This longitudinal cohort case study was conducted in Allegheny County (Pittsburgh), Pa., between October 1986 and August 1989. Allegheny County Children and Youth Service (CYS), the designated child protection agency, identified families for the study who had been referred for child neglect, excluding those cases in which physical or sexual abuse was the primary reason for referral. In the CYS definition, neglect included serious physical neglect, general neglect, deficient supervision, and medical neglect. Case file data were collected by using an instrument that addressed the nature of the referral, demographic data on family members, previous CYS service, risk of child placement, presenting problems, and case status following investigation. Interviews with family caregivers were conducted in the homes of the caregivers. In addition to confirming the impoverishment and ghettoization of African-American families, this study also replicated previous findings about the family history and structure of African-American families. Three times more African-American than Caucasian caregivers reported having been raised on welfare, and twice as many were raised in single- parent households. Despite the severe economic, housing, and health problems that beset them, African-American caregivers in this study have been able to mobilize "internal resources" and minimize their adverse effects on child-rearing. Resilient psychological health is suggested by the finding that African- American caregivers were not more likely than Caucasians to experience psychological distress. Meeting the needs of families referred for child neglect requires income support and employment programs; housing; neighborhood safety and revitalization; health care; and family planning, family support, and family-based service programs that are culturally sensitive. Only by resolving problems of racism, discrimination, and socioeconomic inequality can health and social service systems provide appropriate and adequate assistance with difficult child-rearing problems to all persons in need, regardless of color. 2 tables and 37 references