The neighborhood deprivation gradient and child physical abuse and neglect: A Bayesian spatial model

Abstract

BackgroundChild abuse and neglect is a public health priority due to its long-term maladaptive consequences. No study in the USA has assessed the nature and magnitude of the social deprivation effect on substantiated child maltreatment risk. ObjectivesTo examine linear and non-linear relationships between area level deprivation and the log-risk of both substantiated physical abuse and neglect while accounting for spatial and heterogeneous random effects. MethodsSubstantiated child maltreatment and population data (2008–2015) were aggregated to neighborhoods in Bernalillo County, New Mexico. The contribution of area level deprivation to the geographical variation in the log-risks of substantiated child physical abuse and neglect was modeled using Bayesian spatial regression. ResultsForty-three percent and 46.4 % of the 153 neighborhoods recorded greater risk for either substantiated physical abuse or neglect compared to the county average. The most deprived 20 % of neighborhoods had 71 % and 72 % more cases of substantiated physical abuse and neglect, respectively, than would be expected if the substantiations were randomly distributed throughout the county. Area level deprivation explained 47 % of the variation in substantiated physical abuse and 51 % of the variation in substantiated neglect after controlling for both spatial autocorrelation and heterogeneity. ConclusionsImplications from this study can be used to quantify disparities in substantiated child maltreatment attributed to regional differences in social deprivation and to identify priority areas for intervention.