injury or illness 1% 3% 7%*** 8% 5%** 7%*** 4%
Child went to ER or urgent care for injury or illness 22% 42% 36% 42% 28% 31% 35%
Child had injury/accident or poisoning requiring doctor or nurse 5% 16% 9% 10% 7% 6% 11%
Child currently in any daycare program 21% 15% 28%** 27% 26% 30%** 30%
Child tested for learning problems 41% 27% 37% 41% 25% 38% 36%
Professional says child has learning problem or disability 12% 11% 28% 25% 27% 34%** 20%
Child currently receiving special education services or classes 17% 74%* 80%*** 80% 81%*** 89%*** 78%
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the National Survey of Child and Adolescent Well-Being (NSCAW), a national survey of children who have been investigated for abuse or neglect.

Table 3-8.
Caregiver Reported Program Use(a)
  TANFCOR TANFCOP TANFHH LOWINC KINCARE FOSTER OTHER
WIC 40% 52% 45% 33% 35% 37% 18%
Food Stamps 8% 88%*** 90% 50% 17% 04%*** 16%
TANF, AFDC, General Assistance/ Other Public Assistance 100% 100% 99% 7% 22%*** 04%*** 0%
Housing Support 3% 18%*** 26%*** 13% 4% 2% 5%
SSI 13% 38%* 20% 22% 26% 12% 13%
No One Receives Anything 0% 0% 0% 26% 39%* 51%* 58%
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the National Survey of Child and Adolescent Well-Being (NSCAW), a national survey of children who have been investigated for abuse or neglect.

Table 3-9 shows that all groups of children received peer support at relatively the same levels. TANFHH children, however, did use a drop-in community youth center more often. This is perhaps due to their older age.

Table 3-9.
Percent Reporting Social Services Received by Children(a)
Question Response TANFCOR TANFCOP TANFHH LOWINC KINCARE FOSTER OTHER
Peer Support Group Yes 13% 31% 31% 33% 19% 28% 23%
Drop-In Community Youth Center(b) Yes 9% 2% 32%*** 29% 12% 22% 27%
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the National Survey of Child and Adolescent Well-Being (NSCAW), a national survey of children who have been investigated for abuse or neglect.
(b): For children over 11 years old.

3.2.4 Summary

Overall, the NSCAW data paint a fairly reassuring picture of the well-being of children in TANF child-only cases with relative caregivers when compared to children in other groups. There are no significant indications in service use, service needs, or child well-being measures that this group is exceptionally vulnerable or ill-served. Compared with other children supported by TANF and other children in out-of-home care, children in TANF child-only cases with relative caregivers appear to have equal or better use of preventive health care and lower use of emergency room and inpatient care. They also appear to have comparable or favorable developmental status indicators. Relative caregivers are less likely to report using support services such as food stamps and housing assistance.

Children in TANF child-only cases with relative caregivers compare favorably with other children supported by TANF on most measures, with many similarities to other children in out-of-home care.

The only area of possible vulnerability for these children is in measures of behavioral and emotional well-being, although many of these differences are not statistically significant. Compared to other children supported by TANF, children in TANF child-only cases with relative caregivers show some indications of increased behavioral problems among younger children, as well as increased rates of trauma and depression. These may reflect the effects of disrupted parental relationships. On these measures, children in TANF child-only cases with relative caregivers are similar to other children in out-of-home care, and in some cases report less favorable conditions. However, that interpretation of the NSCAW data should be tempered with the understanding that all children surveyed have had some contact with Child Protective Services, so that children in the TANFHH and TANFCOP categories do not represent the larger populations of TANF recipients. Another caveat is that given the small sample sizes and large standard errors, there may be differences between groups that were not detectable.

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3.3 Analysis of the Survey of Income and Program Participation

3.3.1 Data Overview

The Survey of Income and Program Participation (SIPP) is an ongoing longitudinal, nationally representative survey of between 20,000 and 40,000 households that has been conducted since 1983. In analyzing children in TANF child-only cases with relative caregivers, only the new panel that ran from 1996 to 2000 is relevant. The panel was modified soon after its fielding to account for changes in program details and eligibility with the passing of PRWORA. This panel consists of over 40,000 households comprising 95,000 individuals who are surveyed every 4 months. The core set of questions obtains extensive information on income and assets from all sources, labor force attributes, family structure, health insurance, and education. More detailed questions (modules) on special topics were asked periodically. The child well-being module, including questions on each child's TV viewing, reading or being read to, and activity participation, was included twice between 1996 and 2000. Questions of basic needs and food availability were asked in an adult well-being module once during the period. In the 1996û2000 panel, the survey contained approximately 1,000 children who did not live with any parent.

3.3.2 Identifying Child-Only Cases and Comparison Groups

The SIPP began a new longitudinal panel in 1996, sampling some 80,000 individuals in four subgroups over 12 waves. Because study staff used the SIPP for a cross-sectional snapshot only, they used wave 9, which took place in late 1998. The survey is structured as a core set of questions asked in each wave, with special topical modules asked in only one or two of the 12 waves. Topical modules 2, 6 and 8 had the greatest number of relevant questions on child welfare, welfare reform, and other well-being questions. All were linked to wave 9 core question data. Thus, researchers created a database for each individual in the sample (adults and children, total = approximately 80,000) containing variables from core wave 9, and topical modules 2, 6, and 8.

To define the child-only population, for each child under age 18, staff determined whether he or she was living with a mother or father in the same household by using the person number of the mother and father for each child and the household ID. Staff then used the variable that flags a TANF recipient to further categorize children. Researchers created a variable to indicate whether a child's guardian or household reference person (2) received TANF, and checked whether the household reported receiving foster care payments. Combinations of these variables were used to define groups of children that paralleled the categories defined for the NSCAW analysis.

Table 3-10 summarizes the variables used to define each group. Note that no children in the SIPP met the definition criteria for the FOSTER group. The only households reporting receipt of foster care payments were in the KINCARE group, likely representing relative caregivers who are licensed foster care providers. The SIPP classification algorithm included 18 cases in which children lived with relative caregivers and the entire household received TANF in the TANFCOR group. Similar cases in NSCAW were classified in the KINCARE group, resulting in an unintended inconsistency between the two analyses.

Table 3-10.
Logic and Order of Comparison Group Creation
Kinship Foster Care Payments TANF Our Category N
Unweighted Weighted
Relative No Child or household TANFCOR 117 376,776
Parent No Child TANFCOP 420 1,438,519
Parent No Household TANFHH 694 2,333,692
Parent No No LOWINC 119 434,812
Relative Some No KINCARE 881 2,762,340
Other Yes No FOSTER 0 0
      OTHER 20,036 70,122,574

3.3.3 Analysis

Demographics

Race and age distribution varied substantially among the groups (Table 3-11). Only in the TANFCOR group were a majority of children Black. The majority of children in all other groups were white, although the proportions varied substantially among the groups. The majority of children in each group were aged 5 years or older, and TANFCOR children were least likely of all groups to be under 1 year of age. In the SIPP data, the TANFCOR group is an older group relative to the comparison groups. The TANFCOR group in the NSCAW data was younger relative to the comparison groups. This difference is fortuitous and convenient for examining the well-being of TANFCOR children at older ages, although the SIPP and NSCAW samples do have other underlying differences.

Table 3-11.
Demographics(a,b)
Question Response TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Child's race White 44.4 51.7 45.4* 92.6*** 64.2*** 81.2***
Black 55.2 39.7 42.7 3.4 32.2 13.9
American Indian 1.9 1.5 3.6 0.0 1.5 1.6
Asian or Pacific Islander 1.5 7.1 8.2 4.0 2.1 3.3
Mean age 9.2 7.2 8.0 9.3 9.5 8.4
Age as of last birthday Less than 1 year 1.0 9.1*** 5.3*** 7.2 5.2 6.4**
1-5 23.6 31.2 32.1 20.9 20.9 27.7
6-10 33.9 27.9 28.5 31.5 28.4 28.3
11-17 41.4 31.7 34.2 40.4 45.5 37.6
Relationship of child to reference person Child of reference person 0.0 81.3*** 89.5*** 94.2*** 0.0*** 93.6***
Grandchild of reference person 56.7 15.8 6.6 0.0 37.4 4.1
Brother/sister of reference person 10.1 0.0 4.1 0.1 0.0 0.3
Other relative of reference person 39.9 0.8 2.2 0.3 27.5 1.1
Foster child of reference person 0.0 0.0 0.0 0.0 12.4 0.0
Other 8.5 2.2 1.8 5.5 21.8 1.2
Relationship of reference person to child Biological parent 4.2 78.7 86.8 89.9 18.0 89.2
Stepparent or adoptive parent 1.8 2.5 2.0 8.8 3.7 5.3
Grandparent 68.3 13.2 5.9 1.0 45.6 3.4
Other 26.4 5.8 5.3 0.4 32.4 2.1
Total number of persons in this household in this month 1-2 7.1 5.8 8.1 5.7*** 10.6*** 4.1***
3-4 33.6 36.5 41.7 80.8 47.9 53.8
5 or more 59.4 57.8 50.4 13.5 41.3 42.2
Number of own children under 18 in family (question is asked of the household reference person) 0 70.8 12.3 4.4 19.1 85.5 6.5
1 14.9 17.1 18.2 43.0 8.2 22.3
2 4.9 22.1 25.7 28.4 4.5 37.8
3 or more 9.4 48.7 51.8 9.5 1.9 33.4
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.
(b): Data from the Survey of Income and Program Participation, a national household survey.

The relationships between the child and the reference person (the sampled household member) varied widely across the groups of children. By definition, TANFCOR households were more likely to have a nonparental relative of the child living in the household. A small majority of TANFCOR children lived with their grandparents, though many TANFCOP and KINCARE children also lived with grandparents. Almost a third of TANFCOR children lived with a relative other than their grandparent or sibling, a higher percentage than for any other group.

About 60 percent of TANFCOR households contained more than four people; other groups were more likely to contain four people or fewer. Most reference persons were likely to have up to four of their own children in the household. TANFCOR and KINCARE reference persons were least likely to have any of their own children who were under the age of 18, which makes sense given that the majority of these reference persons are grandparents.

Program Coverage

Children in TANF child-only cases with relative caregivers have lower participation in most assistance programs, and more favorable indicators of housing adequacy and food security.

Table 3-12 shows that TANFCOR households were more likely than other groups to receive SSI and General Assistance, although these distinctions are not statistically significant for most groups. However, a mixed pattern was seen for Medicaid, WIC, and Food Stamp coverage, where TANFCOR children were less likely to receive coverage than TANFCOP or TANFHH children, but more likely to be in households with this coverage than KINCARE children. The low rate of Medicaid coverage among KINCARE children is explained in some small part by their higher rate of other health insurance coverage. The fact that biological parents appear to be receiving more coverage for their household, whether from WIC, Food Stamps, or Medicaid, may indicate greater ability, desire, or assistance in navigating the system as compared with other caregivers. In the case of food stamps, relative caregiver households may be ineligible if they exceed the income limits. Given these differences in levels of public assistance, it is surprising that there are not greater differences in child outcomes. SIPP data for receipt of WIC by children alone do not alter this pattern.

Economic Well-Being

The child well-being measures in the SIPP data are complementary to those presented in NSCAW data, in a sense, because they focus more on the child's environment and experiences than on standardized testing and well-being measures. Unfortunately, the differences in measures and samples make comparisons difficult. In the SIPP data, staff focused on housing and food security as measures of economic well-being, at least at the level of the household.

The majority of each group was at least somewhat satisfied with the quality of their homes (Table 3-13). A common pattern across characteristics of their living situation is that TANFCOR families were more likely to be very or somewhat satisfied than TANFCOP and TANFHH families. Although this finding is a positive one, indicating that TANFCOR families are certainly no worse off than other TANF families, the standard of somewhat satisfied is probably a low one. Also, the differences between the families on TANF and the other groups, including KINCARE, LOWINC, and OTHER, are consistent. The non-TANF families had very high ratings of satisfaction with their housing.

Table 3-12.
Percent Reporting Service Use(a)
Question TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Federal SSI 4.4 3.0 3.6 0.0*** 3.1 1.1*
General Assistance 2.7 1.4 0.7 0.0 1.0 0.2
Foster Care Payment 0.0 0.0* 0.0* 0.0* 3.3*** 0.0*
WIC Coverage 12.1 23.0*** 14.5 0.0*** 4.0** 6.0**
Food Stamp 45.6 83.6*** 88.6*** 0.0*** 9.7*** 6.5***
Medicaid 70.3 87.0*** 89.8*** 0.0*** 28.3*** 11.7***
Health Insurance 8.2 8.8 8.0 93.1*** 38.3*** 72.4***
WIC 1.4 0.6 0.7 0.0 0.9 0.4
SSI 0.8 1.1 1.4 0.0 0.7 0.4
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

While both KINCARE and TANFCOR families are caring for relative children, Table 3-10 shows that TANFCOR households are larger and more likely to be headed by grandparents rather than other relatives. A small percentage of KINCARE families are receiving foster care payments, and may be more likely to be wage-earners. Age, household size, and access to other resources are likely to explain the different levels of satisfaction with housing. To further understand the impact of resources for relative caregivers would require more than a descriptive analysis of the data, since discerning the type of caregiver and caregiver resources is necessary.

Table 3-13.
Child's Home and Environment(a)
Question TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Percent very or somewhat satisfied with:
The general state of repair of home 77.5 73.5 74.3 96.9*** 87.0*** 90.5***
The amount of room or space in home 87.5 6.5*** 75.5*** 98.0*** 86.0 84.6
The warmth of home in winter 80.0 76.3** 73.9*** 96.8*** 86.5 89.5***
Percent who consider neighborhood very safe or safe from crime 77.7 71.1 69.0* 100.0*** 84.7*** 90.7***
Household has:
Personal computer in working condition 26.1 12.1*** 15.0** 88.3*** 34.1 54.5***
Safety devices, alarm system 11.2 10.8 9.5 54.6*** 22.7*** 28.1***
Phone in home 83.6 79.3 79.8 99.1*** 95.5*** 95.9***
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

In addition to housing satisfaction, another important dimension of economic well-being is food security. Table 3-14 shows that a large number of respondents thought issues of food security were not applicable to them, which is a positive finding in itself. The pattern of findings for food security is very similar to that of satisfaction with housing. Again, compared to others on TANF, TANFCOR children had less of a problem having enough to eat. Children in families receiving TANF (TANFHH) were the most likely to have problems with food security, and reported trouble with affording balanced meals, or having enough food for the children to eat. Even in this group, only 6.4 percent of children were reported by a caregiver as often not eating enough. The standard of "enough" is probably quite variable, but consistent with previous research; this finding indicates that the population that is most likely to have food security problems is also the most likely to be covered by WIC and food stamps.

Table 3-14.
Child's Nutrition(a)
Question Response(%) TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Couldn't afford balanced meals Often true 4.8 4.8 10.2*** 3.9*** 3.8 2.2***
Sometimes true 21.1 31.9 32.7 1.9 18.6 10.2
Never true 74.2 63.4 57.1 94.3 77.6 87.6
Children were not eating enough N/A 60.5 50.8 46.1** 94.2*** 71.3** 81.6***
Often true 2.6 1.3 6.4 0.0 1.4 1.0
Sometimes true 8.2 19.4 14.4 1.0 7.8 4.6
Never true 28.7 28.4 33.2 4.8 19.5 12.8
Didn't eat for a whole day N/A 78.2 70.4 67.3** 96.8*** 83.4 90.4***
Yes 2.7 6.2 7.6 0.0 2.3 1.5
Did get breakfast under federal school breakfast program? N/A 63.5 51.9** 51.0*** 94.7*** 74.9** 86.3***
Y 34.9 44.6 43.4 2.7 24.1 12.3
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

As compared with KINCARE, LOWINC, and OTHER children, the TANFCOR group had significantly more issues with food security. This is not surprising, except in the case of children in the KINCARE group. The discussion here parallels that of housing differences. Whether these differences reflect access to public resources, since KINCARE and TANFCOR children lived in households that were less likely to be covered by WIC and Food Stamps, is an important question.

Table 3-15 shows education and caregiver aspirations for their children as another component of child well-being. Small percentages of children in all groups attend a special class for gifted students or do advanced work in any subject. Of those groups, however, TANFCOR children were the least likely to do advanced work and most likely to have been held back, although these differences are not significant. While these characteristics may be due to trauma of separation from parents, it is surprising that there is a large difference between TANFCOR and KINCARE children in these responses. Obviously, some attention to age patterns within comparison categories would be helpful in sorting out these differences. On the surface, TANFCOR children are older as a group, and as such would be more likely to have had the chance to do advanced work, but they would also have had more of a chance to have been held back in school. More detail or multivariate analysis including age would be helpful.

Table 3-15.
Child's Education(a)
Question Response(%) TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
Does child go to a special class for gifted students, or do advanced work in any subject? Yes 5.4 7.8 7.1 24.7 8.7 11.5
How far do you think child will go in school? Graduate from high school or more 95.2 97.4 96.9 89.8 89.2 87.4
Educational attainment you would like for your child Graduate from high school or continue further 95.1 98.7 98.5 91.7 90.4 98.0
Has child been held back in school? Yes 16.3 6.8 9.0 4.9 8.5 5.6
Are there family rules about how early or late child may watch television? Yes 70.8 61.0 71.0 60.3 67.3 69.3
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

The patterns for the other groups are somewhat surprising. Although the LOWINC and KINCARE groups had higher percentages of children in advanced classes and fewer being held back, they were less likely to expect or hope that their child would graduate from high school. It is worth noting that these differences are not statistically significant, and that at least 90 percent of all caregivers reported thinking and hoping that their child will complete high school or more.

Another SIPP question assesses whether the caregiver thinks their child is difficult to care for. Table 3-16 shows that caregivers reported that this is not the case for more than 98 percent of children in all categories. While children in the TANFCOR category were the most likely to be called difficult by a caregiver, the difference is small and not statistically significant.

Table 3-16.
Child's Health and Health Care Utilization(a)
Question TANFCOR(%) TANFCOP(%) TANFHH(%) LOWINC(%) KINCARE(%) OTHER(%)
% reporting child is not hard to care for 98.1 99.8 99.7 99.1 99.4 99.8
% with private health insurance coverage in this month 8.2 9.5 8.8 97.5*** 42.2*** 74.5***
% Reporting excellent/very good/good current health status 91.7 92.9 95.1 99.3 95.4 97.8
% Reporting fair/poor current health status 8.3 7.1 5.0 0.7 4.6 2.3
% reporting no dental visits in past 12 months 58.3 61.0 53.7 22.9*** 44.5*** 43.9***
% reporting no medical provider visits, past 12 months 37.1 40.8 32.3 22.6*** 34.5 30.8
% reporting more than 2 sick days in past 12 months 3.6 2.5 4.3 14.4 6.2 6.3
% who did not see a dentist when needed 8.6 11.6 12.0 1.2*** 12.4 2.5
% who did not see a doctor when needed 11.6 10.1 14.8 3.6** 9.6 7.5
***: Significantly different from TANFCOR at the 0.01 level.
**: Significantly different from TANFCOR at the 0.05 level.
*: Significantly different from TANFCOR at the 0.10 level.
(a): Data from the Survey of Income and Program Participation (SIPP), a nationally representative household survey.

Another dimension of child well-being that is more comparable to data from NSCAW relates to child health and health care utilization. Differences in health status are not very large: across all categories of children, more than 90 percent were reported to be in good, very good, or excellent health. TANFCOR and TANFCOP children were the most likely to report being in fair or poor health, with KINCARE and TANFHH children being in the middle, and LOWINC and OTHER children being in the best health. Although these differences are not statistically significant, the pattern reflects a consistent one, with TANF children doing worse than their nonTANF counterparts, including the KINCARE group. Across all groups, KINCARE, LOWINC, and OTHER had high rates of private insurance coverage for the current month, which likely reflects higher income or caregiver employment, and lower Medicaid eligibility in these groups.

Measures of well-being suggest that children in TANF child-only cases with relative caregivers fare better than other children on TANF, but not as well as children in kinship care.

In terms of health care utilization measures, again the pattern is consistent, but less dramatic. The LOWINC group was more likely to have seen a doctor and a dentist in the past year, consistent with higher reports of sick days. The other non-TANF groups, KINCARE and OTHER, were also more likely to have seen a dentist. This may reflect a lack of dental coverage or limited access to dentists in the state Medicaid programs, since TANF children are more likely to have Medicaid coverage. Differences for dental care are statistically significant, while only the LOWINC group is statistically more likely to have seen a doctor in the past year. The other groups were all similar, with about 60 to 65 percent reporting at least a medical visit in the past year, and small numbers reporting more than one sick day in the past year.

Not surprisingly, LOWINC members were also least likely to report not having received medical or dental care when they needed it. The TANF children had higher rates of unmet need for medical and dental coverage, ranging from 9 to 15 percent. Among TANF children, TANFHH were the most likely to report unmet need, although the difference is not statistically significant. It is interesting to note that in terms of unmet need, the KINCARE group had rates as high as the TANF groups. Given the private insurance coverage in the KINCARE group, this finding might indicate more of a problem with caregiver access than with coverage, but nothing can be concluded from these descriptive results.

3.3.4 Summary

The overall picture from the analysis of the SIPP data is quite interesting. Relative to other groups on TANF, the TANCOR group did not have the same rates of public coverage, whether for WIC, Food Stamps, or Medicaid. While this finding may be because coverage flags were for household coverage, a similar pattern was observed for KINCARE children, except that they had even less public coverage than did the TANFCOR group. In general, except for coverage issues, the TANFCOR group did better on well-being indicators than the others on TANF, but worse than the KINCARE, LOWINC, and OTHER groups. The LOWINC and OTHER groups were likely to be wealthier than KINCARE and TANFCOR groups, as well as having parental caregivers. In trying to assess the relative import of economic resources and caregiver characteristics on child well-being, it seems that both the KINCARE and TANFCOR groups had limited access to public assistance, and the same nonparental (likely to be a grandparent) caregiver. The pattern of TANFCOR faring better than other TANF groups and worse than KINCARE, LOWINC, and OTHER was consistent across dimensions of well-being.

Aside from the public coverage that seems weak for both KINCARE and TANFCOR groups, the KINCARE group rates are consistently better on economic well-being measures, including housing and food security. TANFCOR children were the most likely to have been held back or not be doing advanced work, and as such did worse than KINCARE children on educational well-being measures as well. If this finding is even partially due to the trauma of separation from a parental caregiver, it is surprising that the same finding was not true of the KINCARE group. In terms of access and utilization of health care, the two groups were similar, except that KINCARE children had higher rates of private coverage and higher reports of dental visits in the past year.

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3.4 Discussion

The two surveys analyzed, SIPP and NSCAW, provide largely complementary views of children in TANF child-only cases living with relative caregivers. The samples of children are markedly different, as are the questions asked of them. In both cases, the samples of TANFCOR children are small, so statistical comparison is limited. However, the comparison groups, similar across the data sets, allow a descriptive analysis of the relative well-being of children in the TANFCOR group, which was the goal of this analysis. Despite their statistical limitations, these descriptive analyses also allow, to some extent, a look at the relative impact of public assistance and caregiver assistance on child well-being.

Both SIPP and NSCAW suggest that children in TANF child-only cases with relative caregivers are similar to other children on TANF on many measures of well-being, with some indicators of vulnerability.

Comparing children in TANF child-only cases with relative caregivers to other children on TANF who live with their parents, researchers found little evidence that TANFCOR children are worse off in terms of well-being. However, there are specific areas of vulnerability or concern from NSCAW and SIPP. These include indicators of mental health problems, trauma, and educational problems such as being held back a grade. It is likely that some children who need to live with a relative caregiver will have psychological needs related to both the separation from their parents and events precipitating the separation. Depending upon when the separation occurs, it can affect educational outcomes and well-being generally. Again, it is important to remember that the NSCAW sample is drawn from a child welfare population, so that comparisons will differ from those in SIPP.

Compared to other children in out-of-home-care, children in TANF child-only cases with relative caregivers have generally favorable status, suggesting a positive caregiver effect.

Compared to other children in out-of-home-care, TANFCOR children in NSCAW tend to have a favorable status with respect to health care utilization, developmental indicators, and mental health. The advantage appears to reflect caregiver effect or child characteristics, due to the fact that other categories of children in out-of-home care (KINCARE and FOSTER) should entail higher levels of services available to children. The SIPP findings are almost the inverse, with KINCARE children having higher levels of well-being in most spheres. While many KINCARE children in SIPP have no child welfare involvement, and the NSCAW ones necessarily do, these patterns are somewhat surprising and could be productively analyzed. A multivariate analysis could address the relative impact of resources and caregiver characteristics, while controlling for age differences and policy differences by state, if they were known. Depending on the state program boundaries, TANFCOR children may be similar to children in kinship foster care or foster care, but receiving fewer services and supports.

The analyses were limited by the small numbers of children who are child-only TANF cases living with relative caregivers, as well as the lack of state-level identifying information in the unrestricted-use NSCAW data set. A simple multivariate analysis with careful coding of benefits received to care for the child in question might allow a better distinction between caregiver and resources effects of well-being. This distinction is relevant to the policy considerations regarding how best to protect the well-being of these vulnerable children.

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Endnote

(2) The reference person is the point-person in the sampled household — usually the owner or renter of record.

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