New peer-reviewed research published in JAMA Pediatrics provides rigorous population-level evidence that Michigan State University’s Rx Kids program, the nation’s first community-wide prenatal and infant cash prescription program, is associated with significant reductions in child maltreatment investigations in infants.
Since Rx Kids was launched in January 2024, abuse investigations of Flint infants under six months of age have decreased from 21.7% to 15.5%. During the same period, 21 comparable cities also saw an increase in claims. Thanks to Rx Kids, abuse investigations in Flint decreased by 7 percentage points, or a relative decrease of 32%.
Our study compares what happened in Flint before and after the launch of Rx Kids with what we observed in a control group, and the results are clear. During Rx Kids’ first year, Flint’s toddlers were rarely investigated for abuse. These results show that providing financial support to families early on can make a big difference, and should prompt us to rethink how we proactively support families. ”
Dr. Sumit Agarwal, lead author, physician, health economist, and assistant professor at the U-M School of Medicine and School of Public Health, University of Michigan
Agarwal is an affiliate of Poverty Solutions and a member of the UM Institute for Health Policy Innovation.
The authors of this study, along with research collaborators at three institutions, observed consistent declines across multiple categories of child welfare involvement, including neglect-related and non-neglect-related investigations and substantiated cases. Researchers estimate that the program saved about 57 infants from child welfare investigations in the first year alone. This shows how financial support during pregnancy and early infancy can improve child welfare.
These results may be explained by several routes. Previous research on Rx Kids has demonstrated reduced food and housing hardship and significant reductions in postpartum evictions. These changes are closely associated with reduced parental stress and improved maternal mental health, which are important factors known to influence children’s safety and well-being.
Additionally, the program is associated with improved birth outcomes, including fewer low birth weight and premature births, which are risk factors for later maltreatment.
“The results of these studies are now JAMA Pediatrics“This highlights the powerful role that financial security plays in protecting children. By trusting and investing in families during the earliest and most vulnerable years of life, we not only improve health outcomes, but we also improve the health outcomes of our families,” said Dr. Mona Hanna, Director of Rx Kids and Associate Dean of Public Health at Michigan State University. We prevent trauma before it begins. This is what community-led public health looks like. ”
Many families face significant financial hardship during pregnancy and infancy as mothers quit their jobs and expenses increase for medical bills and basic baby supplies. Reducing this financial burden can play an important role in proactively preventing damage.
“As a child welfare researcher, decades of evidence show that poverty is one of the strongest factors in child maltreatment risk,” said Will Schnieder, associate professor of social work and director of the Center for Child and Family Research at the University of Illinois. “The Rx Kids findings reveal the flip side of that truth: When families are cushioned during economic shocks during pregnancy and early infancy, fewer children are harmed. This is what real prevention looks like.”
Rx Kids, a maternal and child health program, provides cash prescriptions for $1,500 each during the second trimester and $500 per month during infancy. This support can help cover essentials such as diapers, formula, rent, and transportation to prenatal care. This program has demonstrated improved household financial stability, healthier mothers and babies, and meaningful economic benefits, with millions of dollars flowing directly to local businesses and communities. Rx Kids is led by Michigan State University and managed by GiveDirectly through a public-private partnership with support from the State of Michigan and a growing family of funders.
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Michigan Medicine – University of Michigan
Reference magazines:
Agarwal, S. others. (2026) An investigation of cash transfers and infant abuse in the perinatal period. JAMA Pediatrics. DOI: 10.1001/jamapediatrics.2026.1602. https://jamanetwork.com/journals/jamapediatrics/fullarticle/2848787
