Maltreatment Report Rates Research Articles

Substance Use-Associated Infant Maltreatment Report Rates in the Context of Complex Prenatal Substance Use Policy Environments.

State responses to substance use during pregnancy have included policies designed to increase access to substance use treatment as well as punish such substance use. Prior research has found that punitive policies are associated with increased rates of child maltreatment reporting, but it is unclear if the presence of punitive-promoting policies also moderate the association between access-promoting polices and maltreatment reports. Using data from the National Child Abuse and Neglect Data System and state-level fixed effects models, this study investigates how interactions between access-promoting and punitive prenatal substance use policies are associated with rates of substance use-associated maltreatment reports among infants. In states with punitive policies, access-promoting policies were associated with smaller decreases in these reports than in states without punitive policies. In some cases, access-promoting policies were associated with greater increases in these reports when punitive policies were also present than when only one type of policy was adopted. Interactions between prenatal substance use policies may result in unintended and counterproductive consequences for maternal and child health and the child welfare system.

Policies to reduce child poverty and child maltreatment: A scoping review and preliminary estimates of indirect effects

This study includes a scoping review of prior studies investigating the effects of policy changes on child poverty rates. It further conducts an empirical analysis to estimate the relationship between child poverty rates and child maltreatment report (CMR) rates, utilizing national county-level data. The study then calculates the indirect effects of policy changes on CMR rates, mediated through child poverty rates, by integrating information from previous studies with its own empirical findings. Among the policy changes explored in prior studies, those related to a child allowance and a fully refundable Child Tax Credit demonstrate the largest indirect effects but also the highest costs. The expansion of in-kinds and near-cash benefits, such as the Supplemental Nutrition Assistance Program benefits and housing vouchers, shows moderate effects with moderate costs. Tax credits like the Earned Income Tax Credit exhibit lower effects and costs when targeted at the lowest earners, and moderate effects and costs for broader expansion. Focused tax credits, such as the Child and Dependent Care Tax Credit, had lower effects and costs, even if made fully refundable. Despite certain limitations, the study's approach yields consistent estimates with a recent simulation study, indicating its potential validity. While some proposed policy changes may seem expensive, implementing them is anticipated to substantially reduce CMR rates, with the benefits outweighing the associated costs. Overall, the findings suggest that addressing child poverty to reduce CMRs is an attractive strategy with numerous potential benefits.

Has the relationship between community poverty and child maltreatment report rates become stronger or weaker over time?

BackgroundPoverty is among the most powerful predictors of child maltreatment risk and reporting. To date, however, there have been no studies assessing the stability of this relationship over time. ObjectiveTo examine whether the county-level relationship between child poverty rates and child maltreatment report (CMR) rates changed over time in the United States in 2009–2018, overall and across of child age, sex, race/ethnicity, and maltreatment type. Participants and settingU.S. Counties in 2009–2018. MethodsLinear multilevel models estimated this relationship and its longitudinal change, while controlling for potential confounding variables. ResultsWe found that the county-level relationship between child poverty rates and CMR rates had intensified almost linearly from 2009 to 2018. Per one-percentage-point increase in child poverty rates, CMR rates significantly increased by 1.26 per 1000 children in 2009 and by 1.74 per 1000 children in 2018, indicating an almost 40 % increase in the poverty-CMR relationship. This increasing trend was also found within all subgroups of child age and sex. This trend was found among White and Black children, but not among Latino children. This trend was strong among neglect reports, weaker among physical abuse reports, and not found among sexual abuse reports. ConclusionsOur findings highlight the continued, perhaps increasing importance of poverty as a predictor of CMR. To the degree that our findings can be replicated, they could be interpreted as supporting an increased emphasis on reducing child maltreatment incidents and reports through poverty amelioration efforts and the provision of material family supports.

Longitudinal changes in the county-level relationship between opioid prescriptions and child maltreatment reports, United States, 2009-2018.

This article examines whether county opioid prescription rates were associated with county child maltreatment report (CMR) rates in the United States and whether this relationship changed over time. We linked multiple national data sets to assemble retail opioid prescription data, CMR data, rural-urban codes (to control for urbanicity), and census data (to control for other community characteristics, such as poverty rates) covering 2009-2018. Multilevel linear modeling analyzed the linked data. We found that the strength of the county-level relationship between opioid prescription rates and CMR rates increased almost linearly during the study period. The relationship was not significant in 2009-2011; it became significant in 2012 and grew stronger in the next 6 years. In 2012, there was one more CMR per 1,000 children in a county for every 14.3 more opioid prescriptions per 100 people. In 2018, the number of prescriptions related to this effect was 3.6. In other words, the county-level relationship between opioid prescriptions and CMRs was four times as strong in 2018 as it had been in 2012. This trend was also observed within all subgroups of child age and sex. By type, this trend was somewhat more pronounced for neglect, but somewhat less for sexual abuse. Our findings suggest a growing need for greater efforts to prevent child maltreatment in communities with high opioid prescription rates. Further research is warranted to reveal the underlying factors for this concerning trend. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

County-Level Relationships Between Foreign-Born Residents, Latinos, Immigration Enforcement, and Child Maltreatment Report Rates in the United States, 2015-2018.

U.S. Latino and foreign-born populations show lower child maltreatment report (CMR) rates despite their low socioeconomic positions, perhaps due to protective cultural factors within these populations. However, discriminatory Immigration and Customs Enforcement (ICE) activities may attenuate such protection. We examined how ethnic and foreign-born compositions and local ICE activities were associated with community CMR rates, overall and within racial/ethnic groups (i.e., White, Black, Latino), and how these associations changed over time. We used national county-level data linking multiple administrative/archival data sources (i.e., CMR, Census, and ICE data) longitudinally for 2015 to 2018 across the United States. Multilevel (county-years, counties, and states) models estimated how percentages of Latino, percentages of foreign-born, and ICE arrest rates were related to overall and race/ethnicity-specific CMR rates among counties while adjusting for a range of demographic, socioeconomic, child care burden, health insurance, residential mobility, and urbanicity factors. Higher percentages of foreign-born residents within counties were significantly associated with lower CMR rates, both overall and within all racial/ethnic groups. These protective associations became significantly stronger over the study period. Higher percentages of Latino residents were significantly associated with lower total and White CMR rates but not with Black or Latino CMR rates. The interaction between the percentage of Latino residents and year was not significant. ICE arrest rates showed no significant associations with CMR rates. Our findings suggest that communities with more foreign-born and Latino residents may be more protective against CMRs. While the foreign-born and Latino concentrations were both independently predictive of decreased CMR rates, the protective associations of the foreign-born concentration were more consistent within racial/ethnic groups and grew stronger over time. These findings suggest the need to investigate community-level protective mechanisms that may explain these results. The null findings for ICE activity also require further research with alternative measures of discriminatory state action.

Examining the roles of rurality and Latine ethnic density on child maltreatment report and substantiation rates among Latine families: A county-level analysis

ABSTRACT Evidence of geographic variation in child maltreatment report rates among Latine families is growing. This study investigates whether structural community characteristics, namely rurality and Latine ethnic density, associate with variation in Latine child maltreatment rates across 925 US counties. Using ten years of cross-sectional data from the National Child Abuse and Neglect Data System (NCANDS), ACS and USDA, OLS regression models examined rurality and Latine density’s association with child maltreatment report and substantiation rates. Rurality associated with increased maltreatment rates; however, Latine ethnic density buffered this across most maltreatment subtypes. Results highlight a complex interaction between ethnicity, rurality, and maltreatment.

Understanding the Effects of COVID-19 on Child Maltreatment Reporting Among Rural Versus Urban Communities in the United States

The onset of the coronavirus disease 2019 (COVID-19) pandemic impacted child protective services (CPS) reporting systems in the United States. It may have also led to widened gaps between rural and urban communities in child maltreatment (CM) report rates due to decreased interaction between children and mandated reporters especially in urban jurisdictions. Using data from the National Child Abuse and Neglect Data System, this study tests the hypothesis that during the onset of the COVID-19 pandemic, the decrease in CM reports made to CPS in urban counties was more pronounced than in rural counties. Reports of CM received by CPS offices between January 6, 2020 and June 28, 2020 were aggregated to per-county-per-week-per-10,000 children maltreatment report rates. We used changepoint analyses to analyze the inter- and intra-region incidence rate ratios among rural and urban counties. Moreover, we used multilevel random effects models to generate regression coefficients for the associations between rates of children with a maltreatment report, COVID-19 occurrence, rural-urban designation, and maltreatment risk factors. During the study period, rates of children with a maltreatment report among urban counties decreased more dramatically when compared with rural counties. Our findings persisted even with the inclusion of control variables associated with maltreatment risk factors. Social distancing restrictions may have had the unintended consequence of decreasing the visibility of at-risk children in urban counties more so than in rural counties. Considering geography is critical to continue to protect children during the COVID-19 pandemic and as we prepare for future disasters.

Erratum to Community Food Insecurity Predicts Child Maltreatment Report Rates across Illinois Zip Codes, 2011-2018

Erratum to Community Food Insecurity Predicts Child Maltreatment Report Rates across Illinois Zip Codes, 2011-2018

Community home visiting services and child maltreatment report rates, Illinois zip codes, 2011–2018

BackgroundResearch is sparse on the community-level impacts of home visiting programs on child maltreatment. ObjectiveTo examine community-level associations between state-funded home visiting programs (i.e., IDHS-HV), federal-funded home visiting programs (i.e., MIECHV), and child maltreatment report (CMR) rates, overall and within subgroups of age, sex, and maltreatment type. Participants and setting3824 zip code-years during 2011–2018 in Illinois for IDHS-HV/CMR associations and 1896 zip code-years during 2015–2018 for MIECHV/CMR associations. MethodsWe measured county-level IDHS-HV rates (per 1000 children aged 0–5) since data were only available at that level. MIECHV rates (per 1000 children aged 0–5), CMR rates (per 1000 children), and all controls were measured at the zip code level. We used spatial linear models to handle spatial autocorrelation. ResultsAdjusted for controls, longitudinal increases of IDHS-HV rates were significantly associated with decreased overall CMR rates (coefficient: −0.28; 95 % CI: −0.45, −0.11), age 0–5 CMR rates (−0.52; −0.82, −0.22), age 6–11 CMR rates (−0.31; −0.55, −0.06), male CMR rates (−0.25; −0.45, −0.05), female CMR rates (−0.29; −0.49, −0.08), and neglect report rates (−0.13; −0.24, −0.02). In contrast, longitudinal increases of MIECHV rates were significantly associated with increased CMR rates within several subgroups. ConclusionsOur findings suggest that increasing state-funded home visiting services in communities may have benefits in lowering their CMR rates. Given the very low MIECHV service rates and the federal policy that requires MIECHV to target at-risk communities, the significant positive MIECHV/CMR associations we found might indicate MIECHV programs are typically in higher risk communities.

Do county mental health, physical health, and care provider availability predict child maltreatment report rates?

BackgroundResearch on community-level relationships between mental/physical health and child maltreatment is sparse. ObjectiveWe examined how rates of mental distress, physical distress, mental health professionals, and primary care physicians were related to child maltreatment report rates at the county level. Participants and settingU.S. counties from 2014 to 2017. MethodsWithin-between random effects models estimated both within-effects (i.e., longitudinal changes) and between-effects (i.e., inter-county differences) of mental distress rates, physical distress rates, mental health professional rates, and primary care physician rates and their associations with overall and age-specific maltreatment report rates, while adjusting for potential confounders. ResultsLongitudinal increases of mental distress rates marginally significantly (p < .10) increased overall maltreatment report rates (β = 0.50) and significantly (p < .05) increased age 0–5 maltreatment report rates (β = 0.84). Conversely, longitudinal increases of mental health professional rates significantly decreased overall (β = −0.38), age 0–5 (β = −0.59), and age 6–11 (β = −0.31) maltreatment report rates and marginally significantly decreased age 12–17 maltreatment report rates (β = −0.13). Between-effects of metal distress rates and mental health professional rates were mostly not significant. Neither within-effects nor between-effects of physical distress rates and primary care physician rates were significant. ConclusionsOur findings suggest that community mental distress is a risk factor for child maltreatment reports and that community availability of mental health professionals is a protective factor. Community-based strategies to address mental distress and human resource approaches to supply sufficient mental health professionals in communities may help reduce maltreatment report rates in communities. Further research is required to confirm our findings and to better understand underlying mechanisms.

Community food insecurity predicts child maltreatment report rates across Illinois zip codes, 2011–2018

PurposeWe examined how longitudinal changes and inter-community differences of food insecurity rates were associated with child maltreatment report (CMR) rates at the zip code level. We assessed these associations overall, by urbanicity, and within subgroups of age, sex, and maltreatment type. MethodsWe used Illinois statewide zip code-level data from 2011 to 2018. We measured CMR rates based on Illinois child protective services records and food insecurity rates from Feeding America's Map the Meal Gap. We conducted spatial linear modeling to account for spatial dependence with controls for various socioeconomic, demographic, care burden, and instability conditions of communities. ResultsBoth longitudinal changes and inter-community differences of food insecurity rates were significantly associated with increased CMR rates overall and within all subgroups. These associations were significant among all large urban, small urban, and rural areas, while longitudinal changes of food insecurity rates had significantly stronger associations among small urban areas compared with other areas. ConclusionsCommunities experiencing higher food insecurity had higher CMR rates. Increases in food insecurity over time were associated with increases in CMR rates. These associations were reproduced within subgroups of child age, sex, maltreatment type, and urbanicity. Attention and collaborative efforts are warranted for high food insecure communities.

Community Food Insecurity and Child Maltreatment Reports: County-Level Analysis of U.S. National Data From 2009 to 2018.

Current literature suggests that food insecurity increases child maltreatment risk. Yet, existing evidence is limited to individual-level associations among low-income, high-risk populations based on local, mostly urban data. This study aims to generalize prior findings to community-level associations in general populations, using national data including all urban-rural areas. We examined, for the first time, if food insecurity rates increase child maltreatment report (CMR) rates at the county level after controlling for potential confounders. We examined both within-community longitudinal changes (i.e., within-effects) and inter-community differences (i.e., between-effects) of food insecurity rates and their associations with CMR rates. We also examined differences by age, sex, race/ethnicity, maltreatment type, and urbanicity. We constructed longitudinal county-level data by linking multiple national databases, including all substantiated and unsubstantiated CMR records, the Map the Meal Gap's community food insecurity estimates, and Census data. The data covered over 96% of U.S. counties from 2009 to 2018. For analysis, we used within-between random effects models. Regarding between-effects, we found that in inter-community comparisons, higher food insecurity rates were significantly associated with increased CMR rates. This association was consistent by age, sex, maltreatment type, and urbanicity. For within-effects, we found that the association between longitudinal changes of food insecurity rates and CMR rates significantly differed by urbanicity. Specifically, longitudinal increases of food insecurity rates significantly increased CMR rates among large urban counties, but not among small urban and rural counties. Study findings highlight the importance of conducting further research to better understand the mechanisms through which food insecurity impact child maltreatment at both individual and community levels. Our community-level findings from general populations especially have significant implications for community-based programs and large-scale policies to achieve population-level impact on child well-being.

Adult mental health and child maltreatment: An ecological study across rural-urban and economic continua with implications for post-pandemic human services.

This ecological, county-level, cross-sectional study examines relationships between the mental health of adults (IV) and child maltreatment report rates (DV), as they vary by socioeconomic distress and rurality (n = 3015 counties), using the most recent available data from several linked sources. In a two-way model, maltreatment reports increased 20.1% for each additional half day of poor mental health in metro counties, 11.7% in nonmetro counties, and 13% in rural counties. Our zero-inflated negative binomial model, moderated by rurality and economic distress, showed a significant relationship between the number of poor mental health days and increased child maltreatment report rates in counties (χ2 = 145.52, p < 0.0001). Investment in prevention and treatment of adult mental health concerns is imperative, especially in light of the increase in mental health problems caused by the coronavirus disease 2019 pandemic and increased tension within national political debate. Our results indicate successful support of adult mental health will prevent child maltreatment and reduce the cyclical financial burden of child maltreatment and mental health concerns.

The power of the future: Intergenerational income mobility and child maltreatment in the United States

BackgroundRecent research has shown that the likelihood of children experiencing intergenerational, upward income mobility depends on the community in which they are raised. Whether parents consider their children's economic chances in their parenting decisions, however, is not well understood. ObjectiveTo examine the relationship between county-level income mobility–distinct from income inequality and poverty–and child maltreatment. Participants and settingAdministrative data from the National Child Abuse and Neglect Data System: Child File for 2406 counties were merged with measures of intergenerational income mobility from Chetty et al. (2014a), including the probability that a child born in the bottom quintile of the national income distribution reaches the top quintile by age thirty. MethodsWeighted least squares analyses were used to empirically estimate the relationship between intergenerational income mobility and child maltreatment report rates. Maltreatment reports were also divided into subgroups by age and metropolitan status. ResultsCounties where children have a greater chance of moving up the income ladder have lower child maltreatment report rates, independent from income inequality and poverty rates. This relationship is consistent across all child ages (0–17). The relationship between upward income mobility and substantiated child maltreatment is also negatively correlated among non-metropolitan counties. ConclusionsChildren experience a lower risk for maltreatment if they are more likely to move up the income ladder in adulthood. Macroeconomic factors and policies that reduce income inequality and enhance economic mobility are likely to prevent child maltreatment.

A national study of child maltreatment reporting at the county level: Interactions among race/ethnicity, rurality and poverty

Child maltreatment report rates vary widely among states and counties. A portion of the variation likely reflects varying community-level risk and protective factors, but the variation also likely reflects community characteristics unrelated to risk, raising questions of equity and justice, in addition to safety. This study builds on previous research that focused only on the U.S. South to investigate nationally how county racial/ethnic compositions, poverty rates, and rurality relate to child maltreatment report rates. Aggregated county-level data from the National Child Abuse and Neglect Data System (NCANDS) from nearly all U.S. counties (n = 2,966 in 2015) were linked to data from the U.S. census and other sources. Bivariate tests and multi-level regression models assessed county-level factors associated with the child maltreatment investigated report rate. Consistent with previous studies, despite higher child poverty rates, child maltreatment report rates were lower in rural counties with majority populations of color compared to other counties. In addition, although county-level child poverty rates were generally positively associated with child maltreatment report rates, child poverty was not positively associated with child maltreatment report rates in rural counties with majority populations of color, primarily due to low report rates in rural counties with majority Black populations. To our knowledge, this is the first national child maltreatment study to disentangle county rurality from racial/ethnic composition by specifically investigating rural counties with majority populations of color.

Do surprisingly low child maltreatment rates in rural southern counties reflect lower rates of substantiation?

This study aims to help explain surprisingly low official child maltreatment rates in rural southern U.S. counties with many child maltreatment risk factors. It investigates whether comparatively lower child maltreatment rates in rural, majority African-American counties are due to lower rates of substantiation. County-level data from the National Child Abuse and Neglect Data System (NCANDS) were linked with demographic and poverty data from the U.S. Census. Fractional response probit regression models assessed whether substantiation rates were associated with county racial composition, rurality, and poverty rate. Substantiation rates in rural, majority African-American counties were similar to those of other counties in the region, even when accounting for the county poverty rate. The findings clarify that lower maltreatment rates in rural, majority African-American counties in the South are a consequence of lower maltreatment report rates, and not also a consequence of substantiation decisions. The discussion addresses some implications of low levels of formal child welfare intervention in high risk, low resource counties with histories of marginalization.

Drug overdose and child maltreatment across the United States' rural-urban continuum.

This national study of US counties (n = 2963) investigated whether county-level drug overdose mortality is associated with maltreatment report rates, and whether the relationship between overdose mortality and maltreatment reports is moderated by a county's rural, non-metro or metro status. Data included county-level 2015 maltreatment reports from the National Child Abuse and Neglect Data System, modeled drug-overdose mortality from the Centers for Disease Control, United States Department of Agriculture Rural-Urban Continuum Codes, US Census demographic data and crime reports from the Federal Bureau of Investigation. All data were linked across counties. Zero-inflated negative binomial (ZINB) regression was used for county-level analysis. As hypothesized, results from the ZINB model showed a significant and positive relationship between drug overdose mortality and child maltreatment report rates (χ = 101.26, p < .0001). This relationship was moderated by position on the rural-urban continuum (χ=8.76, p = .01). For metro counties, there was a 1.9% increase in maltreatment report rate for each additional increment of overdose deaths (IRR=1.019, CI=[1.010, 1.028]). For non-metro counties, the rate of increase was 1.8% higher than for metro counties (IRR=1.018, CI=[1.006, 1.030]); for rural counties, the rate of increase was 1.2% higher than for metro counties (IRR=1.012, CI=[0.999, 1.026]). Additional research is needed to determine why the relationship between drug overdose mortality and maltreatment reports is stronger in non-metro and rural communities. One potential driver requiring additional inquiry is that access to mental and physical health care and substance use treatment may be more limited outside of metropolitan counties.

Understanding trends in neighborhood child maltreatment rates: A three-wave panel study 1990-2010.

This study examines how changes in the social and economic structure of neighborhoods relate to changes in child maltreatment report rates over an extended period. The panel study design allows us to partition the changes in child maltreatment report rates into a portion associated with how the levels of socio-economic risk factors have changed over time, and a portion related to how the relative importance of those factors in explaining maltreatment report rates has changed over time. Through the application of fixed effects panel models, the analysis is also able to control for unmeasured time-invariant characteristics of neighborhoods that may be a source of bias in cross-sectional studies. The study finds that increases in vacant housing, single parent families and unemployment rates are strongly associated with increases in child maltreatment report rates. Changes in racial/ethnic composition did not produce changes in maltreatment report rates except when they reached extreme levels of segregation. Although poverty rates were predictive of cross-sectional variation in child maltreatment, increases in neighborhood poverty became less associated with increases in child maltreatment report rates over time.

Child maltreatment risk as a function of poverty and race/ethnicity in the USA

Child maltreatment is a pressing social problem in the USA and internationally. There are increasing calls for the use of a public health approach to child maltreatment, but the effective adoption of such an approach requires a sound foundation of epidemiological data. This study estimates for the first time, using national data, total and type-specific official maltreatment risks while simultaneously considering environmental poverty and race/ethnicity. National official maltreatment data (2009-13) were linked to census data. We used additive mixed models to estimate race/ethnicity-specific rates of official maltreatment (total and subtypes) as a function of county-level child poverty rates. The additive model coupled with the multilevel design provided empirically sound estimates while handling both curvilinearity and the nested data structure. With increasing county child poverty rates, total and type-specific official maltreatment rates increased in all race/ethnicity groups. At similar poverty levels, White maltreatment rates trended higher than Blacks and Hispanics showed lower rates, especially where the data were most sufficient. For example, at the 25% poverty level, total maltreatment report rates were 6.91% [95% confidence interval (CI): 6.43%-7.40%] for Whites, 6.30% (5.50%-7.11%) for Blacks and 3.32% (2.88%-3.76%) for Hispanics. We find strong positive associations between official child maltreatment and environmental poverty in all race/ethnicity groups. Our data suggest that Black/White disproportionality in official maltreatment is largely driven by Black/White differences in poverty. Our findings also support the presence of a 'Hispanic paradox' in official maltreatment, where Hispanics have lower risks compared with similarly economically situated Whites and Blacks.

How can county-level maltreatment report rates better inform child welfare practice?

Building on knowledge about community-level characteristics associated with child maltreatment, this study identifies new ways that county-level variation in child maltreatment report rates can be used to assess the adequacy and equity of child welfare services. With data from multiple sources linked to maltreatment data from NCANDS, multi-level models identified county and state-level characteristics associated with county-level maltreatment reports. Characteristics previously found to be associated with child maltreatment reports at the community level were associated at the county level. Further, most counties with high risk characteristics for child maltreatment also had high child maltreatment report rates. Still, 16 counties in the highest risk quartile for child maltreatment were in the lowest quartile of maltreatment reports. Findings illustrate additional ways that national child maltreatment data can be used to inform child welfare practitioners and policymakers and inspire data-informed efforts to improve child welfare services.