Abstract
Background‘Place’ matters in understanding prevalence variations and inequalities in child maltreatment risk. However, most studies examining ecological variations in child maltreatment risk fail to take into account the implications of the spatial and temporal dimensions of neighborhoods. In this study, we conduct a high-resolution small-area study to analyze the influence of neighborhood characteristics on the spatio-temporal epidemiology of child maltreatment risk.MethodsWe conducted a 12-year (2004–2015) small-area Bayesian spatio-temporal epidemiological study with all families with child maltreatment protection measures in the city of Valencia, Spain. As neighborhood units, we used 552 census block groups. Cases were geocoded using the family address. Neighborhood-level characteristics analyzed included three indicators of neighborhood disadvantage—neighborhood economic status, neighborhood education level, and levels of policing activity—, immigrant concentration, and residential instability. Bayesian spatio-temporal modelling and disease mapping methods were used to provide area-specific risk estimations.ResultsResults from a spatio-temporal autoregressive model showed that neighborhoods with low levels of economic and educational status, with high levels of policing activity, and high immigrant concentration had higher levels of substantiated child maltreatment risk. Disease mapping methods were used to analyze areas of excess risk. Results showed chronic spatial patterns of high child maltreatment risk during the years analyzed, as well as stability over time in areas of low risk. Areas with increased or decreased child maltreatment risk over the years were also observed.ConclusionsA spatio-temporal epidemiological approach to study the geographical patterns, trends over time, and the contextual determinants of child maltreatment risk can provide a useful method to inform policy and action. This method can offer a more accurate description of the problem, and help to inform more localized prevention and intervention strategies. This new approach can also contribute to an improved epidemiological surveillance system to detect ecological variations in risk, and to assess the effectiveness of the initiatives to reduce this risk.
Highlights
Child maltreatment is a major social, public health, and human rights problem, with severe, far-reaching, and long-lasting consequences
These results indicate that the risk of substantiated child maltreatment was high in neighborhoods with low economic status and education level, and with high levels of policing activity and immigrant concentration
This study showed that the neighborhoods where the families live matter in understanding spatial and temporal variations in child maltreatment risk [8,9,10,11,12]
Summary
Child maltreatment is a major social, public health, and human rights problem, with severe, far-reaching, and long-lasting consequences. From a public health perspective, child maltreatment is, a preventable problem as potentially risk-modifying factors can be identified and targeted in preventive interventions. A growing body of research is increasingly recognizing the importance of the context in which families live, linking neighborhood characteristics and processes—such as poverty, disorder and crime, immigrant concentration, social impoverishment, or diminished social control—to child maltreatment [13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32].
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