July 15, 2025 • 29 mins
In this episode of The Paid Leave Podcast, I speak with Dr. Lindsay Rose Bullinger. Dr. Bullinger is an associate professor and researcher in the School of Public Policy at Georgia Tech and is the Associate Director of the Health Economics and Policy Innovation Collaborative. We discussed paid leave policies and how it affects children and families. Dr. Bollinger's research in the paper titled, "More Than Snuggles, the Effect of Paid Family Leave on Infant Maltreatment" shows that state-sponsored paid family leave programs reduce infant maltreatment rates and home removals by 46 percent. The study, which focused on California, New Jersey, Rhode Island, and New York, highlights the importance of paid leave in improving maternal mental health and reducing financial stress. Dr. Bollinger emphasizes the need for more research on the long-term effects of paid family leave and its potential to reduce child abuse and neglect.
To find out more about Dr, Lindsey Rose Bullinger's research please go to: Paid Family Leave Helps Reduce Infant Abuse, School of Public Policy Study Finds | Ivan Allen College of Liberal Arts
To find out more information or to apply for benefits please go to: CT Paid Leave
https://ctpaidleave.org/s/?language=en_US
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Nancy Barrow (00:01):
Hello Connecticut, and welcome to The Paid Leave
Podcast. The title basicallysays it all. I'm Nancy Barrow,
and I will be delving into thisnew state program and how it can
help you and your family. Thispodcast will give you
information you should knowabout Connecticut Paid Leave and
maybe just a little bitmore!Connecticut Paid Leave
(00:22):
brings peace of mind to yourhome, family and workplace.
Welcome to The Paid LeavePodcast.
We're very lucky to have such acomprehensive paid leave policy
here in the state ofConnecticut. We are part of a
group of 13 states andWashington D.C. that have passed
paid leave policies when aqualifying need arises. And all
(00:43):
of the states right now areCalifornia, Colorado,
Connecticut, Delaware, Maine,Maryland, Massachusetts,
Minnesota, New Jersey, New York,Oregon, Rhode Island and
Washington and the District ofColumbia. 10 of these programs
are providing benefits now, andfour more are finalizing
regulations and systems to allowbenefits to start in 2026 an
(01:05):
article that our team saw abouthow paid family leave may
protect against rising infantmaltreatment rates crossed us
and we talked about it. And theauthor of that article is Dr
Lindsey Rose Bollinger. She's anassociate professor and
researcher in the School ofPublic Policy at Georgia Tech
and the Associate Director ofthe Health Economics and Policy
Innovation Collaborative. She iscurrently a co-editor of the
(01:29):
Journal of policy analysis andmanagement and a consulting
editor for child maltreatment.
She is also a faculty affiliatewith Georgia Policy Babs, the
Wilson Sheehan Lab for economicopportunities and the Children's
Pediatric Research Alliance. Andher research examines how public
policies affect children andfamilies, health and well being
with a focus on low incomefamilies, and her work focuses
(01:51):
on the role of public policiesin child abuse and neglect and
the effects of health policieson children and families. And
thank you so much for being onThe Paid leave podcast. Dr
Bollinger.
Dr. Lindsey Bullinger (02:02):
It's a pleasure. Thank you for having
Nancy Barrow (02:04):
Dr Bollinger, I know that some of the questions
me.
I asked you weren't in yourresearch, but I'm just going to
ask you to talk about it fromthe best of your ability. I
reached out to you, and you wereso gracious to come on this
podcast to talk about it. Sothank you so much for sharing
your findings with us.
Dr. Lindsey Bullinger (02:19):
Of course, I'm really excited to
talk about this work. I thinkit's very important and has some
some interesting policyimplications.
Unknown (02:27):
Yeah, it sure does. How did you get involved as a
researcher at the School ofPublic Policy at Georgia Tech?
Dr. Lindsey Bullinger (02:33):
Sure. So I did my PhD in public affairs
at the Indiana University. Andwhile I was in graduate school,
I became very interested in therole of public policy and Child
and Family Well Being, and oneof my dissertation chapters was
on the role of paid family leavein maternal mental health. And
(02:56):
at that time, there was kind ofa lot of research on paid family
leave, but it was almostexclusively from European
context or other developedcountries. And part of this is
because at that time, when I wasin graduate school in 2014, 15,
there were not many stateprograms in the United States.
(03:18):
And since then, of course, we'vehad a lot more, as you noted,
but at that time, there reallywasn't much research on us
programs, and so during graduateschool, I I spent a good deal of
time understanding the landscapeof the research at that time on
the role of paid family leave.
Nancy Barrow (03:40):
So interesting.
And how did the research foryour article "More Than
Snuggles, the Effect of PaidFamily Leave on Infant
Maltreatment?" How, how did youbegin that research for this to
actually start to become aproject that you did?
Dr. Lindsey Bullinger (03:54):
Yeah, so in my dissertation chapter, as I
noted, one of the projects thatI worked on in graduate school
was the studying the effects ofpaid family leave on maternal
mental health and well being,and I found significant
improvements in maternal mentalhealth using California as the
case study. And from there, Ibegan doing other research in
(04:19):
the landscape of child abuse andneglect. Along with my
co-authors on this paper, CarrieRacien, and some other
colleagues from Prevent ChildAbuse America, and as we were
studying, as I became more intothe research on child abuse and
neglect, I you know, we sort ofthought about, well, what are
some other policies that aremaybe not within the child
(04:42):
protective services system, thatcould potentially have
significant effects on ChildAbuse and Neglect. And so we
began looking at other policies,things like minimum wage
policies, things like the EarnedIncome Tax Credit, the SNAP
program, the WIC program, andthis paid family leave program
(05:06):
was, was one of the the ideasthat we had, in part, partly
because we came because of mydissertation chapter that found
improvements on maternal mentalhealth, which is a risk factor,
particularly for infantmaltreatment.
Nancy Barrow (05:20):
Yeah, It's so interesting that this research.
Did it? Did you work with UConn?
Did you work with the Universityof Connecticut on this project?
Dr. Lindsey Bullinger (05:29):
Sure, one of my co authors carries it is a
professor at the University ofConnecticut.
Nancy Barrow (05:33):
Oh, that's so cool. We didn't realize that
there was that connection there.
Awesome.
Dr. Lindsey Bullinger (05:37):
She and I are actually long time co
authors on several differentprojects.
Nancy Barrow (05:42):
That's great.
That's wonderful. Did youinterview people? Or what were
some of your references for yourdata? Where does like that data
come from?
Dr. Lindsey Bullinger (05:50):
Yeah. So for this project on child abuse
and neglect, we were looking atadministrative data from all
states across the country onreferrals of child abuse and
neglect to child protectiveservices agencies. And so
there's a national repository ofdata that that have this this
(06:13):
information. And so what we didwas, over the time period from
2004 to 2019 we looked at ChildAbuse and Neglect referrals,
particularly for infants, beforeand after each state during that
time period implemented its paidfamily leave program. So by now
(06:35):
we've got several more statesthat have a program, but during
the course of our study, thesestates would have been
California, New Jersey, RhodeIsland and New York.
Unknown (06:46):
Yeah, those were the big ones at the beginning. And
what were some of the factorsthat you found that led to
parents abusing their infants ormaltreating their infants? What
were some of the factors thatyou found?
Dr. Lindsey Bullinger (07:03):
So we did not actually look specifically
at some of these factors, butthere is a very wide ranging
literature that's been wellestablished that shows various
risk factors for childmaltreatment, especially for
young children. And so some ofthese risk factors are household
(07:24):
financial resources, havinghaving low income, essentially
or low material needs, lowmaterial resources, parental
engagement. When parents aremore
they are better attuned theirchildren's behaviors and more
(07:44):
likely to to respond in positiveparenting practices rather than
harsher parenting practices. Andthen lastly, parental mental
health and family relations issort of how we're thinking about
this. And so this, could becertainly postpartum depression
among mothers, but also just therelationships between family,
(08:08):
family members. And so the birthof a new child is a very
exciting time, but it's also avery stressful time, and
household relationships, intrahousehold relationships, can
sometimes become a bit moretenuous because people aren't
sleeping as much as maybe theyordinarily would, or the nature
(08:30):
of their relationship also justchanges when there's a whole new
person in the household,especially a whole new person
who requires constant care, andso these relationships change.
Parents, mental health changes.
They're the way that they'reparenting, both the new child
and other other children whomight be in the household. Those
also change. Those dynamicschange as well. And then there's
(08:52):
a some, some really interestingresearch showing changes in
household income at in themonths surrounding childbirth.
And the time period aroundchildbirth is a very financially
precarious time period in termsof financial resources. And so
the idea here is that if paidfamily leave can alleviate at
(09:15):
least some of these factors,maybe it buffers the financial
hit that sometimes accompaniesthe birth of a child. Maybe it
allows a parent to stay home forlonger periods of time, to bond
with their child and to spendtime recovering from childbirth.
Maybe it allows the familymembers to be less stressed and
(09:39):
to have more positiveinteractions with one another,
any combination of thesedifferent factors could all be
drivers for improving childhealth and well being. And in
this paper, in this paper, weare specifically looking at
child abuse and neglect, right?
So it could be um. Such that anyof these combination of factors
(10:03):
improves parenting practices andengagement with their children.
Nancy Barrow (10:07):
Yeah, it's a stressful time for parents. You
know, like you said, theadjustment period. Did you find
in your research that if infantabuse is happening, that there
may be more family violencehappening in the home?
Dr. Lindsey Bullinger (10:21):
These two are correlated. We did not
specifically look at this in ourpaper. There have been other
papers that have shown similarimprovements in household
dynamics, in the form of infant,excuse me, in the form of
intimate partner violence.
Nancy Barrow (10:36):
And I just want to note that that Connecticut Paid
Leave has a safe leave that wehave in our program. It gives 12
days of income replacement todomestic violence or sexual
assault survivors to move, orfind medical or psychological
treatment, to use domesticviolence services, or to go to
criminal or civil court. And italso our Connecticut FMLA also
(10:57):
gives 12 days to take the leaveand protect your job.
Connecticut sort of stands apartfrom other leave programs with
this safe leave. How significantis this safe leave? Do you
think?
Dr. Lindsey Bullinger (11:09):
I think that's an open question. I To my
knowledge, there's not been astudy on this particular policy.
You said this is new, though,right? I
Nancy Barrow (11:18):
well, the safe leave is new just because it
added sexual assault in October,but we have had that provision
for domestic violence survivorsto take 12 days of income
replacement.
Dr. Lindsey Bullinger (11:30):
Okay, so this, I would guess, based on
the empirical research that hasbeen done that this would
improve family dynamics andintimate partner violence
outcomes and probably otheroutcomes as well. Though, to my
knowledge, there has not been anempirical study on this topic.
So I think it's a good openquestion.
Nancy Barrow (11:50):
There you go. Your next project.
Dr. Lindsey Bullinger (11:52):
Exactly,
Nancy Barrow (11:53):
We know that children of parents who take
paid leave may get more parentalcare and breastfeeding and
immunizations if parents areable to stay home longer after
birth. Have you found thatparents who take the entire 12
weeks do better than the parentswho go back to week to work
before the 12 weeks or in thisin the terms of stress or infant
(12:15):
abuse?
Dr. Lindsey Bullinger (12:16):
Yeah, this is a good question, and I
don't think we have the answer.
Well, I know we don't have theanswer to it. The challenge, I
think, with answering thisquestion is having better
quality data. So for example, wedon't know in our data on Child
Abuse and Neglect referrals, wedon't know which parents were
able to actually take paidfamily leave after the birth of
(12:37):
their children. A lot of datasets don't ask these type of
questions if they're surveys.
And administrative data on a lotof different outcomes don't
necessarily include thatinformation. So usually, if you
have administrative data on someoutcome like child abuse and
neglect, you'd have to have thatlinked to other administrative
(13:00):
data sources on leave taking,for example, and claim filing,
and we, for this paper, we don'thave access to those linkages.
And in particular, in thispaper, we would have to have
that for multiple states. Andthat's a very large undertaking,
one that I encourage researchersto try to do, but it is a very
(13:24):
hefty investment, and a lot oftimes, states are not always
willing to to partner withresearchers in this way. So So
unfortunately, I think that's athe answer. The short answer is,
I don't know. The longer answeris that, you know, it's possible
that there are linear returns topaid family leave, and what I
(13:49):
mean by that is, the longer theleave is, the more helpful it is
for family members. But therealso might be a point where it
actually becomes counterproductive, and that might be
different for moms than what itis for dads and what it is for
babies. And so those sort ofwhat we might think of as like
optimal levels of leave might bevery different for each
(14:12):
different member of thehousehold. And it's one that
I've been quite curious for awhile, curious about for a
while, but we don't have ananswer to that right now.
Nancy Barrow (14:23):
I know that you mentioned good maternal health
just is good maternal healthtied to the good infant health
and a decrease in infant abuse.
Is that what you found in thispaper?
Dr. Lindsey Bullinger (14:32):
So we did not look at that in this
particular paper, but there isresearch showing that maternal
mental health and infant healthare correlated with one another.
It's not necessarily known atthis point if it's a causal
relationship or not, but theyare correlated. And you know,
one other thing to consider isthat paid family leave is in
(14:55):
terms of wage replacement. It'snot 100% right? So if the prior.
Primary mechanism here isfinancial resources. Well, then
it's actually better for parentsto go back to work if the
primary mechanism is notnecessarily financial resources,
then, then that's maybe notnecessarily true. So I think
(15:16):
it's possibly a combination ofthese different things, right?
So for example, as we're talkingabout partner involvement.
Certainly, we know that that'simportant. But if families
really need the financialresources, then it's actually
probably better for the family,somebody in the family, to go to
work, right, rather than takinga less than 100% wage
(15:37):
replacement or take some timeoff. And you know, these are all
every family is going to bedifferent in terms of what their
optimal leave length is, but onaverage, this this question
about what's what's best formoms and what's best for dads,
and how does that help withinfant health and well being
(15:58):
it's a really importantquestion, And one that I don't
think we really have a verysatisfying answer for.
Nancy Barrow (16:05):
Let's just talk about the social benefits of
paid family leave. Connecticutis like a really rich state, but
there are pockets of real,critical economic insecurity.
Does paid family leave help inthose instances where there
might be poverty helping withthe reduction of infant
maltreatment.
Dr. Lindsey Bullinger (16:26):
Yeah, so there are a few different ways
to think about this question.
One is that families, parentsand lower income families are
oftentimes less privy to paidfamily leave through their
employer, and so they really arerelying on state programs to
fund their leaves or to not takeany leaves at all if they need
(16:47):
to get back to their jobs. Andso there has been research
showing that paid family leaveprograms that are state
sponsored have larger impacts interms of short term employment
and financial hardships they arethey have stronger effects for
(17:10):
parents from lower incomehouseholds. In part, for this
reason, it's also where was Igoing with that second part in
this particular study, it's alsotrue that children from low
income families aredisproportionately involved in
(17:32):
the child welfare system, and sothese two populations overlap
quite a bit for the context thatwe're studying here. That isn't
necessarily true in allcontexts, but in these states
that we have studied, there isgood evidence to show that lower
income families have benefitedsubstantially more than higher
(17:56):
income families from the paidfamily leave program.
Nancy Barrow (18:02):
So it decreases the removal of kids from their
homes and into social services,which is another expense for the
state.
Dr. Lindsey Bullinger (18:09):
That's right, it is another expense for
the state. We can't actuallyidentify whether the children
that are removed from theirhomes or at lower rates in this
particular study, or that areless likely to be referred to
child protective servicesagencies. We don't know whether,
whether these children come fromhigher income or low income
families, so we can't speak tothat directly, but there is a
(18:34):
large disproportionality ofHouse of low income households
in the child welfare system andthat are benefiting the most
from paid family leave.
Nancy Barrow (18:44):
Yeah, and I imagine that some might be
single moms, which is a strugglein itself,
Dr. Lindsey Bullinge (18:51):
Absolutely certainly, children from single
female headed households arealso disproportionately involved
in the child welfare system.
Nancy Barrow (19:01):
Yeah, we have something called caregiver
leave, where someone canactually help a single mom and
the and that caregiver can getincome replacement from a paid
leave program to help the momafter the baby's born. So
Connecticut Paid Leave allowscaregivers who are family or
friends or that are like family.
We call it related by affinity,so it's a pretty, you know,
(19:21):
expansive definition of family.
So they could take time off tohelp the mom if she's
recuperating from giving birth,maybe a C section or something
like that, and she has nopartner there. So how
significant is that kind ofprogram to a single mom, to have
help from a friend or a lovedone when you're feeling
overwhelmed and you're alone.
Dr. Lindsey Bullinger (19:42):
oh, I'm sure it's, it's quite huge.
Again, I don't, I'm not speakinghere off of empirical evidence.
I don't think we have a strongenough base for that, but I
think we have a strong enoughliterature on sort of what it
takes to raise a child and forpositive child development and
for positive household dynamicsand interactions. And so, you
(20:05):
know, having a strong supportduring the postpartum period is
very important, and a lot ofpeople, unfortunately, don't
have that. And if they aretrying to get back to work very
quickly, then you know, any sortof financial resources that can
potentially help either themothers or the parents or, you
(20:28):
know, the family by affinity, Ilove that term, to support these
children. I mean, it's reallyall about the children and the
parents who are recovering aswell from childbirth. It's a
very serious procedure to have achild, and people are oftentimes
expected to sort of bounce backas quickly as possible. And
(20:49):
that's not necessarily how thehuman body works.
Nancy Barrow (20:52):
We call that, we look at pregnancy as a serious
health condition. That's why youcan take Connecticut Paid Leave.
And it is. It is a really, youknow, it's a serious health
condition. What was your endgame for your research? What was
something that you wanted tohave come out of your research?
Dr. Lindsey Bullinger (21:10):
So when, when states are considering
implementing a paid family leaveprogram, a lot of times, the
conversation revolves aroundeffects on employment and
effects on families, but it'srare that thinking about child
abuse and neglect and and otherstate agencies like Child
(21:33):
Protective Services. It's rarethat these components are
brought up in the conversation,and maybe that's because we
haven't had strong empiricalevidence for this or to sort of
bring these outcomes and thisdimension to the conversation.
So the goal of our research isto really get a strong sense for
(21:54):
what are the costs and what arethe benefits of paid family
leave programs, so that policymakers at the state, at the
local, at the federal level, canhave these estimates and have
this information and this datato make better decisions for
their constituents and for theirresidents, because these these
(22:16):
types of policies, I think, havebeen missing a big component in
the in the conversations, and sowe're hoping that by providing
some of that evidence, that wecan strengthen the debate and
strengthen the informationthat's used in the debate.
really.
Nancy Barrow (22:34):
I think that's fantastic. I mean, you know, we
are the only industrializednation that does not have a
national policy, and, and it's,it's, I think there's like,
Tonga, Micronesia, Palau, thingslike that, that that don't have
a national policy. But, yeah, wewere, we are absent of a
(22:54):
national policy. And I hope thatthat changes sometime.
Dr. Lindsey Bullinger (23:00):
I mean, there's so much research now
showing, particularly in theshort term, how beneficial these
programs are for women andchildren and families and state
governments as well. I think wealso need more research in terms
of the longer term effects. Andso it's an ongoing debate, as I
(23:20):
like to say. And as aresearcher, you know, there's
always been the new research tostudy to strengthen the evidence
base.
Nancy Barrow (23:28):
Did anything surprise you while you were
doing your research?
Dr. Lindsey Bullinger (23:35):
So my biggest surprise from this paper
was the effects on the homeremoval. So in this paper, what,
what we find is that state paidfamily leave programs reduce
infant maltreatment reportrates, but they also reduce the
rate at which infants areremoved from their homes by
about 46% and that's a that thatwas very interesting to us. We
(24:00):
expected to find improvements inchild abuse and neglect
referrals, but if you thinkabout home removals as being, in
some ways, a proxy or a measureof more extreme or more severe
abuse and neglect. We were a bitsurprised by this, but this was
(24:24):
very robust in all of ourestimates.
Nancy Barrow (24:27):
Yeah, so were you really satisfied with how this
this research, kind ofconcluded? Are you really
satisfied with everything thathappened in your research?
Dr. Lindsey Bullinger (24:39):
We are excited that we have findings
and that we are sharing thesefindings with the world. I
think, I think these resultswere mostly in line with what we
expected, but our goal asresearchers is to bear the
evidence and find the truth, andso if the results would have
gone a different way. That wouldnot have been unsatisfying. That
(25:04):
would have been, well, this iswhat happens when paid family
leave programs are areimplemented. In this particular
case, we see improvements inchild abuse and neglect and so,
so that's good, right? I think,I think most reasonable people
can agree that we would likeless abuse and neglect of
children, especially when wethink about infants. And so now
(25:29):
we have a a very tangible waythat we can potentially reduce
abuse and neglect. And so thatis very satisfying when we think
about all the abuse and neglectof children that that's out
there in the US. How can welower that rate? Well, one of
the things that that my team andI are doing is trying to find,
(25:50):
what are the solutions for this,for this problem, and one of
them, not the only one, ofcourse, but one of them is,
well, let's implement paidfamily leave programs. And it's
not free, right? These areexpensive programs, but Child
Abuse and Neglect is a reallycostly problem for society, and
it has all sorts of consequencesin the long term. And so if we
(26:12):
can reduce abuse and neglectearly in life, we're setting
kids off on a much better path.
So to find a solution thatactually works and is effective
at reducing abuse and neglectthat is very satisfying. That
wasn't necessarily what we setout to do right? We wanted to
really, truly understand, isthis a policy solution for abuse
(26:32):
and neglect? And it turns out,yes, it is.
Nancy Barrow (26:37):
What are the most critical times for infants for
maltreatment, was, did you finda time that was it the first few
weeks of of life?
Dr. Lindsey Bullinger (26:45):
What we know from from data is that
infants are at the highest riskof maltreatment, and the the
risk for maltreatment lowerswith each year of age. So infant
maltreatment is a very seriouspolicy problem that we need to
devote a bit more attention toas policy scholars and and
(27:09):
policy makers. So within thefirst year, I'm not exactly
sure, and part of this isbecause a lot of times we don't
have the data that disaggregatebetween, for example, a child
who is one month old versus achild who is 11 months old, at
(27:29):
least within the childmaltreatment reports data at
national level.
Nancy Barrow (27:36):
And what would you like people to take away from
this podcast with youDr.Bollinger?
Dr. Lindsey Bullinger (27:44):
The paid family leave programs have been
spreading across the country,and a lot of these are motivated
by factors such as, you know,bonding with with children, or
it's good for parents. Sometimesthere are arguments that it's
good for states. We're showinghere that it's good for a lot of
(28:08):
things. We're showing here, thatchild abuse and neglect reduces
in the short term. We don't showthe long term effects here, but
we know that child abuse andneglect has a lot of negative
consequences in the long term.
And so this research highlightsthe potential very long term
benefits of paid family leavethat hasn't been explored as
(28:34):
much in research or included inthe policy debate as much. And
so my hope is that that we canuse this information about
reducing abuse and neglect andsaving for child protective
services agencies and savingsfor all state agencies. I hope
we can use this information inthe debates and the dialog
(28:57):
regarding paid family leaveprograms.
Nancy Barrow (29:00):
So I want to thank you, Dr Lindsay Bollinger of
Georgia Tech, the School ofPublic Policy, your research for
being on The Paid Leave Podcast.
Thank you so much for joiningus.
Dr. Lindsey Bullinger (29:11):
It's been a pleasure. Thanks so much for
having me.
Nancy Barrow (29:13):
For more information or to apply for
benefits. Please go toctpaldleave.org This has been
another edition of The PaidLeave Podcast, please like and
subscribe so you'll be notifiedabout new podcasts that become
available. Connecticut PaidLeave is a public act with a
personal purpose. I'm NancyBarrow, and thanks for
(29:34):
listening!
Hello Connecticut, and welcome to The Paid Leave
Podcast. The title basicallysays it all. I'm Nancy Barrow,
and I will be delving into thisnew state program and how it can
help you and your family. Thispodcast will give you
information you should knowabout Connecticut Paid Leave and
maybe just a little bitmore!Connecticut Paid Leave
(00:22):
brings peace of mind to yourhome, family and workplace.
Welcome to The Paid LeavePodcast.
We're very lucky to have such acomprehensive paid leave policy
here in the state ofConnecticut. We are part of a
group of 13 states andWashington D.C. that have passed
paid leave policies when aqualifying need arises. And all
(00:43):
of the states right now areCalifornia, Colorado,
Connecticut, Delaware, Maine,Maryland, Massachusetts,
Minnesota, New Jersey, New York,Oregon, Rhode Island and
Washington and the District ofColumbia. 10 of these programs
are providing benefits now, andfour more are finalizing
regulations and systems to allowbenefits to start in 2026 an
(01:05):
article that our team saw abouthow paid family leave may
protect against rising infantmaltreatment rates crossed us
and we talked about it. And theauthor of that article is Dr
Lindsey Rose Bollinger. She's anassociate professor and
researcher in the School ofPublic Policy at Georgia Tech
and the Associate Director ofthe Health Economics and Policy
Innovation Collaborative. She iscurrently a co-editor of the
(01:29):
Journal of policy analysis andmanagement and a consulting
editor for child maltreatment.
She is also a faculty affiliatewith Georgia Policy Babs, the
Wilson Sheehan Lab for economicopportunities and the Children's
Pediatric Research Alliance. Andher research examines how public
policies affect children andfamilies, health and well being
with a focus on low incomefamilies, and her work focuses
(01:51):
on the role of public policiesin child abuse and neglect and
the effects of health policieson children and families. And
thank you so much for being onThe Paid leave podcast. Dr
Bollinger.
Dr. Lindsey Bullinger (02:02):
It's a pleasure. Thank you for having
Nancy Barrow (02:04):
Dr Bollinger, I know that some of the questions
me.
I asked you weren't in yourresearch, but I'm just going to
ask you to talk about it fromthe best of your ability. I
reached out to you, and you wereso gracious to come on this
podcast to talk about it. Sothank you so much for sharing
your findings with us.
Dr. Lindsey Bullinger (02:19):
Of course, I'm really excited to
talk about this work. I thinkit's very important and has some
some interesting policyimplications.
Unknown (02:27):
Yeah, it sure does. How did you get involved as a
researcher at the School ofPublic Policy at Georgia Tech?
Dr. Lindsey Bullinger (02:33):
Sure. So I did my PhD in public affairs
at the Indiana University. Andwhile I was in graduate school,
I became very interested in therole of public policy and Child
and Family Well Being, and oneof my dissertation chapters was
on the role of paid family leavein maternal mental health. And
(02:56):
at that time, there was kind ofa lot of research on paid family
leave, but it was almostexclusively from European
context or other developedcountries. And part of this is
because at that time, when I wasin graduate school in 2014, 15,
there were not many stateprograms in the United States.
(03:18):
And since then, of course, we'vehad a lot more, as you noted,
but at that time, there reallywasn't much research on us
programs, and so during graduateschool, I I spent a good deal of
time understanding the landscapeof the research at that time on
the role of paid family leave.
Nancy Barrow (03:40):
So interesting.
And how did the research foryour article "More Than
Snuggles, the Effect of PaidFamily Leave on Infant
Maltreatment?" How, how did youbegin that research for this to
actually start to become aproject that you did?
Dr. Lindsey Bullinger (03:54):
Yeah, so in my dissertation chapter, as I
noted, one of the projects thatI worked on in graduate school
was the studying the effects ofpaid family leave on maternal
mental health and well being,and I found significant
improvements in maternal mentalhealth using California as the
case study. And from there, Ibegan doing other research in
(04:19):
the landscape of child abuse andneglect. Along with my
co-authors on this paper, CarrieRacien, and some other
colleagues from Prevent ChildAbuse America, and as we were
studying, as I became more intothe research on child abuse and
neglect, I you know, we sort ofthought about, well, what are
some other policies that aremaybe not within the child
(04:42):
protective services system, thatcould potentially have
significant effects on ChildAbuse and Neglect. And so we
began looking at other policies,things like minimum wage
policies, things like the EarnedIncome Tax Credit, the SNAP
program, the WIC program, andthis paid family leave program
(05:06):
was, was one of the the ideasthat we had, in part, partly
because we came because of mydissertation chapter that found
improvements on maternal mentalhealth, which is a risk factor,
particularly for infantmaltreatment.
Nancy Barrow (05:20):
Yeah, It's so interesting that this research.
Did it? Did you work with UConn?
Did you work with the Universityof Connecticut on this project?
Dr. Lindsey Bullinger (05:29):
Sure, one of my co authors carries it is a
professor at the University ofConnecticut.
Nancy Barrow (05:33):
Oh, that's so cool. We didn't realize that
there was that connection there.
Awesome.
Dr. Lindsey Bullinger (05:37):
She and I are actually long time co
authors on several differentprojects.
Nancy Barrow (05:42):
That's great.
That's wonderful. Did youinterview people? Or what were
some of your references for yourdata? Where does like that data
come from?
Dr. Lindsey Bullinger (05:50):
Yeah. So for this project on child abuse
and neglect, we were looking atadministrative data from all
states across the country onreferrals of child abuse and
neglect to child protectiveservices agencies. And so
there's a national repository ofdata that that have this this
(06:13):
information. And so what we didwas, over the time period from
2004 to 2019 we looked at ChildAbuse and Neglect referrals,
particularly for infants, beforeand after each state during that
time period implemented its paidfamily leave program. So by now
(06:35):
we've got several more statesthat have a program, but during
the course of our study, thesestates would have been
California, New Jersey, RhodeIsland and New York.
Unknown (06:46):
Yeah, those were the big ones at the beginning. And
what were some of the factorsthat you found that led to
parents abusing their infants ormaltreating their infants? What
were some of the factors thatyou found?
Dr. Lindsey Bullinger (07:03):
So we did not actually look specifically
at some of these factors, butthere is a very wide ranging
literature that's been wellestablished that shows various
risk factors for childmaltreatment, especially for
young children. And so some ofthese risk factors are household
(07:24):
financial resources, havinghaving low income, essentially
or low material needs, lowmaterial resources, parental
engagement. When parents aremore
they are better attuned theirchildren's behaviors and more
(07:44):
likely to to respond in positiveparenting practices rather than
harsher parenting practices. Andthen lastly, parental mental
health and family relations issort of how we're thinking about
this. And so this, could becertainly postpartum depression
among mothers, but also just therelationships between family,
(08:08):
family members. And so the birthof a new child is a very
exciting time, but it's also avery stressful time, and
household relationships, intrahousehold relationships, can
sometimes become a bit moretenuous because people aren't
sleeping as much as maybe theyordinarily would, or the nature
(08:30):
of their relationship also justchanges when there's a whole new
person in the household,especially a whole new person
who requires constant care, andso these relationships change.
Parents, mental health changes.
They're the way that they'reparenting, both the new child
and other other children whomight be in the household. Those
also change. Those dynamicschange as well. And then there's
(08:52):
a some, some really interestingresearch showing changes in
household income at in themonths surrounding childbirth.
And the time period aroundchildbirth is a very financially
precarious time period in termsof financial resources. And so
the idea here is that if paidfamily leave can alleviate at
(09:15):
least some of these factors,maybe it buffers the financial
hit that sometimes accompaniesthe birth of a child. Maybe it
allows a parent to stay home forlonger periods of time, to bond
with their child and to spendtime recovering from childbirth.
Maybe it allows the familymembers to be less stressed and
(09:39):
to have more positiveinteractions with one another,
any combination of thesedifferent factors could all be
drivers for improving childhealth and well being. And in
this paper, in this paper, weare specifically looking at
child abuse and neglect, right?
So it could be um. Such that anyof these combination of factors
(10:03):
improves parenting practices andengagement with their children.
Nancy Barrow (10:07):
Yeah, it's a stressful time for parents. You
know, like you said, theadjustment period. Did you find
in your research that if infantabuse is happening, that there
may be more family violencehappening in the home?
Dr. Lindsey Bullinger (10:21):
These two are correlated. We did not
specifically look at this in ourpaper. There have been other
papers that have shown similarimprovements in household
dynamics, in the form of infant,excuse me, in the form of
intimate partner violence.
Nancy Barrow (10:36):
And I just want to note that that Connecticut Paid
Leave has a safe leave that wehave in our program. It gives 12
days of income replacement todomestic violence or sexual
assault survivors to move, orfind medical or psychological
treatment, to use domesticviolence services, or to go to
criminal or civil court. And italso our Connecticut FMLA also
(10:57):
gives 12 days to take the leaveand protect your job.
Connecticut sort of stands apartfrom other leave programs with
this safe leave. How significantis this safe leave? Do you
think?
Dr. Lindsey Bullinger (11:09):
I think that's an open question. I To my
knowledge, there's not been astudy on this particular policy.
You said this is new, though,right? I
Nancy Barrow (11:18):
well, the safe leave is new just because it
added sexual assault in October,but we have had that provision
for domestic violence survivorsto take 12 days of income
replacement.
Dr. Lindsey Bullinger (11:30):
Okay, so this, I would guess, based on
the empirical research that hasbeen done that this would
improve family dynamics andintimate partner violence
outcomes and probably otheroutcomes as well. Though, to my
knowledge, there has not been anempirical study on this topic.
So I think it's a good openquestion.
Nancy Barrow (11:50):
There you go. Your next project.
Dr. Lindsey Bullinger (11:52):
Exactly,
Nancy Barrow (11:53):
We know that children of parents who take
paid leave may get more parentalcare and breastfeeding and
immunizations if parents areable to stay home longer after
birth. Have you found thatparents who take the entire 12
weeks do better than the parentswho go back to week to work
before the 12 weeks or in thisin the terms of stress or infant
(12:15):
abuse?
Dr. Lindsey Bullinger (12:16):
Yeah, this is a good question, and I
don't think we have the answer.
Well, I know we don't have theanswer to it. The challenge, I
think, with answering thisquestion is having better
quality data. So for example, wedon't know in our data on Child
Abuse and Neglect referrals, wedon't know which parents were
able to actually take paidfamily leave after the birth of
(12:37):
their children. A lot of datasets don't ask these type of
questions if they're surveys.
And administrative data on a lotof different outcomes don't
necessarily include thatinformation. So usually, if you
have administrative data on someoutcome like child abuse and
neglect, you'd have to have thatlinked to other administrative
(13:00):
data sources on leave taking,for example, and claim filing,
and we, for this paper, we don'thave access to those linkages.
And in particular, in thispaper, we would have to have
that for multiple states. Andthat's a very large undertaking,
one that I encourage researchersto try to do, but it is a very
(13:24):
hefty investment, and a lot oftimes, states are not always
willing to to partner withresearchers in this way. So So
unfortunately, I think that's athe answer. The short answer is,
I don't know. The longer answeris that, you know, it's possible
that there are linear returns topaid family leave, and what I
(13:49):
mean by that is, the longer theleave is, the more helpful it is
for family members. But therealso might be a point where it
actually becomes counterproductive, and that might be
different for moms than what itis for dads and what it is for
babies. And so those sort ofwhat we might think of as like
optimal levels of leave might bevery different for each
(14:12):
different member of thehousehold. And it's one that
I've been quite curious for awhile, curious about for a
while, but we don't have ananswer to that right now.
Nancy Barrow (14:23):
I know that you mentioned good maternal health
just is good maternal healthtied to the good infant health
and a decrease in infant abuse.
Is that what you found in thispaper?
Dr. Lindsey Bullinger (14:32):
So we did not look at that in this
particular paper, but there isresearch showing that maternal
mental health and infant healthare correlated with one another.
It's not necessarily known atthis point if it's a causal
relationship or not, but theyare correlated. And you know,
one other thing to consider isthat paid family leave is in
(14:55):
terms of wage replacement. It'snot 100% right? So if the prior.
Primary mechanism here isfinancial resources. Well, then
it's actually better for parentsto go back to work if the
primary mechanism is notnecessarily financial resources,
then, then that's maybe notnecessarily true. So I think
(15:16):
it's possibly a combination ofthese different things, right?
So for example, as we're talkingabout partner involvement.
Certainly, we know that that'simportant. But if families
really need the financialresources, then it's actually
probably better for the family,somebody in the family, to go to
work, right, rather than takinga less than 100% wage
(15:37):
replacement or take some timeoff. And you know, these are all
every family is going to bedifferent in terms of what their
optimal leave length is, but onaverage, this this question
about what's what's best formoms and what's best for dads,
and how does that help withinfant health and well being
(15:58):
it's a really importantquestion, And one that I don't
think we really have a verysatisfying answer for.
Nancy Barrow (16:05):
Let's just talk about the social benefits of
paid family leave. Connecticutis like a really rich state, but
there are pockets of real,critical economic insecurity.
Does paid family leave help inthose instances where there
might be poverty helping withthe reduction of infant
maltreatment.
Dr. Lindsey Bullinger (16:26):
Yeah, so there are a few different ways
to think about this question.
One is that families, parentsand lower income families are
oftentimes less privy to paidfamily leave through their
employer, and so they really arerelying on state programs to
fund their leaves or to not takeany leaves at all if they need
(16:47):
to get back to their jobs. Andso there has been research
showing that paid family leaveprograms that are state
sponsored have larger impacts interms of short term employment
and financial hardships they arethey have stronger effects for
(17:10):
parents from lower incomehouseholds. In part, for this
reason, it's also where was Igoing with that second part in
this particular study, it's alsotrue that children from low
income families aredisproportionately involved in
(17:32):
the child welfare system, and sothese two populations overlap
quite a bit for the context thatwe're studying here. That isn't
necessarily true in allcontexts, but in these states
that we have studied, there isgood evidence to show that lower
income families have benefitedsubstantially more than higher
(17:56):
income families from the paidfamily leave program.
Nancy Barrow (18:02):
So it decreases the removal of kids from their
homes and into social services,which is another expense for the
state.
Dr. Lindsey Bullinger (18:09):
That's right, it is another expense for
the state. We can't actuallyidentify whether the children
that are removed from theirhomes or at lower rates in this
particular study, or that areless likely to be referred to
child protective servicesagencies. We don't know whether,
whether these children come fromhigher income or low income
families, so we can't speak tothat directly, but there is a
(18:34):
large disproportionality ofHouse of low income households
in the child welfare system andthat are benefiting the most
from paid family leave.
Nancy Barrow (18:44):
Yeah, and I imagine that some might be
single moms, which is a strugglein itself,
Dr. Lindsey Bullinge (18:51):
Absolutely certainly, children from single
female headed households arealso disproportionately involved
in the child welfare system.
Nancy Barrow (19:01):
Yeah, we have something called caregiver
leave, where someone canactually help a single mom and
the and that caregiver can getincome replacement from a paid
leave program to help the momafter the baby's born. So
Connecticut Paid Leave allowscaregivers who are family or
friends or that are like family.
We call it related by affinity,so it's a pretty, you know,
(19:21):
expansive definition of family.
So they could take time off tohelp the mom if she's
recuperating from giving birth,maybe a C section or something
like that, and she has nopartner there. So how
significant is that kind ofprogram to a single mom, to have
help from a friend or a lovedone when you're feeling
overwhelmed and you're alone.
Dr. Lindsey Bullinger (19:42):
oh, I'm sure it's, it's quite huge.
Again, I don't, I'm not speakinghere off of empirical evidence.
I don't think we have a strongenough base for that, but I
think we have a strong enoughliterature on sort of what it
takes to raise a child and forpositive child development and
for positive household dynamicsand interactions. And so, you
(20:05):
know, having a strong supportduring the postpartum period is
very important, and a lot ofpeople, unfortunately, don't
have that. And if they aretrying to get back to work very
quickly, then you know, any sortof financial resources that can
potentially help either themothers or the parents or, you
(20:28):
know, the family by affinity, Ilove that term, to support these
children. I mean, it's reallyall about the children and the
parents who are recovering aswell from childbirth. It's a
very serious procedure to have achild, and people are oftentimes
expected to sort of bounce backas quickly as possible. And
(20:49):
that's not necessarily how thehuman body works.
Nancy Barrow (20:52):
We call that, we look at pregnancy as a serious
health condition. That's why youcan take Connecticut Paid Leave.
And it is. It is a really, youknow, it's a serious health
condition. What was your endgame for your research? What was
something that you wanted tohave come out of your research?
Dr. Lindsey Bullinger (21:10):
So when, when states are considering
implementing a paid family leaveprogram, a lot of times, the
conversation revolves aroundeffects on employment and
effects on families, but it'srare that thinking about child
abuse and neglect and and otherstate agencies like Child
(21:33):
Protective Services. It's rarethat these components are
brought up in the conversation,and maybe that's because we
haven't had strong empiricalevidence for this or to sort of
bring these outcomes and thisdimension to the conversation.
So the goal of our research isto really get a strong sense for
(21:54):
what are the costs and what arethe benefits of paid family
leave programs, so that policymakers at the state, at the
local, at the federal level, canhave these estimates and have
this information and this datato make better decisions for
their constituents and for theirresidents, because these these
(22:16):
types of policies, I think, havebeen missing a big component in
the in the conversations, and sowe're hoping that by providing
some of that evidence, that wecan strengthen the debate and
strengthen the informationthat's used in the debate.
really.
Nancy Barrow (22:34):
I think that's fantastic. I mean, you know, we
are the only industrializednation that does not have a
national policy, and, and it's,it's, I think there's like,
Tonga, Micronesia, Palau, thingslike that, that that don't have
a national policy. But, yeah, wewere, we are absent of a
(22:54):
national policy. And I hope thatthat changes sometime.
Dr. Lindsey Bullinger (23:00):
I mean, there's so much research now
showing, particularly in theshort term, how beneficial these
programs are for women andchildren and families and state
governments as well. I think wealso need more research in terms
of the longer term effects. Andso it's an ongoing debate, as I
(23:20):
like to say. And as aresearcher, you know, there's
always been the new research tostudy to strengthen the evidence
base.
Nancy Barrow (23:28):
Did anything surprise you while you were
doing your research?
Dr. Lindsey Bullinger (23:35):
So my biggest surprise from this paper
was the effects on the homeremoval. So in this paper, what,
what we find is that state paidfamily leave programs reduce
infant maltreatment reportrates, but they also reduce the
rate at which infants areremoved from their homes by
about 46% and that's a that thatwas very interesting to us. We
(24:00):
expected to find improvements inchild abuse and neglect
referrals, but if you thinkabout home removals as being, in
some ways, a proxy or a measureof more extreme or more severe
abuse and neglect. We were a bitsurprised by this, but this was
(24:24):
very robust in all of ourestimates.
Nancy Barrow (24:27):
Yeah, so were you really satisfied with how this
this research, kind ofconcluded? Are you really
satisfied with everything thathappened in your research?
Dr. Lindsey Bullinger (24:39):
We are excited that we have findings
and that we are sharing thesefindings with the world. I
think, I think these resultswere mostly in line with what we
expected, but our goal asresearchers is to bear the
evidence and find the truth, andso if the results would have
gone a different way. That wouldnot have been unsatisfying. That
(25:04):
would have been, well, this iswhat happens when paid family
leave programs are areimplemented. In this particular
case, we see improvements inchild abuse and neglect and so,
so that's good, right? I think,I think most reasonable people
can agree that we would likeless abuse and neglect of
children, especially when wethink about infants. And so now
(25:29):
we have a a very tangible waythat we can potentially reduce
abuse and neglect. And so thatis very satisfying when we think
about all the abuse and neglectof children that that's out
there in the US. How can welower that rate? Well, one of
the things that that my team andI are doing is trying to find,
(25:50):
what are the solutions for this,for this problem, and one of
them, not the only one, ofcourse, but one of them is,
well, let's implement paidfamily leave programs. And it's
not free, right? These areexpensive programs, but Child
Abuse and Neglect is a reallycostly problem for society, and
it has all sorts of consequencesin the long term. And so if we
(26:12):
can reduce abuse and neglectearly in life, we're setting
kids off on a much better path.
So to find a solution thatactually works and is effective
at reducing abuse and neglectthat is very satisfying. That
wasn't necessarily what we setout to do right? We wanted to
really, truly understand, isthis a policy solution for abuse
(26:32):
and neglect? And it turns out,yes, it is.
Nancy Barrow (26:37):
What are the most critical times for infants for
maltreatment, was, did you finda time that was it the first few
weeks of of life?
Dr. Lindsey Bullinger (26:45):
What we know from from data is that
infants are at the highest riskof maltreatment, and the the
risk for maltreatment lowerswith each year of age. So infant
maltreatment is a very seriouspolicy problem that we need to
devote a bit more attention toas policy scholars and and
(27:09):
policy makers. So within thefirst year, I'm not exactly
sure, and part of this isbecause a lot of times we don't
have the data that disaggregatebetween, for example, a child
who is one month old versus achild who is 11 months old, at
(27:29):
least within the childmaltreatment reports data at
national level.
Nancy Barrow (27:36):
And what would you like people to take away from
this podcast with youDr.Bollinger?
Dr. Lindsey Bullinger (27:44):
The paid family leave programs have been
spreading across the country,and a lot of these are motivated
by factors such as, you know,bonding with with children, or
it's good for parents. Sometimesthere are arguments that it's
good for states. We're showinghere that it's good for a lot of
(28:08):
things. We're showing here, thatchild abuse and neglect reduces
in the short term. We don't showthe long term effects here, but
we know that child abuse andneglect has a lot of negative
consequences in the long term.
And so this research highlightsthe potential very long term
benefits of paid family leavethat hasn't been explored as
(28:34):
much in research or included inthe policy debate as much. And
so my hope is that that we canuse this information about
reducing abuse and neglect andsaving for child protective
services agencies and savingsfor all state agencies. I hope
we can use this information inthe debates and the dialog
(28:57):
regarding paid family leaveprograms.
Nancy Barrow (29:00):
So I want to thank you, Dr Lindsay Bollinger of
Georgia Tech, the School ofPublic Policy, your research for
being on The Paid Leave Podcast.
Thank you so much for joiningus.
Dr. Lindsey Bullinger (29:11):
It's been a pleasure. Thanks so much for
having me.
Nancy Barrow (29:13):
For more information or to apply for
benefits. Please go toctpaldleave.org This has been
another edition of The PaidLeave Podcast, please like and
subscribe so you'll be notifiedabout new podcasts that become
available. Connecticut PaidLeave is a public act with a
personal purpose. I'm NancyBarrow, and thanks for
(29:34):
listening!
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