To describe how child maltreatment chronicity is related to negative outcomes in later childhood and early adulthood.
The study included 5994 low-income children from St Louis, including 3521 with ...child maltreatment reports, who were followed from 1993-1994 through 2009. Children were 1.5 to 11 years of age at sampling. Data include administrative and treatment records indicating substance abuse, mental health treatment, brain injury, sexually transmitted disease, suicide attempts, and violent delinquency before age 18 and child maltreatment perpetration, mental health treatment, or substance abuse in adulthood. Multivariate analysis controlled for potential confounders.
Child maltreatment chronicity predicted negative childhood outcomes in a linear fashion (eg, percentage with at least 1 negative outcome: no maltreatment = 29.7%, 1 report = 39.5%, 4 reports = 67.1%). Suicide attempts before age 18 showed the largest proportionate increase with repeated maltreatment (no report versus 4+ reports = +625%, P < .0001). The dose-response relationship was reduced once controls for other adverse child outcomes were added in multivariate models of child maltreatment perpetration and mental health issues. The relationship between adult substance abuse and maltreatment report history disappeared after controlling for adverse child outcomes.
Child maltreatment chronicity as measured by official reports is a robust indicator of future negative outcomes across a range of systems, but this relationship may desist for certain adult outcomes once childhood adverse events are controlled. Although primary and secondary prevention remain important approaches, this study suggests that enhanced tertiary prevention may pay high dividends across a range of medical and behavioral domains.
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.
In a recent issue of Child Maltreatment (2023 vol. 28 (4)), an editorial by Palusci et al. and a commentary by Briggs et al. were published. These two publications express the American Professional ...Society on the Abuse of Children (APSAC) Board's and the
editorial team's stance relative to Diversity, Equity, Inclusion and Justice (DEIJ). The current commentary expresses a range of concerns regarding how APSAC and Child Maltreatment plan to advance DEIJ through their editorial policies.
Abstract The evidence for association between child maltreatment victimization and later maltreatment perpetration is both scant and mixed. The objective of the present study was to assess the ...association between childhood maltreatment experiences and later perpetration of maltreatment in young adulthood controlling for proximal young adult functioning, prior youth risk behaviors, and childhood poverty. The study included 6,935 low-income children with ( n = 4,470) or without ( n = 2,465) maltreatment reports prior to age 18 followed from ages 1.5 through 11 years through early adulthood (ages 18–26). Administrative data from multiple regional and statewide agencies captured reports of maltreatment, family poverty and characteristics, system contact for health, behavioral risks and mental health in adolescence, and concurrent adult functioning (crime, mental health and poverty). After controlling for proximal adult functioning, repeated instances of neglect or mixed type maltreatment remained associated with young adult perpetration. Females and subjects with adolescent history of runaway, violent behaviors or non-violent delinquency also had higher risk. Greater caregiver education remained associated with reduced risk. The study concludes that prevention of recurrent neglect and mixed forms of maltreatment may reduce risk of maltreatment for future generations. Intervening to increase parental education and decrease adolescent risk behaviors may offer additional benefit.
Abstract Purpose The purpose of the study was to compare risk for teen pregnancies between children living in poverty with no child protective services (CPS) report history and those in poverty with ...a history of CPS report. Methods Children selected from families in poverty, both with and without CPS report histories were prospectively followed from 1993 to 2009 using electronic administrative records from agencies including CPS, emergency departments, Medicaid services, and juvenile courts. A total of 3,281 adolescent females were followed until the age of 18 years. Results For teens with history of poverty only, 16.8% had been pregnant at least once by the age of 17 years. In teens with history of both poverty and report of child abuse or neglect, 28.9% had been pregnant at least once by the age of 17 years. Although multivariate survival analyses revealed several other significant factors at the family and youth services levels, a report of maltreatment remained significant (about a 66% higher risk). Conclusions Maltreatment is a significant risk factor for teen pregnancy among low income youth even after controlling for neighborhood disadvantage, other caregiver risks and indicators of individual emotional and behavioral problems.
We estimated cumulative probabilities of onset and recurrences of child maltreatment reports from birth to age 11 years. Estimates were provided overall and within subcategories of race/ethnicity, ...sex, and subtype.
We developed synthetic life tables from national Child Protective Services records (2003-2016) and Census data. Although 28 states and the District of Columbia were used for estimates due to data quality, sensitivity analyses suggest that our estimates may be very similar to national estimates, with very minor underestimation.
The probability of having at least "X-number" of maltreatment reports by age 12 years was 32.41% for 1 report, 13.71% for 2 reports, 7.57% for 3 reports, 4.50% for reports, 2.80% for 5 reports, and 1.79% for 6 reports. Children with more prior reports were more likely to have future reports. The risk increased from 42.31% when having 1 prior report to 64.01% when having 5 prior reports. Asian/Pacific Islanders showed exceptionally lower onset and recurring rates than others. Individuals of nonwhite ethnicity (African American/black, Native American, and Hispanic) had higher onset rates than white individuals. Once initially reported, however, white persons had generally slightly higher rates of recurrence than nonwhite persons. Neglect was the most frequent subtype in both onset and recurring reports. No practical difference existed in overall onset and recurring rates by sex.
Many United States children experience reported maltreatment, and many experience repeated or chronic maltreatment. The increased risk of recurring with more prior reports suggests preventive efforts for serially reported children. The large racial disparity at the onset stage disappears at the recurring stages, suggesting interventions prior to the onset.
One hanging question in child welfare policy and research is whether there is an artificial overrepresentation of the poor in child welfare caseloads or whether this reflects the co-occurrence of ...poverty and need. In order to address this question, this study uses data from child welfare (report, assessment, service and re-report), income maintenance, special education, hospitals, juvenile court, public mental health treatment, and census data. Poor children reported to child welfare are compared to non-poor children reported to child welfare and also to poor children not reported to child welfare. Poor children reported for maltreatment had greater risk factors at the parent and neighborhood levels and higher rates of negative outcomes than children in either comparison group. Among children reported for maltreatment, poor children have worse outcomes, both within child welfare (e.g., recurrence) and outside of child welfare (e.g. juvenile court, hospitalization for violence) than non-poor children. These data suggest that the overrepresentation of poor children is driven largely by the presence of increased risk among the poor children that come to the attention of child welfare rather than high levels of systemic class bias.
Poverty 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.
To 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.
U.S. Counties in 2009–2018.
Linear multilevel models estimated this relationship and its longitudinal change, while controlling for potential confounding variables.
We 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.
Our 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.
To estimate the lifetime prevalence of official investigations for child maltreatment among children in the United States.
We used the National Child Abuse and Neglect Data System Child Files ...(2003-2014) and Census data to develop synthetic cohort life tables to estimate the cumulative prevalence of reported childhood maltreatment. We extend previous work, which explored only confirmed rates of maltreatment, and we add new estimations of maltreatment by subtype, age, and ethnicity.
We estimate that 37.4% of all children experience a child protective services investigation by age 18 years. Consistent with previous literature, we found a higher rate for African American children (53.0%) and the lowest rate for Asians/Pacific Islanders (10.2%).
Child maltreatment investigations are more common than is generally recognized when viewed across the lifespan. Building on other recent work, our data suggest a critical need for increased preventative and treatment resources in the area of child maltreatment.
•Seven percent of foster children nationally entered care due to parental incarceration.•Compared to other foster children, they were younger, more often White and less often Black.•Parental ...incarceration was often one of multiple reasons for entering care, with parental substance abuse commonly co-occurring.•Standardization of child welfare data collection procedures is needed to better understand this population.•Investments in substance abuse treatment over incarceration is needed to protect children.
Using national child welfare data, we created a longitudinal data set (N = 142,143) to examine a subset of foster children (7%) who entered care due to parental incarceration (PI). Spanning FY 2005–2017, the dataset allowed us to compare children who entered care due to PI to children entering for other reasons. We found children of incarcerated parents were younger (median age of 4 vs. 6), more often White (47% vs. 42%), and less often Black (15% vs. 20%) when compared to other foster children. Parental use of alcohol (12% v. 6%) and drugs (42% v. 26%) were both more common among children who entered due to PI compared to those who entered for other reasons. Our understanding of this population is limited by inadequate data collection procedures that fail to account for societal changes created by mass incarceration. Our data indicate that investments in substance use treatment could decrease the number of children entering care.
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