Disparities in Reported and Substantiated Infant Maltreatment By Maternal Hispanic Origin and Nativity: A Birth Cohort Study

Background & Purpose. Latino children represent the fastest growing child population in the United States and in the public child protection system. Infants are particularly vulnerable to the consequences of maltreatment given their dependence on caregivers during a critical period of human development. Latino families are highly diverse with regard to factors such as nativity, place of origin, and socioeconomic status (SES). However, with few exceptions, Latino children who come to the attention of the US child protective service (CPS) system have been studied as a pan-ethnic group. The few studies of CPS-involvement among Latinos inclusive of nativity indicate important subgroup variations in maltreatment type, risk factors, and substantiation patterns consistent with the Latino health paradox. The purpose of this study was to address two critical yet unexplored issues (1) whether protective advantages against child maltreatment extend to infants of foreign-born mothers across Hispanic-origin groups, and (2) whether the likelihood an infant is reported or substantiated for maltreatment varies by Hispanic origin.

Methods. Data were drawn for all Latino infants born in California between 2000 and 2006 (N=1,909,155) from population-based birth records probabilistically linked to CPS data. For each child, we longitudinally documented CPS-involvement through age 1. Infants were categorized based on self-reported maternal Hispanic origin in the birth record (Mexican, Puerto Rican, Cuban, Central/South American, other Hispanic) and analyses were stratified based on maternal nativity (foreign-born, US-born). We used χ2 tests to assess distributional differences in covariates including proxies for SES, measures of maternal health behaviors, infant characteristics, and birth outcomes. We utilized generalized linear models to estimate the adjusted relative risk of report and substantiation in models stratified by nativity.

Results. Significant health advantages were observed in reported and substantiated maltreatment for infants of foreign-born mothers within every Hispanic-origin group. Despite socioeconomic advantage, risks of report and substantiation among infants of Mexican (reference group) and Central/South American mothers [(RR: 1.22; 95% CI: 1.18, 1.25), (RR: 1.19; 95% CI: 1.12, 1.26), respectively] were consistently lower than Puerto Rican [(RR: 2.80; 95% CI: 2.41, 3.24), (RR: 3.24; 95% CI: 2.53, 4.17)] and Cuban mothers [(RR: 2.03; 95% CI: 1.53, 2.67), (RR: 2.45; 95% CI: 1.49, 4.03)]. Infant low birth weight, delayed initiation of prenatal care, presence of a birth abnormality, lower maternal education, lack of established paternity, and public insurance utilization were significant predictors of reported and substantiated maltreatment.

Conclusions & Implications. The reduced risk of CPS-involvement observed for infants of foreign born mothers across Hispanic-origin groups aligns with literature that has identified health advantages among immigrants in the United States. While further research is warranted to unravel the processes underlying observed relationships, the presence of disparities among Hispanic-origin groups in child maltreatment report and substantiation during infancy has implications for the health of Latinos across the life course. Epidemiologic data represent a valuable tool to enhance the field’s understanding of the diversity of Latino children and families who come to the attention of the CPS system and to provide population-level monitoring of the success of prevention efforts over time.