Alcohol Outlets and Child Maltreatment: The Role of Community Substance Abuse Treatment Facilities

Background The literature on the effects of neighborhoods on rates of child maltreatment has established a connection between poverty, unemployment, high ratios of children to adults, population density, and residential mobility to increased rates of child maltreatment . Additionally, authors have investigated the role that the substance use environment plays in affecting rates of child maltreatment, finding greater density of bars and drug crimes to be linked with greater rates of child maltreatment (Freisthler, Needell & Gruenewald, 2005). The purpose of this study is to further investigate the role that the substance use environment plays in rates of child maltreatment, exploring the moderating role community treatment facilities may play. Research Question Do community substance abuse treatment facilities moderate the relationship between alcohol outlet density and child maltreatment? Method The data used for this study comes from four sources: 2003 child maltreatment reports, listing of alcohol retailers, listing of licensed substance abuse care providers, and the 2000 United States Census. Using ArcGIS, addresses were geocoded to place them in neighborhoods under analysis: child maltreatment incidents, separated by type (physical abuse, neglect); alcohol outlets, separated by type (on premises, off premises); licensed substance abuse treatment facility. The United States Census was used to create control variables of factors found in previous studies to be linked with child maltreatment. The study uses neighborhood as the unit of analysis, defined as a residential census tract. The dependent variable is the rate of child maltreatment per 10,000 children, differentiated by child physical abuse and child neglect. The main independent variable is alcohol outlet density within a neighborhood, measured as the number of outlets per 10km of roadway. These were also differentiated by license type, on premises and off premises. Treatment facilities were measures as the number per 10km of roadway. Control variables include measures of a neighborhood's socioeconomic and demographic profile previously found to predict rates of child maltreatment (Coulton, et al., 2007). Linear regression was applied to test the relationship between predictor and criterion variables for one county. The county consisted of 163 census tracts, 503 reports of physical abuse, 248 reports of neglect, 737 on premises alcohol outlets, and 240 off premises alcohol outlets. Findings Principal components analysis revealed three factors: poverty, residential instability and immigrant concentration. Regression models were applied for child physical abuse and neglect. Child physical abuse was positively related to impoverishment (b=14.77 SE=2.07 p,.001) and residential instability (b=3.85 SE=1.59 p<.05) only. In the original model, child neglect was related to on premises alcohol outlets (b=1.97 SE=.78, p<.05), poverty (b=6.72 SE=1.78 p<.001), residential instability (b=3.49 SE=1.37 p<.05) and immigrant concentration (b=6.18 SE=1.41 p<.001). For child neglect, community substance abuse treatment facilities were found to moderate the relationship between alcohol outlets and child maltreatment (b=8.22 SE=1.80 p<.001) reducing on premises outlets to non-significance. Implications These findings indicate the presence of substance abuse treatment facilities in a neighborhood may influence rates of child maltreatment. Further research should be conducted to investigate the mechanisms by which this moderating relationship acts.