A new study reveals that Michigan State University’s Rx Kids, the nation’s first community-wide prenatal and infant cash prescription program, is associated with a significant reduction in child maltreatment allegations among infants in Flint, Michigan.
Rx Kids provides every pregnant woman with $1,500 during mid-pregnancy and $500 per month throughout the baby’s first 6–12 months of life. Originally launched in Flint, Michigan in 2024, Rx Kids has expanded across the state to reach more than 4,100 families with more than $17 million in direct cash support. With near universal participation, the program has already demonstrated measurable impacts on family financial security, prenatal care, maternal mental health and wellbeing, infant health, civic engagement, and local economic revitalization. Now, new evidence reveals a significant impact on child welfare system involvement.
In the latest study, a multidisciplinary research team from the University of Michigan, Michigan State University and University of Illinois found the following impacts related to the launch of Rx Kids in Flint in 2024:
- Prior to the launch of Rx Kids, 21.7% of infants born in Flint experienced an investigation into child maltreatment; this decreased to 15.5% in 2024 after the launch of Rx Kids.
- During this same time period, there was an increase in allegations in 21 similar comparison cities.
- Rx Kids thus led to a 32% reduction in allegations of maltreatment among infants in Flint after implementation of Rx Kids compared to a group of control cities.
- This reflects a statistically significant decrease in the maltreatment allegation rate by 7.0 percentage points.
- At a population level, Flint’s infant maltreatment rate decreased from 21.7% to 15.5% as compared to 10.0% for the state of Michigan. This narrowed Flint’s disparity in infant maltreatment allegations among infants compared to the state by 50%.
- Consistent with other studies, Flint saw declines across all types of allegations, and these reductions represent an unprecedented population-level impact.
This research used rigorous, population-level methods designed to measure the real-world impact of policies like Rx Kids. Using a quasi-experimental design—specifically a Synthetic Difference-in-Difference model—the study applied the approach best suited for this type of population-wide data. This methodology is the strongest tool available for isolating the program’s effects and determining whether the changes observed are statistically meaningful.
“Our research involved population-level data that compared what happened in Flint before and after Rx Kids compared to a control group of over 20 similar cities,” said lead author Dr. Sumit Agarwal, physician, health economist and Poverty Solutions affiliate at the University of Michigan.
Sumit added: “In consultation with leading experts in the field, our study used highly rigorous and state-of-the-art methods along with multiple robustness checks, and the results are undeniable: the first year of Rx Kids led to statistically significant reductions in allegations of maltreatment among infants born in Flint in 2024.”
Poverty heightens the risk of child maltreatment by creating material hardship, family stress and instability. Rx Kids tackles these root causes by providing unconditional cash support during pregnancy and infancy, which is the period of greatest vulnerability for economic instability and child welfare involvement, when maltreatment rates are two to four times higher than among older children.
“These findings show that when we entrust families early with an economic cushion, we can keep babies safe,” said Dr. Mona Hanna, pediatrician, Rx Kids sirector and associate dean of Public Health at Michigan State University.
Hanna added: “By reducing maltreatment allegations, Rx Kids is demonstrating that direct cash support during pregnancy and infancy isn’t just a financial lifeline; it’s a powerful public health intervention that protects our youngest children. Preventing CPS involvement not only has profound implications for the health and welfare of children and families, but it also has the potential to save millions of taxpayer dollars and reduce dependency on government systems.”
As a child welfare researcher, this study aligns with decades of evidence showing that poverty is a key driver of child maltreatment risk,” said Will Schnieder, associate professor of Social Work and Faculty Director of the Children and Family Research Center at the University of Illinois.
Schnieder added: “It adds to the growing body of research demonstrating that simple, prevention‑driven interventions—like unconditional cash support during pregnancy and infancy—can reduce family stress, strengthen protective factors, and ultimately prevent children from entering the child welfare system.”
Rx Kids is demonstrating how unconditional cash support can reduce involvement in the child welfare system through multiple, overlapping pathways. By addressing poverty-related stressors, Rx Kids has been shown to lower rates of food insecurity, housing instability, and financial hardship, including nearly eliminating postpartum evictions among eligible mothers. The program has also improved maternal mental health and reduced parenting stress. In addition, Rx Kids has increased healthy behaviors such as increased prenatal care visits and decreased third trimester smoking with healthier birth outcomes at a population level, including reduced rates of premature and low birthweight births. Together, these findings highlight how Rx Kids strengthens family stability, improves maternal and infant health, and creates safer, healthier environments for infants during their most vulnerable stage of development.
View the full research paper and register for the webinar with the research team to discuss these findings.
Figure: Maltreatment Allegations Within the First Six Months of Life for Infants in Flint, Control Cities, and State of Michigan
Note: The vertical dashed line differentiates the pre-intervention period (2021-2023) from the post-intervention period (2024).
About Rx Kids
Rx Kids is a program run by Michigan State University-Hurley Children’s Hospital Pediatric Public Health Initiative in collaboration with the University of Michigan’s Poverty Solutions and administered by GiveDirectly. Rx Kids is a public-private partnership made possible with generous support from the State of Michigan and a growing family of funders and supporters.
More potent than any prescribed pill, Rx Kids aims to improve health, hope and opportunity. Science demonstrates the lifelong consequences of early adversity but also the promise of science-based, community-driven solutions. For many families, income plunges and poverty spikes right before a child is born and remains high throughout the first year. Built on the tremendous success of the expanded Child Tax Credit, which cut child poverty to its lowest level in recorded history, and in line with global evidence, Rx Kids boldly reimagines how we care for each other by walking alongside families during the challenging time of pregnancy and infancy.
