Navigating Service Needs, Referrals, and Receipts for

Navigating Service Needs, Referrals, and Receipts for | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Navigating Service Needs, Referrals, and Receipts for Chien-jen Chiang, Hyunil Kim, Miyoun Yang, Junhong Chen This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8733549/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract The growing presence of Latino families in the U.S. child welfare system raises significant concerns regarding service adequacy. Utilizing data from the National Survey on Child and Adolescent Well-being II (NSCAW II), this study investigates disparities in service needs, referrals, and receipts by ethnicity and nativity. While these data serve as a critical historical baseline for understanding the system prior to the major immigration policy shifts of the 2016–2020 era, our analysis reveals nuanced disparities. Compared to White families, foreign-born Latino families generally showed significantly lower service needs, supporting the "immigrant paradox". However, we identify a concerning "Domestic Violence Paradox": foreign-born Latino caregivers demonstrate significantly higher needs for domestic violence services (OR = 1.80, p < 0.05) yet experience lower service receipts for children’s behavioral and health problems. These findings underscore the need for targeted, culturally responsive interventions that address specific safety gaps while leveraging the resilience of immigrant families to ensure equitable support across the child welfare continuum. (Funding Declaration: The authors received no financial support for the research, authorship, or publication of this article.) Navigating Service Needs, Referrals, and Receipts for Latino Families in Child Protective Services Figures Figure 1 Introduction In the last twenty years, there has been a significant rise in Latino involvement in the US child welfare system (US Department of Health and Human Services [DHHS], 2003; 2023) which has paralleled an increase in the percentage of the total child population that is Latino in the United States (US Census Bureau, 2023 ). Accompanying this trend, the volume of research examining the nuances of the Latino demographic within child protective services (CPS) has gradually expanded over the same period (Cardoso et al., 2014 ; Johnson-Motoyama, 2014 ). Studies to date have revealed that the services provided to Latino families, along with their associated risks and protective factors, vary greatly depending on the families' country of origin and their immigration status (Cardoso et al., 2014 ; Millett, 2016 ). However, the unaddressed service needs of Latino families and how their children's pathways through the child welfare system unfold continue to be understudied. Latino Families Involved with CPS Latino children, constituting 24% of the U.S. child population, experienced a rise in child maltreatment reports from 14.5% in 2001 to 25.6% in 2021, representing a significant and growing demographic within the child welfare system (US DHHS, 2003; 2023). Reflecting the community's diversity, with origins across Spanish-speaking countries in the Americas, nearly half of Latino caregivers in the US are foreign-born, including a notable portion of undocumented immigrants (Budiman, 2020). The representation of Latinos-identified children in child maltreatment cases varies by state and type of maltreatment, indicating the complexity of issues they face, such as immigration status. This has spurred extensive research into the unique characteristics and challenges of Latino families in the child welfare context (Cardoso et al., 2014 ; Dettlaff & Rycraft, 2010; Luken et al., 2021). US-born and foreign-born Latino families Immigrating and adjusting to a new cultural setting can significantly strain immigrant families, complicating the challenges of raising children. This difficulty can be exacerbated by the absence of a support network and feelings of isolation and uncertainty that come with settling into an unfamiliar environment (Finno-Velasquez et al., 2016 ; Rumbaut, 1999 ). Additionally, immigrant caregivers often encounter financial difficulties, leading to a scarcity of adequate food, medical care, and overall insufficient childcare. Moreover, immigrants without citizenship or permanent residency may be ineligible for some services, such as mental health or other healthcare (Derr, 2015 ), which may in turn impact their ability to nurture and provide for their children. This further complicates their circumstances compared to their White counterparts (DeNavas-Walt & Proctor, 2015 ; Johnson-Motoyama et al., 2014; Lu et al., 2004 ). Prior research has highlighted distinct disparities in CPS reports, risk factors, and patterns of maltreatment between U.S.-born and foreign-born Latino families (Dettlaff & Johnson, 2011 ). Specifically, children from foreign-born Latino families are less often reported for issues like drug misuse, cognitive disabilities, poor parenting skills, and previous arrests compared to their U.S.-born counterparts (Dettlaff et al., 2009b ). Conversely, children from foreign-born Latino families are more likely to be reported for neglect-related issues, such as inadequate food and care, and face a higher risk of sexual abuse compared to children from US-born Latino families (Johnson-Motoyama, 2014 ). Despite these disparities in risk factors and maltreatment types, Cardoso and colleagues ( 2014 ) found no differences between U.S. and foreign-born Latino in terms of the in-home (family preservation services, parental training, and respite of child care. Legal immigration status Although few recent studies have reported on the proportion of children with undocumented caregivers in child welfare, in 2014, Cardoso and colleagues reported that Latino children of undocumented immigrants made up 5% of all children and approximately 20% of Latino children are involved with CPS. Children whose parents are undocumented face distinct challenges, such as reduced access to essential services and a heightened risk of experiencing maltreatment. Undocumented Latino immigrant caregivers, lacking legal status, face significant barriers to accessing services. For example, undocumented caregivers are not able to legally seek work and may face barriers when seeking insurance, medical care, and mental health services (Cabral & Cuevas, 2020 ; Hacker et al., 2015 ). Additionally, there may be an increased reluctance to utilize public services stemming from a fear of deportation and ineligibility for federal or state insurance and benefits (Capps et al., 2004 ; Dettlaff & Johnson, 2011 ; Velazquez & Dettlaff, 2011 ). Compared to US-born caregivers, undocumented noncitizen caregivers tend to have lower levels of education and face greater financial struggles (Cardoso et al., 2014 ). These factors can significantly affect children's overall well-being (Schmeer, 2012 ) and increase the likelihood of CPS intervention for children of undocumented individuals (Johnson-Motoyama, 2014 ). Disparities in Child Welfare Services There have been mixed findings on disparities in the provision of services to Latino families within the child welfare system. Several earlier studies found that Latino families were less likely to receive services than White families (Courtney, 2000 ; Courtney et al., 1996 ). However, Cheng and Lo ( 2012 ) later found that Latino families were more likely to receive services in the child welfare system. For specific services, Black families were more likely to be referred to basic needs services such as housing compared with Latino families (Lovato-Hermann et al., 2017 ), while Latino families were more likely to be referred to mental health services than White and Black families (Garcia et al., 2012 ; Lovato-Hermann et al., 2017 ). Conversely, other studies found that Latino children were less likely to access mental health services compared to their White and Black counterparts (Garland et al., 2000; Garland et al., 2003; Leslie et al., 2000). Disparities have been more consistently identified for Latino children in foster care in mental health care access and utilization. Latino children in the foster care system are less likely to access mental health services in comparison to White and Black children, a trend consistently observed across various studies (Garland et al., 2000; Garland et al., 2003; Leslie et al., 2000; Tingus et al., 1996). This finding persists even when accounting for factors such as socioeconomic status and the severity of mental health symptoms (Garland et al., 2003; Hurlburt et al., 2004; McCabe et al., 1999). However, it is worth noting that many of these studies were conducted over 20 years ago, highlighting a need for research that captures the changing profiles and heterogeneity of Latino families in the United States. Present Study This study examines service gaps of needs, referrals, and receipts for Latino caregivers and children in CPS compared to White families. Understanding these disparities is crucial for improving the effectiveness and equity of child welfare systems, leading to better outcomes for CPS-involved families. Identifying these gaps enables policymakers and service providers to allocate resources more efficiently and facilitates the implementation of targeted interventions where referrals fail to translate into services received. Methods Data and Sample Data for this study come from the National Survey on Child and Adolescent Well-being II (NSCAW II). NSCAW II employed a panel design study, utilizing a national probability sample of children and families reported to CPS. The NSCAW II cohort for national weighting consisted of 5,251 children aged birth to 17.5 years who had investigated reports of maltreatment. This study used the baseline (wave 1) data collected from March 2008 to September 2009. The data collection involved comprehensive face-to-face interviews with various stakeholders, including children, parents, foster parents, kin caregivers, and investigative caseworkers. This approach allowed for a more in-depth understanding of the needs, referrals, and receiving of the services for children and caregivers within the child welfare system. Measurement Race/ethnicity/nativity For this study, five distinct race and ethnic groups were established to facilitate the study. Caregivers who self-identified as White and not Spanish/Hispanic/Latino were classified as (1) Non-Latino White. Those who identified as Black and not Spanish/Hispanic/Latino were designated as (2) Non-Latino Black. To further explore disparities among Latino families engaged with Child Protective Services (CPS), an additional division was made based on nativity, resulting in two separate categories: (3) U.S.-born Latino and (4) foreign-born Latino. All other caregivers were grouped into the (5) Others category. This classification aimed to provide a clear understanding of the diverse backgrounds of caregivers involved with CPS. For the focus of this study, the results for the “Black” and "Other" groups have been omitted from the subsequent discussion but are presented in the tables. Outcome variables Services needed. Caseworkers were asked about the service needs and services provided to caregivers and children based on the case record and their knowledge of the case, regardless of service availability. Using the information from caseworker interviews, we created binary variables (yes = 1 or no = 0) to represent caregiver service needs across nine domains: (1) housing, (2) employment, (3) domestic violence, (4) legal aid, (5) Substance misuse (including both alcohol and drug misuse), (6) mental health (e.g., emotional, psychological, depression, bipolar disorder, schizophrenia, or other), (7) serious health problems, (8) income assistance programs (e.g., TANF, AFDC, or general assistance), and (9) Medicaid. For children, we developed binary service need variables (yes = 1 or no = 0) for the following six domains: (1) learning or developmental problems, (2) special education, (3) emotional, behavioral, or attention problems, (4) health problems, (5) routine checkups and immunizations, and (6) dental care. Services referred. Service referral variables (yes = 1 or no = 0) were measured based on caseworker interviews regarding whether a referral had been explicitly outlined in the case plan or safety plan for each of the nine caregiver services and the six child services. Services received. Service receipt variables (yes = 1 or no = 0) were measured based on caseworker interviews regarding whether a service had been utilized by either caregivers or children within the family for each of the nine caregiver services and the six child services. Demographic and child welfare variables in the regression models Certain family characteristics have been found to influence service needs, referrals, and receipts. In our regression model, we considered specific demographic factors like the child’s age (Garcia et al., 2016 ), the child’s sex (Alzate & Rosenthal, 2012), and the caregivers’ marital status (Cardoso et al., 2014 ). Additionally, studies have shown whether the case is substantiated (Garcia et al., 2016 ) and types of maltreatment, including neglect, physical abuse, emotional abuse, and sexual abuse (Millett, 2016 ), are relevant to services and are therefore included in our regression model. Given the strong relationship between poverty and child maltreatment (Pelton, 2015), our model also included the poverty variable, indicating whether the family’s income was below 100% of the federal poverty line. Data Analysis All caregivers and children were included to examine service needs. We then used the identified service needs to examine service referrals, and subsequently, the service referrals to examine service receipts (see Fig. 1). All descriptive and multivariate estimates were weighted for national representation. We used SAS 9.4 for data management and analysis. The PROC SURVEYFREQ procedure was used for descriptive analysis. For multivariate analysis, which examined disparities in service needs, referrals, and receipts between ethnic and nativity groups while controlling for demographic and child welfare variables, we use the PROC SURVEYLOGISTIC procedure. Results Sample Characteristics Table 1 reveals demographic trends among different caregiver groups. A significant portion of caregivers lacked a high school diploma, with nearly half of Foreign-born Latino caregivers (44.7%) compared to one-third of U.S.-born Latino caregivers (32.8%) and one-fifth of White caregivers (21.1%). Marital status showed differences as well. U.S.-born Latino caregivers were never married (43.7%), a figure almost double that of Foreign-born Latino caregivers (23.9%) and White caregivers (26.5%). Among children, most groups have a nearly equal distribution of boys and girls in terms of biological gender. U.S.-born Latino families had a slightly higher percentage of children aged 0 to 2 years (58.3%) compared to White (47.0%) and Foreign-born Latino children (46.8%). In terms of types of maltreatment reported, Foreign-born Latino families had a slightly higher percentage of emotional abuse (9.1%) compared to White (6.7%) and U.S.-born Latino families (5.6%). On the other hand, White and U.S.-born Latino families had a slightly higher percentage of physical neglect (17.5% and 15.2%, respectively) compared to Foreign-born Latino families (9.8%). In addition, nearly half of Latino families, regardless of nativity, were in poverty compared to one-third of White families (36.0%). Table 1 Sample Characteristics across Race and Ethnicity (%) White (n = 2,306) Black (n = 1,348) U.S.-born Latine (n = 792) Foreign-born Latine (n = 508) CG Education 21.1 22.4 32.8 44.7 CG Marriage Status Married 43.4 21.0 27.9 46.4 Sep./Div./Wid. 30.2 26.5 28.5 29.9 Never 26.5 52.5 43.7 23.9 CH Gender (Boys = 1) 52.2 50.8 51.3 48.9 CH Age 0–2 47.0 55.6 58.3 46.8 3–5 15.5 14.0 12.5 14.0 6–10 19.4 16.0 17.2 18.9 11 and older 18.2 14.4 12.0 20.3 Maltreatment Types Emotional Abuse 6.7 5.0 5.6 9.1 Physical Abuse 22.6 22.0 21.2 23.6 Sexual Abuse 7.7 5.0 5.7 7.7 Physical Neglect 17.5 14.5 15.2 9.8 Other Neglect 33.1 30.9 36.2 33.3 Poor 36.0 51.6 51.9 50.8 Note: CG=Caregiver; CH=Children. All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latine (e.g., Asian American, Native American, Pacific Islander, multiracial). Services to children’s caregivers In examining the service needs, referrals, and receipts among caregivers across nine service domains, Table 2 reveals notable differences among White, U.S.-born Latino, and Foreign-born Latino caregivers. In terms of service needs, Foreign-born Latino caregivers generally showed the lowest need for most services, including housing, employment, substance misuse, mental health, and Medicaid. In contrast, White and U.S.-born Latino caregivers displayed similar trends, with a majority needing services such as housing, employment assistance, legal aid, substance abuse treatment, mental health support, and Medicaid. For example, only 5.9% of Foreign-born Latino caregivers had housing needs, compared to 10.1% of White caregivers and 10.7% of U.S.-born Latino caregivers. Similarly, just 4.0% of Foreign-born Latino caregivers needed substance misuse services, much lower than the 13.5% of White caregivers and 15.4% of U.S.-born Latino caregivers. In terms of mental health services, 11.0% of Foreign-born Latino caregivers had needs, which is almost half the percentage of White caregivers (20.6%) and U.S.-born Latino caregivers (18.2%). However, Latino families, regardless of nativity, showed a relatively higher need for domestic violence services compared to White families. In terms of service referrals, Foreign-born Latino caregivers generally showed the lowest referrals for housing services (30.7%), but the highest for domestic violence (86.0%), mental health (63.0%), and Medicaid services (41.3%) compared to their White and U.S.-born counterparts. U.S.-born Latino caregivers displayed higher referrals for employment assistance (47.5%), substance abuse (74.2%), and serious health problems (27.4%). For services receipts, Foreign-born Latino caregivers displayed the lowest receipts for housing services (12.3%), legal aids (34.5%), substance misuse (50.6%), income assistance (46.3%), and Medicaid (31.7%). On the contrary, U.S.-born caregivers displayed the highest receipts in many of the services, including housing services (37.3%), employment assistance (49.4%), legal aids (77.4%), mental health (79.5%), and income assistance (73.7%). Table 2 Caregiver’s Needs, Referrals, and Receipt of the Services (N = 5,872) (%, Weighted) Service needs among all caregivers (N = 5,872) White (n = 2,306) Black (n = 1,348) US-born Latine (n = 792) Foreign-born Latine (n = 508) Other (n = 918) Housing Assistance 10.1 14.4 10.7 5.9 3.4 Employment 18.5 24.7 19.0 12.4 7.3 Domestic Violence 13.8 13.5 17.8 19.4 4.3 Legal Aid 11.2 11.1 10.6 13.1 3.4 Substance Misuse 13.5 12.7 15.4 4.0 3.2 Mental Health Prob. 20.6 13.8 18.2 11.0 7.9 Serious health Prob. 6.3 4.8 2.7 1.9 1.4 Income Assistance 14.6 17.1 22.2 16.1 6.1 Medicaid 9.6 7.8 9.7 8.8 4.4 Service referrals among caregivers with any service needs (n = 3,214) White Black US-born Latine Foreign-born Latine Other Housing Assistance 12.1 13.0 14.4 7.4 12.7 Employment 8.3 13.4 12.8 5.0 11.3 Domestic Violence 15.2 16.6 18.5 19.9 10.4 Legal Aid 13.3 12.8 12.9 12.2 3.7 Substance Misuse 13.5 16.4 18.8 5.9 10.9 Mental Health Prob. 20.2 13.0 18.5 21.4 26.2 Serious health Prob. 1.1 2.2 3.8 1.0 5.3 Income Assistance 6.2 9.6 5.5 7.0 16.2 Medicaid 4.6 6.4 4.6 7.1 12.4 Service receipts among caregivers with any service referrals (n = 2,408) White Black US-born Latine Foreign-born Latine Other Housing Assistance 8.7 12.7 14.1 4.1 24.0 Employment 8.9 9.6 17.3 5.6 8.0 Domestic Violence 15.5 20.5 27.4 43.4 17.6 Legal Aid 21.7 14.6 25.2 13.7 9.5 Substance Misuse 23.6 14.7 36.1 17.0 34.0 Mental Health Prob. 38.7 23.1 40.4 51.6 28.2 Serious Health Prob. 1.7 5.3 2.7 3.0 2.5 Income Assistance 20.3 23.6 22.5 10.8 59.6 Medicaid 19.1 20.9 18.7 9.7 38.9 Note : All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latino (e.g., Asian American, Native American, Pacific Islander, multiracial). The percentages presented are descriptive; formal tests for statistically significant differences between groups are detailed in the logistic regression results (Table 4 ). Services to children Table 3 offers an overview of the different service needs, referrals, and outcomes among children, highlighting the specific demands within each group. Foreign-born Latino children consistently showed the lowest need for all services, including learning and developmental problems (6.5%), special education (4.0%), emotional and behavioral problems (14.0%), health services (3.0%), routine checkups (19.8%), and dental care (13.8%). This trend is similar to their caregivers, where children of White and U.S.-born Latino caregivers exhibited higher needs for most services, with the exception of emotional, behavioral, and attention problems. For service referrals, children of U.S.-born Latino caregivers had the highest referral rates across most types of services, except for health services. Children of Foreign-born Latino caregivers generally had lower referral rates than children of U.S.-born Latino caregivers but higher than children of White caregivers, except in health services, where they showed the highest referral rates. In terms of service receipts, children of Foreign-born Latino caregivers had the lowest receipt rates across all services compared to their White and U.S.-born Latino counterparts. Conversely, children of White caregivers had the highest service receipt rates, followed by children of U.S.-born Latino caregivers, except for dental care services. Table 3 Children’s Needs, Referrals, and Receipt of the Services % (Weighted) Service needs among all children (N = 5,872) White (n = 2,306) Black (n = 1,348) US-born Latine (n = 792) Foreign-born Latine (n = 508) Other (n = 918) Learning/Dev. Prob. 11.9 11.6 10.6 6.5 3.5 Special Education 10.8 7.9 9.2 4.0 2.9 Emo. /Beh. /Atten. 21.6 12.3 14.2 14.0 7.9 Health Problem 9.7 6.6 13.0 3.0 3.9 Routine Checkups 39.6 42.1 34.9 19.8 12.7 Dental Care 21.8 14.3 15.4 13.8 4.7 Hearing Problems 7.0 4.9 4.1 2.5 1.2 Vision Problems 7.9 3.9 6.0 4.4 1.9 Service referrals among children with any service needs (n = 3,341) White (n = 1,552) Black (n = 892) US-born Latine (n = 429) Foreign-born Latine (n = 238) Other (n = 230) Learning/Dev. Prob. 10.8 10.9 16.6 14.7 15.3 Special Education 2.8 2.1 6.1 2.7 7.1 Emo. /Beh. /Atten. 22.8 15.9 26.0 31.4 29.7 Health Problem 5.7 5.9 11.6 4.9 10.3 Routine Checkups 40.4 40.0 60.4 51.5 42.3 Dental Care 14.0 11.9 20.5 23.4 18.0 Hearing Problems 4.1 3.0 5.2 6.6 6.8 Vision Problems 4.8 2.8 5.1 12.2 8.4 Service receipts among children with any service referrals (n = 2,478) White (n = 1130) Black (n = 652) US-born Latine (n = 324) Foreign-born Latine (n = 189) Other (n = 183) Learning/Dev. Prob. 18.7 6.0 29.5 9.9 27.5 Special Education 6.0 1.1 13.7 1.0 11.8 Emo. /Beh. /Atten. 37.1 14.7 39.7 26.6 21.6 Health Problem 7.9 6.5 7.9 4.2 25.9 Routine Checkups 63.0 76.1 64.0 34.6 72.6 Dental Care 19.0 17.9 29.4 17.4 40.0 Hearing Problems 10.9 5.6 13.4 11.6 16.5 Vision Problems 10.6 6.0 14.1 9.4 11.7 Note : All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latine (e.g., Asian American, Native American, Pacific Islander, multiracial). The percentages presented are descriptive; formal tests for statistically significant differences between groups are detailed in the logistic regression results (Table 5 ) Ethnic/nativity disparities on service needs, referrals, and receipts The logistic regression analysis presented in Tables 4 and 5 investigates the patterns of service needs, referrals, and receipts by ethnicity and nativity. Caregiver’s needs, referrals, and receipts of services Table 4 shows the results of the regression model regarding caregivers’ service needs, referrals, and receipts across ethnic/nativity groups. Among all reported caregivers, U.S.-born Latino caregivers were less likely than their White counterparts to report needing serious health issues (OR = 0.37, p < 0.05). Foreign-born Latino caregivers demonstrated a higher need for domestic violence (OR = 1.80, p < 0.05), but a lower likelihood of reporting needs for substance misuse (OR = 0.26, p < 0.05) and mental health problems (OR = 0.56, p < 0.05) services. There are not many significant differences in referrals across ethnic/nativity groups for any specific service. Among caregivers with service needs, U.S.-born Latino caregivers were more likely to be referred for serious health problems (OR = 6.39, p < 0.05) than White caregivers. In terms of service receipt, among caregivers referred to services, US-born Latino caregivers more often received mental health services (OR = 4.19, p < 0.05) than White caregivers. Table 4 Caregiver’s Needs, Referrals, and Receipts of the Services across Racial/Ethnic/Nativity Groups. Ref. White Odds Ratio (OR) Service Need Models Need vs. no need among all caregivers (N = 5,872) Housing Services Employment Domestic Violence Legal Aid Substance misuse Mental Health Prob Serious Health Income Assistance Medi-caid Black 1.60** 1.28 0.97 1.12 0.91 0.68 0.78 0.89 1.14 U.S.- born Latine 0.99 0.91 1.26 1.01 0.97 0.82 0.37** 0.87* 1.48 Foreign - born Latine 0.64 0.61* 1.80** 1.57 0.26** 0.56** 0.31 0.79 1.10 Other 0.37* 0.35* 0.30* 0.36* 0.20* 0.23* 0.27* 0.31* 0.34* Service Referral Models Referral vs. no referral among caregivers with any service needs (N = 3,214) Black 0.70 1.48 1.93* 1.19 1.86 0.75 2.41 1.95 2.79* U.S.- born Latine 1.18 1.47 1.82 1.15 1.73 0.86 6.39** 0.62 0.66 Foreign - born Latine 0.93 0.77 1.86* 0.96 1.15 1.21 1.71 0.90 2.37 Other 1.27 1.71* 1.21 1.00 1.01 0.87 1.01 1.75 2.09 Service Receipt Model Receipt vs no receipt among caregivers with any service referrals (N = 2,408) Black 1.83 0.61 0.98 0.69 0.45 0.71 4.12 0.69 0.64 U.S.- born Latine 2.72 1.57 1.92 3.28 0.99 4.19** 0.28 1.37 1.38 Foreign - born Latine 1.14 1.94 0.32 0.23* 1.77 2.47 1.36 0.56 0.63 Other 1.67 2.14* 1.09 1.12 0.84 0.65 1.13 0.84 1.08 Note: All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latino (e.g., Asian American, Native American, Pacific Islander, multiracial). Demographic and case variables were controlled, but not shown. * p < .05. ** p < .01. Children’s needs, referrals, and receipts of services Table 5 shows that among all reported children, those with Foreign-born Latino caregivers were less likely to need some of the services compared to White children, including special education services (OR = 0.29, p < 0.05), health (OR = 0.30, p < 0.05), and routine checkups (OR = 0.40, p < 0.05). Regarding service receipts, among children referred to services, those with Foreign-born Latino caregivers were less likely to receive many of the services compared to White children, including learning and developmental problems (OR = 0.23, p < 0.5), and emotional, behavioral, or attention (OR = 0.09, p < 0.05). Table 5 Children’s Needs, Referrals, and Receipts of the Services across Racial/Ethnic/Nativity Groups. Ref. White Odds Ratio (OR) Service Need Models Need vs. no need among all children (N = 5,872) Learning/Dev. Problem Special Education Emo./Beh./Att Health Problem Routine Checkups Dental Care Hearing Problem Vision Problem Black 1.10 0.84 0.56** 0.63* 1.06 0.73 1.15 1.02 U.S.- born Latine 0.89 0.91 0.67 1.28 0.71 0.68 0.80 0.80 Foreign - born Latine 0.54* 0.29** 0.52* 0.30** 0.40** 0.60 0.62* 0.56* Other 0.31* 0.21* 0.23* 0.39* 0.17* 0.28* 0.41* 0.46* Service Referral Models Referral vs. no referral among children with service needs (N = 3,341) Black 1.04 1.01 1.35** 1.98* 1.09 1.78** 1.08 1.13 U.S.- born Latine 1.75* 1.71 2.16 2.00* 2.58* 2.15 1.10 1.00 Foreign - born Latine 1.79 2.06 1.81 1.53 1.95 1.76 1.53 1.10 Other 1.35 0.52 0.85 1.53 1.55* 1.23 1.61 1.94* Service Receipt Model Receipt vs no receipt among children with service referrals (N = 2,478) Black 0.14** NR 3.01 1.05 1.15 5.38** 1.13 1.10 U.S.- born Latine 0.80 NR 2.18 3.77 0.62 1.65 1.14 0.92 Foreign - born Latine 0.23* NR 0.09** 0.01** 0.19 0.54 1.23 0.91 Other 0.96 0.30 0.23* 1.27 1.21 1.39 1.31 1.12 Note. Dev. = Developmental. Emo./Beh./Att. = Emotional/Behavioral/Attention. NR = Not Reliable. Ref = reference. All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latino (e.g., Asian American, Native American, Pacific Islander, multiracial). Demographic and case variables were controlled, but not shown. * p < .05. ** p < .01. Discussion Significant differences were observed in service needs, but limited distinctions were found in referrals and receipts across ethnic and nativity groups. Foreign-born Latino families generally had lower service needs compared to White families. Additionally, Latino families, regardless of nativity, showed no significant statistical differences in service referrals and receipts in most cases when compared to their White counterparts. Service Needs We found White families exhibited higher service needs than Latino families, especially foreign-born Latino families, except in the area of domestic violence services. This aligns with previous research that caregivers from foreign-born Latino families are less often reported for issues like drug misuse, cognitive disabilities, poor parenting skills, and previous arrests compared to their U.S.-born counterparts (Dettlaff et al., 2009b ). Moreover, LaBrenz and colleagues ( 2023 ) found that White caregivers have more risk factors (indicating higher needs) than Latino families when entering foster care. For example, only 19.3% of Latino families in the study had reported parental substance misuse, compared with 39.6% of white families; similarly, 12.8% of white families experienced inadequate housing that contributed to the child’s foster care entry, compared with only 7.0% of Latino families. However, we noticed that foreign-born caregivers were particularly more likely to have needs related to domestic violence. While existing studies showed a huge range of intimate partner violence (IPV) among Hispanic women from 9% to 80% (Cavanaugh et al., 2014 ; Cho, 2012 ), it is concerning that a recent study indicates that Latino immigrant women might report lower rates of IPV, potentially due to fear of deportation, language barriers, and limited access to resources (Garza et al., 2024). More studies are needed to understand the unique challenges faced by foreign-born caregivers regarding intimate partner violence and to develop culturally sensitive interventions. Our findings reveal a concerning 'Domestic Violence Paradox' among foreign-born caregivers. While these caregivers exhibit the protective effects of the immigrant paradox in areas like substance use and mental health, they are nearly twice as likely to have domestic violence needs compared to their White counterparts ( $ OR = 1.80 $ ). This suggests that while traditional clinical risk factors may be lower, the unique stressors of the immigration experience—such as cultural isolation and the absence of support networks—may manifest more acutely as interpersonal conflict. This is particularly alarming given that Latino immigrant women may underreport IPV due to fear of deportation, implying that the actual need for domestic violence services may be even higher than the caseworker-reported data suggests. Moreover, children from foreign-born backgrounds were generally less likely to exhibit service needs for most of the services, including learning and developmental problems, special education, behavioral problems, health problems, and routine checkups. This may be due to the immigrant paradox, where foreign-born parents and children tend to have better health, mental health, and behavioral health outcomes than their U.S.-born counterparts. Despite socioeconomic disadvantages and healthcare barriers, Hispanic and Latino populations in the U.S. often show resilience due to strong family bonds, support networks, and coping mechanisms (Marks et al., 2014 ). This resilience could explain the lower utilization of behavioral health services among these groups, and a substantial body of research supports the protective effects of being born outside the U.S. on various outcomes such as mental health (Zhang et al., 2021 ), maltreatment risk (Zhang et al., 2021 ), cognitive growth (Fuller et al., 2009 ), and physical health (Oh et al., 2019 ). Service Referrals There were minimal differences observed between White and Latino caregivers in terms of service referrals. Our findings for caregivers align with previous research (Finno-Velasquez, 2013; Lovato-Hermann et al., 2017 ), indicating no observed racial/ethnic differences in requests for psychosocial services, basic needs, and well-being services among caregivers involved in CPS. Service Receipts We also found minimal differences between White and Latino caregivers regarding service receipts. Previous studies have mixed findings, with some suggesting Latino families receive fewer and less effective services than White families (Cheng & Lo, 2012 ; Courtney, 2000 ; Courtney et al., 1996 ; LaBrenz et al., 2023 ). Limited statistical power due to the moderate sample size for national weighting may mask the statistical significance of moderate differences. The diversity within the Latino population complicates identifying uniform service patterns, and additional challenges such as acculturation stress, eligibility issues, linguistic differences, discrimination, violence exposure, and economic hardships add complexity (Bowe, 2017; Crimmins et al., 2007; Derr, 2015 ; Salas-Wright et al., 2016). Children of foreign-born Latino caregivers were less likely to receive services for emotional, behavioral, or attention problems than their White counterparts. This finding aligns with previous studies that Latino families tend to underutilize mental health services, compared to their non-Latino counterparts (Alegria et al., 2004; Gudiño et al., 2009 ), and a recent systematic review identified the barriers to accessing services for their child’s mental health problems, including cultural stigma, problem recognition and identification, and fears about seeking therapy (Santana et al., 2023 ). For example, cultural stigma regarding mental health often causes hesitation in seeking help among Latino families, as mental health issues are perceived as personal or familial failings. Additionally, children of foreign-born Latino caregivers were notably less likely to receive services for health problems compared to their White peers. This disparity may stem from economic challenges and limited access to health care resulting from a lack of insurance (Putnam-Hornstein et al., 2013 ; Shiro & Reeves, 2020 ). These obstacles can impede Latino families' ability to access essential support, emphasizing the need for targeted interventions to ensure equitable access to health services for Latino children. While our findings suggest potential general tendencies of lower service receipt rates among Latino children compared to White children, the lack of statistical significance warrants cautious interpretation and underscores the need for further research. Variations in these outcomes may be influenced by cultural interpretations of behaviors, access to culturally competent services, and recent changes in immigration policies, highlighting the need for larger datasets to investigate these disparities more thoroughly. Limitations and Strengths One strength of this study is its comprehensive approach, addressing service needs, referrals, and receipt disparities across ethnic and nativity groups involved in CPS. This distinguishes our research as one of the few studies to provide a holistic view of the complexities involved in the service dynamics across these critical demographic factors. Furthermore, our research builds upon prior studies, offering fresh insights into the immigration status of Latino families in accessing a variety of services, thereby contributing to the evolving body of knowledge in this domain. While the NSCAW II data were collected between 2008 and 2009, this timeframe represents a critical historical baseline for the U.S. child welfare system. Establishing this foundation is essential for understanding the trajectory of service delivery prior to the significant shifts in immigration policy and social climate observed during the 2010s and specifically the 2016–2020 era. By documenting these pre-existing disparities, this study provides the necessary longitudinal context to evaluate whether subsequent policy changes or shifting social attitudes have exacerbated or mitigated service gaps for Latino families. First, we recognize that the NSCAW II data were collected from 2008 to 2009, which may be somewhat outdated. Despite the limited data on the Hispanic population, this is essential to serve as a valuable baseline for future research. Additionally, the weighting used to generate nationally representative estimates, combined with the moderate sample size, constrained the statistical power of our findings. The lack of detailed information regarding specific reasons for service referrals or denials also limited our ability to conduct a more granular analysis. While NSCAW II provides longitudinal data, the caseworker interviews on service provision were confined to Wave I, which only covered the 12 months prior to the interview. This restricted the study's ability to explore temporal changes, and the absence of data on evolving policies or shifting social attitudes introduced further complexity. Although culturally sensitive factors were acknowledged, they may not have been fully captured, leaving room for additional exploration. In conclusion, these strengths and limitations underscore areas for future research, emphasizing the need for a more nuanced and culturally sensitive approach to addressing service disparities in the child welfare system. Implications Our research highlights the need for targeted policies to address disparities in most of the services for Latino families, especially foreign-born Latino caregivers and children. Policymakers should allocate resources based on specific needs, strategically distributing them to areas with significant disparities. Collaboration among child welfare agencies, community organizations, and stakeholders is essential for successful policy implementation and to foster partnerships for comprehensive solutions. For example, sustainable housing has been identified as crucial for preserving and reunifying families (Bai et al., 2023 ; Fowler et al., 2020 ), yet some subsidies may be limited to U.S. citizens or permanent residents. In addition, within the child welfare system, clinicians must adopt a culturally responsive approach, particularly when serving Latino families. This could include meaningful engagement of parents and an openness to learning about cultural beliefs/norms among each family they work with (Leake et al., 2010 ). Further, providers could consider how nativity may impact service accessibility and provision, and adapt plans accordingly. Efforts to address disparities in service receipts, especially for Latino children, should be prioritized at the clinical level, implementing targeted interventions to overcome potential barriers. Continued research is vital for monitoring trends and identifying evolving needs in the child welfare system. Further exploration into the reasons for the lack of referrals or service receipts is necessary, requiring in-depth analyses considering limited sample sizes. Research efforts should focus on understanding the association between service needs, referrals, and receipts, including rereport, for specific subpopulations. Large datasets and robust statistical analyses are essential to draw definitive conclusions and inform targeted interventions. Conclusion In conclusion, our study illuminates significant disparities in service needs, referrals, and receipts within the child welfare system across ethnic and nativity groups. It underscores the need for targeted policies ensuring equitable resource allocation. Culturally competent approaches by clinicians, tailored interventions for nuanced differences, and prioritized efforts to address service receipt disparities are crucial. Continued research is essential for monitoring trends and understanding dynamics, contributing to targeted interventions, and advancing the understanding of service dynamics within the child welfare system. Declarations (Funding Declaration: The authors received no financial support for the research, authorship, or publication of this article.) Author Contribution Dr. Chien-jen Chiang wrote the main manuscript text and Dr. Hyunil Kim helped with the data analysis. Dr. Miyoun Yang and Junghon Chen edited and reviewed the manuscript. Data Availability The data used in this study were obtained from the National Data Archive on Child Abuse and Neglect (NDACAN). These data are available to the research community through a formal application process and licensing agreement to ensure respondent confidentiality. Interested researchers can find access information at https://www.ndacan.acf.hhs.gov/. References Alegria, M., Robles, R., Freeman, D. H., Vera, M., Jimenez, A. L., Rios, C. & Rios, R. (1991). Patterns of mental health utilization among island Puerto Rican poor. American Journal of Public Health (1971), 81 (7), 875–879. https://doi.org/10.2105/AJPH.81.7.875. Allison, P. D. (2012). 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Frontiers in Public Health, 9 . https://doi.org/10.3389/fpubh.2021.619164 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8733549","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":588622020,"identity":"708f3da2-748b-4fa4-90a7-5146a471d02f","order_by":0,"name":"Chien-jen Chiang","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABFElEQVRIiWNgGAWjYDACCcYGIMnGACYSgCQ/VAIsTpwWyQZmQloQTLA+BoMDBLTwz25ufFzAwCdnzsD87MGDmjt2m2/kH/7wg8FGdsMBHJbcOdhsPIOBzdiygc3cIOHYs+RtN5LZJHsY0oxxaTGQSGyT5v3HlrjhAA+bRALb4WQzoBYGHobDiXi0tP/mYWCrh2j5dzjZeEYy88c/DP/xaWljBmpJMABpSWw7bGcgkcwgzcNwAKcWiRuJzUAFbIYbDrOZSST2HU6QOPPYTFrGINl4Jg4t/DPSH37mYTgmb3C8+Znkj2+H7fnbEx9/fFNhJ9uHQwsUHGNggMQGQ2IDxMF4lYNADZxlT1DtKBgFo2AUjDgAAPCxWaJ2OZmdAAAAAElFTkSuQmCC","orcid":"","institution":"The University of Texas at San Antonio","correspondingAuthor":true,"prefix":"","firstName":"Chien-jen","middleName":"","lastName":"Chiang","suffix":""},{"id":588622024,"identity":"dade463f-cb8e-4dd1-be54-9c3793918c00","order_by":1,"name":"Hyunil Kim","email":"","orcid":"","institution":"University of Illinois Urbana-Champaign","correspondingAuthor":false,"prefix":"","firstName":"Hyunil","middleName":"","lastName":"Kim","suffix":""},{"id":588622028,"identity":"8e581cd8-b5ce-417b-8496-449c977978cf","order_by":2,"name":"Miyoun Yang","email":"","orcid":"","institution":"Keimyung University","correspondingAuthor":false,"prefix":"","firstName":"Miyoun","middleName":"","lastName":"Yang","suffix":""},{"id":588622030,"identity":"895078f7-a11d-4818-9d03-a49a3b99fe65","order_by":3,"name":"Junhong Chen","email":"","orcid":"","institution":"Saint Louis University","correspondingAuthor":false,"prefix":"","firstName":"Junhong","middleName":"","lastName":"Chen","suffix":""}],"badges":[],"createdAt":"2026-01-29 16:08:58","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8733549/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8733549/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102594890,"identity":"5a64dade-a214-4a59-b596-cd9ad1c7fceb","added_by":"auto","created_at":"2026-02-13 11:59:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":71899,"visible":true,"origin":"","legend":"\u003cp\u003eSee image above for figure legend\u003c/p\u003e","description":"","filename":"floatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-8733549/v1/182a63ad04d84433e4bc8506.png"},{"id":102747714,"identity":"34eb53d6-962a-4fb8-9e9d-3564e710b911","added_by":"auto","created_at":"2026-02-16 09:05:16","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1642748,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8733549/v1/deb7aab3-f5d6-495d-a744-7d947329da90.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Navigating Service Needs, Referrals, and Receipts for","fulltext":[{"header":"Introduction","content":"\u003cp\u003eIn the last twenty years, there has been a significant rise in Latino involvement in the US child welfare system (US Department of Health and Human Services [DHHS], 2003; 2023) which has paralleled an increase in the percentage of the total child population that is Latino in the United States (US Census Bureau, \u003cspan citationid=\"CR65\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Accompanying this trend, the volume of research examining the nuances of the Latino demographic within child protective services (CPS) has gradually expanded over the same period (Cardoso et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Johnson-Motoyama, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Studies to date have revealed that the services provided to Latino families, along with their associated risks and protective factors, vary greatly depending on the families' country of origin and their immigration status (Cardoso et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Millett, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). However, the unaddressed service needs of Latino families and how their children's pathways through the child welfare system unfold continue to be understudied.\u003c/p\u003e\n\u003ch3\u003eLatino Families Involved with CPS\u003c/h3\u003e\n\u003cp\u003eLatino children, constituting 24% of the U.S. child population, experienced a rise in child maltreatment reports from 14.5% in 2001 to 25.6% in 2021, representing a significant and growing demographic within the child welfare system (US DHHS, 2003; 2023). Reflecting the community's diversity, with origins across Spanish-speaking countries in the Americas, nearly half of Latino caregivers in the US are foreign-born, including a notable portion of undocumented immigrants (Budiman, 2020). The representation of Latinos-identified children in child maltreatment cases varies by state and type of maltreatment, indicating the complexity of issues they face, such as immigration status. This has spurred extensive research into the unique characteristics and challenges of Latino families in the child welfare context (Cardoso et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Dettlaff \u0026amp; Rycraft, 2010; Luken et al., 2021).\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eUS-born and foreign-born Latino families\u003c/h2\u003e \u003cp\u003eImmigrating and adjusting to a new cultural setting can significantly strain immigrant families, complicating the challenges of raising children. This difficulty can be exacerbated by the absence of a support network and feelings of isolation and uncertainty that come with settling into an unfamiliar environment (Finno-Velasquez et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2016\u003c/span\u003e; Rumbaut, \u003cspan citationid=\"CR59\" class=\"CitationRef\"\u003e1999\u003c/span\u003e). Additionally, immigrant caregivers often encounter financial difficulties, leading to a scarcity of adequate food, medical care, and overall insufficient childcare. Moreover, immigrants without citizenship or permanent residency may be ineligible for some services, such as mental health or other healthcare (Derr, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2015\u003c/span\u003e), which may in turn impact their ability to nurture and provide for their children. This further complicates their circumstances compared to their White counterparts (DeNavas-Walt \u0026amp; Proctor, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Johnson-Motoyama et al., 2014; Lu et al., \u003cspan citationid=\"CR52\" class=\"CitationRef\"\u003e2004\u003c/span\u003e).\u003c/p\u003e \u003cp\u003ePrior research has highlighted distinct disparities in CPS reports, risk factors, and patterns of maltreatment between U.S.-born and foreign-born Latino families (Dettlaff \u0026amp; Johnson, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Specifically, children from foreign-born Latino families are less often reported for issues like drug misuse, cognitive disabilities, poor parenting skills, and previous arrests compared to their U.S.-born counterparts (Dettlaff et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2009b\u003c/span\u003e). Conversely, children from foreign-born Latino families are more likely to be reported for neglect-related issues, such as inadequate food and care, and face a higher risk of sexual abuse compared to children from US-born Latino families (Johnson-Motoyama, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Despite these disparities in risk factors and maltreatment types, Cardoso and colleagues (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2014\u003c/span\u003e) found no differences between U.S. and foreign-born Latino in terms of the in-home (family preservation services, parental training, and respite of child care.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eLegal immigration status\u003c/h3\u003e\n\u003cp\u003eAlthough few recent studies have reported on the proportion of children with undocumented caregivers in child welfare, in 2014, Cardoso and colleagues reported that Latino children of undocumented immigrants made up 5% of all children and approximately 20% of Latino children are involved with CPS. Children whose parents are undocumented face distinct challenges, such as reduced access to essential services and a heightened risk of experiencing maltreatment. Undocumented Latino immigrant caregivers, lacking legal status, face significant barriers to accessing services. For example, undocumented caregivers are not able to legally seek work and may face barriers when seeking insurance, medical care, and mental health services (Cabral \u0026amp; Cuevas, \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Hacker et al., \u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Additionally, there may be an increased reluctance to utilize public services stemming from a fear of deportation and ineligibility for federal or state insurance and benefits (Capps et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2004\u003c/span\u003e; Dettlaff \u0026amp; Johnson, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2011\u003c/span\u003e; Velazquez \u0026amp; Dettlaff, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2011\u003c/span\u003e). Compared to US-born caregivers, undocumented noncitizen caregivers tend to have lower levels of education and face greater financial struggles (Cardoso et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). These factors can significantly affect children's overall well-being (Schmeer, \u003cspan citationid=\"CR61\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) and increase the likelihood of CPS intervention for children of undocumented individuals (Johnson-Motoyama, \u003cspan citationid=\"CR41\" class=\"CitationRef\"\u003e2014\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eDisparities in Child Welfare Services\u003c/h3\u003e\n\u003cp\u003eThere have been mixed findings on disparities in the provision of services to Latino families within the child welfare system. Several earlier studies found that Latino families were less likely to receive services than White families (Courtney, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2000\u003c/span\u003e; Courtney et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e1996\u003c/span\u003e). However, Cheng and Lo (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2012\u003c/span\u003e) later found that Latino families were more likely to receive services in the child welfare system. For specific services, Black families were more likely to be referred to basic needs services such as housing compared with Latino families (Lovato-Hermann et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), while Latino families were more likely to be referred to mental health services than White and Black families (Garcia et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Lovato-Hermann et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2017\u003c/span\u003e). Conversely, other studies found that Latino children were less likely to access mental health services compared to their White and Black counterparts (Garland et al., 2000; Garland et al., 2003; Leslie et al., 2000).\u003c/p\u003e \u003cp\u003eDisparities have been more consistently identified for Latino children in foster care in mental health care access and utilization. Latino children in the foster care system are less likely to access mental health services in comparison to White and Black children, a trend consistently observed across various studies (Garland et al., 2000; Garland et al., 2003; Leslie et al., 2000; Tingus et al., 1996). This finding persists even when accounting for factors such as socioeconomic status and the severity of mental health symptoms (Garland et al., 2003; Hurlburt et al., 2004; McCabe et al., 1999). However, it is worth noting that many of these studies were conducted over 20 years ago, highlighting a need for research that captures the changing profiles and heterogeneity of Latino families in the United States.\u003c/p\u003e\n\u003ch3\u003ePresent Study\u003c/h3\u003e\n\u003cp\u003eThis study examines service gaps of needs, referrals, and receipts for Latino caregivers and children in CPS compared to White families. Understanding these disparities is crucial for improving the effectiveness and equity of child welfare systems, leading to better outcomes for CPS-involved families. Identifying these gaps enables policymakers and service providers to allocate resources more efficiently and facilitates the implementation of targeted interventions where referrals fail to translate into services received.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eData and Sample\u003c/h2\u003e \u003cp\u003eData for this study come from the National Survey on Child and Adolescent Well-being II (NSCAW II). NSCAW II employed a panel design study, utilizing a national probability sample of children and families reported to CPS. The NSCAW II cohort for national weighting consisted of 5,251 children aged birth to 17.5 years who had investigated reports of maltreatment. This study used the baseline (wave 1) data collected from March 2008 to September 2009. The data collection involved comprehensive face-to-face interviews with various stakeholders, including children, parents, foster parents, kin caregivers, and investigative caseworkers. This approach allowed for a more in-depth understanding of the needs, referrals, and receiving of the services for children and caregivers within the child welfare system.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eMeasurement\u003c/h3\u003e\n\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eRace/ethnicity/nativity\u003c/h2\u003e \u003cp\u003eFor this study, five distinct race and ethnic groups were established to facilitate the study. Caregivers who self-identified as White and not Spanish/Hispanic/Latino were classified as (1) Non-Latino White. Those who identified as Black and not Spanish/Hispanic/Latino were designated as (2) Non-Latino Black. To further explore disparities among Latino families engaged with Child Protective Services (CPS), an additional division was made based on nativity, resulting in two separate categories: (3) U.S.-born Latino and (4) foreign-born Latino. All other caregivers were grouped into the (5) Others category. This classification aimed to provide a clear understanding of the diverse backgrounds of caregivers involved with CPS. For the focus of this study, the results for the \u0026ldquo;Black\u0026rdquo; and \"Other\" groups have been omitted from the subsequent discussion but are presented in the tables.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec11\" class=\"Section2\"\u003e \u003ch2\u003eOutcome variables\u003c/h2\u003e \u003cp\u003e \u003cb\u003eServices needed.\u003c/b\u003e Caseworkers were asked about the service needs and services provided to caregivers and children based on the case record and their knowledge of the case, regardless of service availability. Using the information from caseworker interviews, we created binary variables (yes\u0026thinsp;=\u0026thinsp;1 or no\u0026thinsp;=\u0026thinsp;0) to represent caregiver service needs across nine domains: (1) housing, (2) employment, (3) domestic violence, (4) legal aid, (5) Substance misuse (including both alcohol and drug misuse), (6) mental health (e.g., emotional, psychological, depression, bipolar disorder, schizophrenia, or other), (7) serious health problems, (8) income assistance programs (e.g., TANF, AFDC, or general assistance), and (9) Medicaid. For children, we developed binary service need variables (yes\u0026thinsp;=\u0026thinsp;1 or no\u0026thinsp;=\u0026thinsp;0) for the following six domains: (1) learning or developmental problems, (2) special education, (3) emotional, behavioral, or attention problems, (4) health problems, (5) routine checkups and immunizations, and (6) dental care.\u003c/p\u003e \u003cp\u003e \u003cb\u003eServices referred.\u003c/b\u003e Service referral variables (yes\u0026thinsp;=\u0026thinsp;1 or no\u0026thinsp;=\u0026thinsp;0) were measured based on caseworker interviews regarding whether a referral had been explicitly outlined in the case plan or safety plan for each of the nine caregiver services and the six child services.\u003c/p\u003e \u003cp\u003e \u003cb\u003eServices received.\u003c/b\u003e Service receipt variables (yes\u0026thinsp;=\u0026thinsp;1 or no\u0026thinsp;=\u0026thinsp;0) were measured based on caseworker interviews regarding whether a service had been utilized by either caregivers or children within the family for each of the nine caregiver services and the six child services.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eDemographic and child welfare variables in the regression models\u003c/h2\u003e \u003cp\u003eCertain family characteristics have been found to influence service needs, referrals, and receipts. In our regression model, we considered specific demographic factors like the child\u0026rsquo;s age (Garcia et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), the child\u0026rsquo;s sex (Alzate \u0026amp; Rosenthal, 2012), and the caregivers\u0026rsquo; marital status (Cardoso et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Additionally, studies have shown whether the case is substantiated (Garcia et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2016\u003c/span\u003e) and types of maltreatment, including neglect, physical abuse, emotional abuse, and sexual abuse (Millett, \u003cspan citationid=\"CR55\" class=\"CitationRef\"\u003e2016\u003c/span\u003e), are relevant to services and are therefore included in our regression model. Given the strong relationship between poverty and child maltreatment (Pelton, 2015), our model also included the poverty variable, indicating whether the family\u0026rsquo;s income was below 100% of the federal poverty line.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eData Analysis\u003c/h2\u003e \u003cp\u003eAll caregivers and children were included to examine service needs. We then used the identified service needs to examine service referrals, and subsequently, the service referrals to examine service receipts (see Fig.\u0026nbsp;1). All descriptive and multivariate estimates were weighted for national representation. We used SAS 9.4 for data management and analysis. The PROC SURVEYFREQ procedure was used for descriptive analysis. For multivariate analysis, which examined disparities in service needs, referrals, and receipts between ethnic and nativity groups while controlling for demographic and child welfare variables, we use the PROC SURVEYLOGISTIC procedure.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eSample Characteristics\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e reveals demographic trends among different caregiver groups. A significant portion of caregivers lacked a high school diploma, with nearly half of Foreign-born Latino caregivers (44.7%) compared to one-third of U.S.-born Latino caregivers (32.8%) and one-fifth of White caregivers (21.1%). Marital status showed differences as well. U.S.-born Latino caregivers were never married (43.7%), a figure almost double that of Foreign-born Latino caregivers (23.9%) and White caregivers (26.5%).\u003c/p\u003e \u003cp\u003eAmong children, most groups have a nearly equal distribution of boys and girls in terms of biological gender. U.S.-born Latino families had a slightly higher percentage of children aged 0 to 2 years (58.3%) compared to White (47.0%) and Foreign-born Latino children (46.8%).\u003c/p\u003e \u003cp\u003eIn terms of types of maltreatment reported, Foreign-born Latino families had a slightly higher percentage of emotional abuse (9.1%) compared to White (6.7%) and U.S.-born Latino families (5.6%). On the other hand, White and U.S.-born Latino families had a slightly higher percentage of physical neglect (17.5% and 15.2%, respectively) compared to Foreign-born Latino families (9.8%). In addition, nearly half of Latino families, regardless of nativity, were in poverty compared to one-third of White families (36.0%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSample Characteristics across Race and Ethnicity (%)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;2,306)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;1,348)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eU.S.-born Latine\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;792)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eForeign-born\u003c/p\u003e \u003cp\u003eLatine (n\u0026thinsp;=\u0026thinsp;508)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCG Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e21.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e32.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e44.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCG Marriage Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e21.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e27.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e46.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSep./Div./Wid.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e30.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e28.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e29.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e26.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e52.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e43.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCH Gender (Boys\u0026thinsp;=\u0026thinsp;1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e48.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCH Age\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0\u0026ndash;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e47.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e55.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e58.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e46.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e19.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e16.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e18.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11 and older\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e12.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e20.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMaltreatment Types\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmotional Abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical Abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e22.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e22.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e21.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSexual Abuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical Neglect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e14.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e15.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther Neglect\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e33.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e33.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePoor\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e36.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e51.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e50.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003eNote: CG=Caregiver; CH=Children. All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latine (e.g., Asian American, Native American, Pacific Islander, multiracial).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eServices to children\u0026rsquo;s caregivers\u003c/h2\u003e \u003cp\u003eIn examining the service needs, referrals, and receipts among caregivers across nine service domains, Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e reveals notable differences among White, U.S.-born Latino, and Foreign-born Latino caregivers.\u003c/p\u003e \u003cp\u003eIn terms of service needs, Foreign-born Latino caregivers generally showed the lowest need for most services, including housing, employment, substance misuse, mental health, and Medicaid. In contrast, White and U.S.-born Latino caregivers displayed similar trends, with a majority needing services such as housing, employment assistance, legal aid, substance abuse treatment, mental health support, and Medicaid.\u003c/p\u003e \u003cp\u003eFor example, only 5.9% of Foreign-born Latino caregivers had housing needs, compared to 10.1% of White caregivers and 10.7% of U.S.-born Latino caregivers. Similarly, just 4.0% of Foreign-born Latino caregivers needed substance misuse services, much lower than the 13.5% of White caregivers and 15.4% of U.S.-born Latino caregivers. In terms of mental health services, 11.0% of Foreign-born Latino caregivers had needs, which is almost half the percentage of White caregivers (20.6%) and U.S.-born Latino caregivers (18.2%). However, Latino families, regardless of nativity, showed a relatively higher need for domestic violence services compared to White families.\u003c/p\u003e \u003cp\u003eIn terms of service referrals, Foreign-born Latino caregivers generally showed the lowest referrals for housing services (30.7%), but the highest for domestic violence (86.0%), mental health (63.0%), and Medicaid services (41.3%) compared to their White and U.S.-born counterparts. U.S.-born Latino caregivers displayed higher referrals for employment assistance (47.5%), substance abuse (74.2%), and serious health problems (27.4%).\u003c/p\u003e \u003cp\u003eFor services receipts, Foreign-born Latino caregivers displayed the lowest receipts for housing services (12.3%), legal aids (34.5%), substance misuse (50.6%), income assistance (46.3%), and Medicaid (31.7%). On the contrary, U.S.-born caregivers displayed the highest receipts in many of the services, including housing services (37.3%), employment assistance (49.4%), legal aids (77.4%), mental health (79.5%), and income assistance (73.7%).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCaregiver\u0026rsquo;s Needs, Referrals, and Receipt of the Services (N\u0026thinsp;=\u0026thinsp;5,872)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e(%, Weighted)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService needs among all caregivers (N\u0026thinsp;=\u0026thinsp;5,872)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite (n\u0026thinsp;=\u0026thinsp;2,306)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;1,348)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUS-born Latine (n\u0026thinsp;=\u0026thinsp;792)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eForeign-born Latine (n\u0026thinsp;=\u0026thinsp;508)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;918)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousing Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomestic Violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLegal Aid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubstance Misuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental Health Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerious health Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedicaid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService referrals among caregivers with any service needs (n\u0026thinsp;=\u0026thinsp;3,214)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUS-born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eForeign-born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousing Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomestic Violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLegal Aid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubstance Misuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental Health Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e26.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerious health Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedicaid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService receipts among caregivers with any service referrals (n\u0026thinsp;=\u0026thinsp;2,408)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUS-born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eForeign-born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHousing Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e24.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e17.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDomestic Violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e43.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLegal Aid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e25.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubstance Misuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental Health Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e38.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e40.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e28.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSerious Health Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eIncome Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e20.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e59.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedicaid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e38.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eNote\u003c/b\u003e: All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latino (e.g., Asian American, Native American, Pacific Islander, multiracial). The percentages presented are descriptive; formal tests for statistically significant differences between groups are detailed in the logistic regression results (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e).\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eServices to children\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e offers an overview of the different service needs, referrals, and outcomes among children, highlighting the specific demands within each group. Foreign-born Latino children consistently showed the lowest need for all services, including learning and developmental problems (6.5%), special education (4.0%), emotional and behavioral problems (14.0%), health services (3.0%), routine checkups (19.8%), and dental care (13.8%). This trend is similar to their caregivers, where children of White and U.S.-born Latino caregivers exhibited higher needs for most services, with the exception of emotional, behavioral, and attention problems.\u003c/p\u003e \u003cp\u003eFor service referrals, children of U.S.-born Latino caregivers had the highest referral rates across most types of services, except for health services. Children of Foreign-born Latino caregivers generally had lower referral rates than children of U.S.-born Latino caregivers but higher than children of White caregivers, except in health services, where they showed the highest referral rates.\u003c/p\u003e \u003cp\u003eIn terms of service receipts, children of Foreign-born Latino caregivers had the lowest receipt rates across all services compared to their White and U.S.-born Latino counterparts. Conversely, children of White caregivers had the highest service receipt rates, followed by children of U.S.-born Latino caregivers, except for dental care services.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eChildren\u0026rsquo;s Needs, Referrals, and Receipt of the Services\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003e% (Weighted)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService needs among all children (N\u0026thinsp;=\u0026thinsp;5,872)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite (n\u0026thinsp;=\u0026thinsp;2,306)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;1,348)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUS-born Latine (n\u0026thinsp;=\u0026thinsp;792)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eForeign-born Latine (n\u0026thinsp;=\u0026thinsp;508)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;918)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLearning/Dev. Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpecial Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmo. /Beh. /Atten.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth Problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e9.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoutine Checkups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e39.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e42.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDental Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e21.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e4.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHearing Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVision Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService referrals among children with any service needs (n\u0026thinsp;=\u0026thinsp;3,341)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;1,552)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;892)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUS-born Latine\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;429)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eForeign-born Latine (n\u0026thinsp;=\u0026thinsp;238)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;230)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLearning/Dev. Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpecial Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmo. /Beh. /Atten.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e26.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth Problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoutine Checkups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e42.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDental Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e14.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e20.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHearing Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVision Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e12.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e8.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"6\" nameend=\"c6\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService receipts among children with any service referrals (n\u0026thinsp;=\u0026thinsp;2,478)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite (n\u0026thinsp;=\u0026thinsp;1130)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;652)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eUS-born Latine\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;324)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eForeign-born Latine\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;189)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003cp\u003e(n\u0026thinsp;=\u0026thinsp;183)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLearning/Dev. Prob.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e18.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e27.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSpecial Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEmo. /Beh. /Atten.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e37.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e21.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHealth Problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e25.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRoutine Checkups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e63.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e76.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e64.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e34.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e72.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDental Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e19.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e29.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e17.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHearing Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e16.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVision Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"6\"\u003e\u003cb\u003eNote\u003c/b\u003e: All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latine (e.g., Asian American, Native American, Pacific Islander, multiracial). The percentages presented are descriptive; formal tests for statistically significant differences between groups are detailed in the logistic regression results (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e)\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eEthnic/nativity disparities on service needs, referrals, and receipts\u003c/h2\u003e \u003cp\u003eThe logistic regression analysis presented in Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e and \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e investigates the patterns of service needs, referrals, and receipts by ethnicity and nativity.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eCaregiver\u0026rsquo;s needs, referrals, and receipts of services\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows the results of the regression model regarding caregivers\u0026rsquo; service needs, referrals, and receipts across ethnic/nativity groups. Among all reported caregivers, U.S.-born Latino caregivers were less likely than their White counterparts to report needing serious health issues (OR\u0026thinsp;=\u0026thinsp;0.37, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Foreign-born Latino caregivers demonstrated a higher need for domestic violence (OR\u0026thinsp;=\u0026thinsp;1.80, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), but a lower likelihood of reporting needs for substance misuse (OR\u0026thinsp;=\u0026thinsp;0.26, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) and mental health problems (OR\u0026thinsp;=\u0026thinsp;0.56, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) services.\u003c/p\u003e \u003cp\u003eThere are not many significant differences in referrals across ethnic/nativity groups for any specific service. Among caregivers with service needs, U.S.-born Latino caregivers were more likely to be referred for serious health problems (OR\u0026thinsp;=\u0026thinsp;6.39, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) than White caregivers. In terms of service receipt, among caregivers referred to services, US-born Latino caregivers more often received mental health services (OR\u0026thinsp;=\u0026thinsp;4.19, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05) than White caregivers.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCaregiver\u0026rsquo;s Needs, Referrals, and Receipts of the Services across Racial/Ethnic/Nativity Groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"10\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eRef. White\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e \u003cp\u003eOdds Ratio (OR)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService Need Models\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNeed vs. no need among all caregivers (N\u0026thinsp;=\u0026thinsp;5,872)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHousing Services\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eEmployment\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eDomestic Violence\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eLegal Aid\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eSubstance misuse\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMental Health Prob\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSerious Health\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eIncome Assistance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003eMedi-caid\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.60**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.14\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU.S.- born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.37**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.87*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign - born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.61*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.80**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.26**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.56**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.37*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.35*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.30*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.36*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.20*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.23*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.27*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.31*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.34*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService Referral Models\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eReferral vs. no referral among caregivers with any service needs (N\u0026thinsp;=\u0026thinsp;3,214)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.93*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.79*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU.S.- born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.39**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign - born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.86*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.71*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e2.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService Receipt Model\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"9\" nameend=\"c10\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eReceipt vs no receipt among caregivers with any service referrals (N\u0026thinsp;=\u0026thinsp;2,408)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU.S.- born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4.19**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.38\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign - born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.23*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e0.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.14*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"10\"\u003eNote: All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latino (e.g., Asian American, Native American, Pacific Islander, multiracial). Demographic and case variables were controlled, but not shown. *\u003cem\u003ep\u003c/em\u003e \u0026lt; .05. **\u003cem\u003ep\u003c/em\u003e \u0026lt; .01.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec20\" class=\"Section2\"\u003e \u003ch2\u003eChildren\u0026rsquo;s needs, referrals, and receipts of services\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e shows that among all reported children, those with Foreign-born Latino caregivers were less likely to need some of the services compared to White children, including special education services (OR\u0026thinsp;=\u0026thinsp;0.29, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), health (OR\u0026thinsp;=\u0026thinsp;0.30, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05), and routine checkups (OR\u0026thinsp;=\u0026thinsp;0.40, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05). Regarding service receipts, among children referred to services, those with Foreign-born Latino caregivers were less likely to receive many of the services compared to White children, including learning and developmental problems (OR\u0026thinsp;=\u0026thinsp;0.23, p\u0026thinsp;\u0026lt;\u0026thinsp;0.5), and emotional, behavioral, or attention (OR\u0026thinsp;=\u0026thinsp;0.09, p\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eChildren\u0026rsquo;s Needs, Referrals, and Receipts of the Services across Racial/Ethnic/Nativity Groups.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eRef. White\u003c/em\u003e\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"8\" nameend=\"c9\" namest=\"c2\"\u003e \u003cp\u003eOdds Ratio (OR)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService Need Models\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c9\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eNeed vs. no need among all children (N\u0026thinsp;=\u0026thinsp;5,872)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLearning/Dev. Problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSpecial Education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eEmo./Beh./Att\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eHealth Problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eRoutine Checkups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eDental Care\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eHearing Problem\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003eVision Problem\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.56**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.63*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.02\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU.S.- born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign - born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.54*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.29**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.52*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.30**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.40**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.62*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.56*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.31*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.21*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.23*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.39*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.17*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.28*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0.41*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.46*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService Referral Models\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c9\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eReferral vs. no referral among children with service needs (N\u0026thinsp;=\u0026thinsp;3,341)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.35**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.98*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.78**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU.S.- born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.75*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.00*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.58*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e2.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.00\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign - born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.55*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.94*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cb\u003eService Receipt Model\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"8\" nameend=\"c9\" namest=\"c2\"\u003e \u003cp\u003e\u003cb\u003eReceipt vs no receipt among children with service referrals (N\u0026thinsp;=\u0026thinsp;2,478)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.14**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5.38**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.10\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU.S.- born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.92\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eForeign - born Latine\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.23*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eNR\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.09**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0.01**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e0.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.91\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.23*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e1.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003eNote. Dev. = Developmental. Emo./Beh./Att. = Emotional/Behavioral/Attention. NR\u0026thinsp;=\u0026thinsp;Not Reliable. Ref\u0026thinsp;=\u0026thinsp;reference. All percentages are weighted to represent the US population reported to and investigated by CPS. The 'Other' group includes caregivers/children not identifying as White, Black, or Latino (e.g., Asian American, Native American, Pacific Islander, multiracial). Demographic and case variables were controlled, but not shown. *\u003cem\u003ep\u003c/em\u003e \u0026lt; .05. **\u003cem\u003ep\u003c/em\u003e \u0026lt; .01.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eSignificant differences were observed in service needs, but limited distinctions were found in referrals and receipts across ethnic and nativity groups. Foreign-born Latino families generally had lower service needs compared to White families. Additionally, Latino families, regardless of nativity, showed no significant statistical differences in service referrals and receipts in most cases when compared to their White counterparts.\u003c/p\u003e \u003cdiv id=\"Sec22\" class=\"Section2\"\u003e \u003ch2\u003eService Needs\u003c/h2\u003e \u003cp\u003eWe found White families exhibited higher service needs than Latino families, especially foreign-born Latino families, except in the area of domestic violence services. This aligns with previous research that caregivers from foreign-born Latino families are less often reported for issues like drug misuse, cognitive disabilities, poor parenting skills, and previous arrests compared to their U.S.-born counterparts (Dettlaff et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2009b\u003c/span\u003e). Moreover, LaBrenz and colleagues (\u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) found that White caregivers have more risk factors (indicating higher needs) than Latino families when entering foster care. For example, only 19.3% of Latino families in the study had reported parental substance misuse, compared with 39.6% of white families; similarly, 12.8% of white families experienced inadequate housing that contributed to the child\u0026rsquo;s foster care entry, compared with only 7.0% of Latino families.\u003c/p\u003e \u003cp\u003eHowever, we noticed that foreign-born caregivers were particularly more likely to have needs related to domestic violence. While existing studies showed a huge range of intimate partner violence (IPV) among Hispanic women from 9% to 80% (Cavanaugh et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2014\u003c/span\u003e; Cho, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2012\u003c/span\u003e), it is concerning that a recent study indicates that Latino immigrant women might report lower rates of IPV, potentially due to fear of deportation, language barriers, and limited access to resources (Garza et al., 2024). More studies are needed to understand the unique challenges faced by foreign-born caregivers regarding intimate partner violence and to develop culturally sensitive interventions.\u003c/p\u003e \u003cp\u003eOur findings reveal a concerning 'Domestic Violence Paradox' among foreign-born caregivers. While these caregivers exhibit the protective effects of the immigrant paradox in areas like substance use and mental health, they are nearly twice as likely to have domestic violence needs compared to their White counterparts (\u003cspan\u003e$\u003c/span\u003eOR\u0026thinsp;=\u0026thinsp;1.80\u003cspan\u003e$\u003c/span\u003e). This suggests that while traditional clinical risk factors may be lower, the unique stressors of the immigration experience\u0026mdash;such as cultural isolation and the absence of support networks\u0026mdash;may manifest more acutely as interpersonal conflict. This is particularly alarming given that Latino immigrant women may underreport IPV due to fear of deportation, implying that the actual need for domestic violence services may be even higher than the caseworker-reported data suggests.\u003c/p\u003e \u003cp\u003eMoreover, children from foreign-born backgrounds were generally less likely to exhibit service needs for most of the services, including learning and developmental problems, special education, behavioral problems, health problems, and routine checkups. This may be due to the immigrant paradox, where foreign-born parents and children tend to have better health, mental health, and behavioral health outcomes than their U.S.-born counterparts. Despite socioeconomic disadvantages and healthcare barriers, Hispanic and Latino populations in the U.S. often show resilience due to strong family bonds, support networks, and coping mechanisms (Marks et al., \u003cspan citationid=\"CR53\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). This resilience could explain the lower utilization of behavioral health services among these groups, and a substantial body of research supports the protective effects of being born outside the U.S. on various outcomes such as mental health (Zhang et al., \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), maltreatment risk (Zhang et al., \u003cspan citationid=\"CR74\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), cognitive growth (Fuller et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2009\u003c/span\u003e), and physical health (Oh et al., \u003cspan citationid=\"CR56\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cdiv id=\"Sec23\" class=\"Section3\"\u003e \u003ch2\u003eService Referrals\u003c/h2\u003e \u003cp\u003eThere were minimal differences observed between White and Latino caregivers in terms of service referrals. Our findings for caregivers align with previous research (Finno-Velasquez, 2013; Lovato-Hermann et al., \u003cspan citationid=\"CR51\" class=\"CitationRef\"\u003e2017\u003c/span\u003e), indicating no observed racial/ethnic differences in requests for psychosocial services, basic needs, and well-being services among caregivers involved in CPS.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec24\" class=\"Section2\"\u003e \u003ch2\u003eService Receipts\u003c/h2\u003e \u003cp\u003eWe also found minimal differences between White and Latino caregivers regarding service receipts. Previous studies have mixed findings, with some suggesting Latino families receive fewer and less effective services than White families (Cheng \u0026amp; Lo, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2012\u003c/span\u003e; Courtney, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2000\u003c/span\u003e; Courtney et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e1996\u003c/span\u003e; LaBrenz et al., \u003cspan citationid=\"CR49\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Limited statistical power due to the moderate sample size for national weighting may mask the statistical significance of moderate differences. The diversity within the Latino population complicates identifying uniform service patterns, and additional challenges such as acculturation stress, eligibility issues, linguistic differences, discrimination, violence exposure, and economic hardships add complexity (Bowe, 2017; Crimmins et al., 2007; Derr, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2015\u003c/span\u003e; Salas-Wright et al., 2016).\u003c/p\u003e \u003cp\u003eChildren of foreign-born Latino caregivers were less likely to receive services for emotional, behavioral, or attention problems than their White counterparts. This finding aligns with previous studies that Latino families tend to underutilize mental health services, compared to their non-Latino counterparts (Alegria et al., 2004; Gudi\u0026ntilde;o et al., \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e2009\u003c/span\u003e), and a recent systematic review identified the barriers to accessing services for their child\u0026rsquo;s mental health problems, including cultural stigma, problem recognition and identification, and fears about seeking therapy (Santana et al., \u003cspan citationid=\"CR60\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). For example, cultural stigma regarding mental health often causes hesitation in seeking help among Latino families, as mental health issues are perceived as personal or familial failings.\u003c/p\u003e \u003cp\u003eAdditionally, children of foreign-born Latino caregivers were notably less likely to receive services for health problems compared to their White peers. This disparity may stem from economic challenges and limited access to health care resulting from a lack of insurance (Putnam-Hornstein et al., \u003cspan citationid=\"CR57\" class=\"CitationRef\"\u003e2013\u003c/span\u003e; Shiro \u0026amp; Reeves, \u003cspan citationid=\"CR62\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). These obstacles can impede Latino families' ability to access essential support, emphasizing the need for targeted interventions to ensure equitable access to health services for Latino children.\u003c/p\u003e \u003cp\u003eWhile our findings suggest potential general tendencies of lower service receipt rates among Latino children compared to White children, the lack of statistical significance warrants cautious interpretation and underscores the need for further research. Variations in these outcomes may be influenced by cultural interpretations of behaviors, access to culturally competent services, and recent changes in immigration policies, highlighting the need for larger datasets to investigate these disparities more thoroughly.\u003c/p\u003e \u003cdiv id=\"Sec25\" class=\"Section3\"\u003e \u003ch2\u003eLimitations and Strengths\u003c/h2\u003e \u003cp\u003eOne strength of this study is its comprehensive approach, addressing service needs, referrals, and receipt disparities across ethnic and nativity groups involved in CPS. This distinguishes our research as one of the few studies to provide a holistic view of the complexities involved in the service dynamics across these critical demographic factors. Furthermore, our research builds upon prior studies, offering fresh insights into the immigration status of Latino families in accessing a variety of services, thereby contributing to the evolving body of knowledge in this domain.\u003c/p\u003e \u003cp\u003eWhile the NSCAW II data were collected between 2008 and 2009, this timeframe represents a critical historical baseline for the U.S. child welfare system. Establishing this foundation is essential for understanding the trajectory of service delivery prior to the significant shifts in immigration policy and social climate observed during the 2010s and specifically the 2016\u0026ndash;2020 era. By documenting these pre-existing disparities, this study provides the necessary longitudinal context to evaluate whether subsequent policy changes or shifting social attitudes have exacerbated or mitigated service gaps for Latino families.\u003c/p\u003e \u003cp\u003eFirst, we recognize that the NSCAW II data were collected from 2008 to 2009, which may be somewhat outdated. Despite the limited data on the Hispanic population, this is essential to serve as a valuable baseline for future research. Additionally, the weighting used to generate nationally representative estimates, combined with the moderate sample size, constrained the statistical power of our findings. The lack of detailed information regarding specific reasons for service referrals or denials also limited our ability to conduct a more granular analysis. While NSCAW II provides longitudinal data, the caseworker interviews on service provision were confined to Wave I, which only covered the 12 months prior to the interview. This restricted the study's ability to explore temporal changes, and the absence of data on evolving policies or shifting social attitudes introduced further complexity. Although culturally sensitive factors were acknowledged, they may not have been fully captured, leaving room for additional exploration. In conclusion, these strengths and limitations underscore areas for future research, emphasizing the need for a more nuanced and culturally sensitive approach to addressing service disparities in the child welfare system.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec26\" class=\"Section3\"\u003e \u003ch2\u003eImplications\u003c/h2\u003e \u003cp\u003eOur research highlights the need for targeted policies to address disparities in most of the services for Latino families, especially foreign-born Latino caregivers and children. Policymakers should allocate resources based on specific needs, strategically distributing them to areas with significant disparities. Collaboration among child welfare agencies, community organizations, and stakeholders is essential for successful policy implementation and to foster partnerships for comprehensive solutions. For example, sustainable housing has been identified as crucial for preserving and reunifying families (Bai et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2023\u003c/span\u003e; Fowler et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2020\u003c/span\u003e), yet some subsidies may be limited to U.S. citizens or permanent residents.\u003c/p\u003e \u003cp\u003eIn addition, within the child welfare system, clinicians must adopt a culturally responsive approach, particularly when serving Latino families. This could include meaningful engagement of parents and an openness to learning about cultural beliefs/norms among each family they work with (Leake et al., \u003cspan citationid=\"CR50\" class=\"CitationRef\"\u003e2010\u003c/span\u003e). Further, providers could consider how nativity may impact service accessibility and provision, and adapt plans accordingly. Efforts to address disparities in service receipts, especially for Latino children, should be prioritized at the clinical level, implementing targeted interventions to overcome potential barriers.\u003c/p\u003e \u003cp\u003eContinued research is vital for monitoring trends and identifying evolving needs in the child welfare system. Further exploration into the reasons for the lack of referrals or service receipts is necessary, requiring in-depth analyses considering limited sample sizes. Research efforts should focus on understanding the association between service needs, referrals, and receipts, including rereport, for specific subpopulations. Large datasets and robust statistical analyses are essential to draw definitive conclusions and inform targeted interventions.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, our study illuminates significant disparities in service needs, referrals, and receipts within the child welfare system across ethnic and nativity groups. It underscores the need for targeted policies ensuring equitable resource allocation. Culturally competent approaches by clinicians, tailored interventions for nuanced differences, and prioritized efforts to address service receipt disparities are crucial. Continued research is essential for monitoring trends and understanding dynamics, contributing to targeted interventions, and advancing the understanding of service dynamics within the child welfare system.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e(Funding Declaration: The authors received no financial support for the research, authorship, or publication of this article.)\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eDr. Chien-jen Chiang wrote the main manuscript text and Dr. Hyunil Kim helped with the data analysis. Dr. Miyoun Yang and Junghon Chen edited and reviewed the manuscript.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThe data used in this study were obtained from the National Data Archive on Child Abuse and Neglect (NDACAN). These data are available to the research community through a formal application process and licensing agreement to ensure respondent confidentiality. 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Available from https://www.acf.hhs.gov/cb/data-research/child-maltreatment.\u003c/li\u003e\n\u003cli\u003eVelazquez, S. C., \u0026amp; Dettlaff, A. J. (2011). Immigrant children and child welfare in the United States: Demographics, legislation, research, policy, and practice impacting public services. Child Indicators Research 4(4). https://doi.org/10.1007/s12187-011-9111-9 \u003c/li\u003e\n\u003cli\u003eZhang, L., Bo, A., \u0026amp; Lu, W. (2021). To unfold the immigrant paradox: Maltreatment risk and mental health of racial-ethnic minority children. \u003cem\u003eFrontiers in Public Health, 9\u003c/em\u003e. https://doi.org/10.3389/fpubh.2021.619164\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-8733549/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8733549/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"The growing presence of Latino families in the U.S. child welfare system raises significant concerns regarding service adequacy. Utilizing data from the National Survey on Child and Adolescent Well-being II (NSCAW II), this study investigates disparities in service needs, referrals, and receipts by ethnicity and nativity. While these data serve as a critical historical baseline for understanding the system prior to the major immigration policy shifts of the 2016–2020 era, our analysis reveals nuanced disparities. Compared to White families, foreign-born Latino families generally showed significantly lower service needs, supporting the \"immigrant paradox\". However, we identify a concerning \"Domestic Violence Paradox\": foreign-born Latino caregivers demonstrate significantly higher needs for domestic violence services (OR = 1.80, p \u003c 0.05) yet experience lower service receipts for children’s behavioral and health problems. These findings underscore the need for targeted, culturally responsive interventions that address specific safety gaps while leveraging the resilience of immigrant families to ensure equitable support across the child welfare continuum.\n(Funding Declaration: The authors received no financial support for the research, authorship, or publication of this article.)\nNavigating Service Needs, Referrals, and Receipts for\nLatino Families in Child Protective Services","manuscriptTitle":"Navigating Service Needs, Referrals, and Receipts for","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-13 11:59:17","doi":"10.21203/rs.3.rs-8733549/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c7c7794f-7294-47cc-a1e4-e7f8c2b73443","owner":[],"postedDate":"February 13th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-02-14T06:24:23+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-13 11:59:17","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8733549","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8733549","identity":"rs-8733549","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}