Racial/ethnic differences in Medicaid expenditures on psychotropic medications among maltreated children

Ramesh Raghavan, Derek S. Brown, Benjamin T. Allaire, Lauren D. Garfield, Raven E. Ross, Lonnie R. Snowden

Research output: Contribution to journalArticlepeer-review


This study quantifies racial/ethnic differences in Medicaid expenditures on psychotropic drugs among a national sample of children with suspected maltreatment. We linked 4,445 child participants in the National Survey of Child and Adolescent Well-Being (NSCAW) - consisting of children investigated for suspected abuse and neglect - to their Medicaid claims obtained from 36 states. We used propensity score matching to construct a comparison group of children without known child welfare involvement, and estimated two-part generalized linear models to examine differences in annual psychotropic drug expenditures per child between children of different races/ethnicities. When compared to a matched sample of children, African American and Latino children incur $292 and $144 less expenditures on psychotropic drugs, respectively, than white children. Among NSCAW children alone, African American children display $614 less spending on psychotropic drugs when compared to white children. Racial/ethnic differences in expenditures on psychotropic drugs occur among all children on Medicaid, but the differences are especially pronounced among African American children in contact with the child welfare system. These findings demonstrate that policymakers will need to pay special attention to the needs of children of color as Medicaid expansions proceed nationwide.

Original languageEnglish (US)
Pages (from-to)1002-1010
Number of pages9
JournalChild Abuse and Neglect
Issue number6
StatePublished - Jun 2014


  • Disparities
  • Ethnicity
  • Expenditures
  • Medicaid
  • Psychotropic drugs
  • Race

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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