Abstract: The Lifetime Prevalence of Child Abuse and Neglect Investigation Among US Children (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Schedule:

Friday, January 13, 2017: 5:15 PM

Preservation Hall Studio 2 (New Orleans Marriott)

* noted as presenting author

Hyunil Kim, MSW, PhD Student, Washington University in Saint Louis, Saint Louis, MO

Christopher Wildeman, PhD, Associate Professor, Co-director of the National Data Archive on Child Abuse and Neglect, Cornell University, Ithaca, NY

Melissa Jonson-Reid, PhD, Professor, Washington University in Saint Louis, St. Louis, MO

Brett Drake, PhD, Professor, Washington University in Saint Louis, St Louis, MO

Background and Purposes:

Child maltreatment is associated with a wide range of child, adolescent and adult mental health and health outcomes, including increased risk of mortality. Children with substantiated investigations are virtually indistinguishable from those with unsubstantiated allegations with regard to practically all associated negative outcomes. Investigated reports, not limited to substantiation, are increasingly used as a proxy for the presence of maltreatment in economic, health, and social science research. Despite this, there is no national estimate of the cumulative prevalence of maltreatment investigation for children. This means that cost estimates as well as estimates of the need for services are severely limited. The purpose of this study is to estimate, for the first time, the cumulative prevalence of maltreatment investigations by Child Protective Services among US children by 18 years of age. We also estimate age-specific cumulative risks of total and type-specific (i.e., neglect, physical abuse, sexual abuse, and emotional abuse) maltreatment investigations by race/ethnicity and sex.

Methods:

The National Child Abuse and Neglect Data System Child Files (2003-2014) and Census data are used to develop synthetic cohort life tables to estimate the cumulative prevalence. For greater accuracy, two additional innovations are employed. First, substantial efforts are made to detect true first time events and avoid overestimation by duplicate counts of children with multiple investigations during their lifetime. Second, with regard to accurately determining what proportion of the population has not had a prior investigation and is thus “at risk” for a true first investigation, we reduce each age-specific population to reflect children investigated before the age in question. Standard errors of cumulative risks are estimated by Greenwood’s method.

Results:

We estimate that 37.4% (99.9% CI: 37.3%-37.5%) of all US children ever experience a maltreatment investigation by age 18. Neglect is the most common subtype, including 25.2% (25.2%-25.3%) of all children, followed by Physical abuse at 11.5% (11.4%-11.6%) and Sexual Abuse at 4.1% (4.0%-4.1%). Consistent with prior research, we found that Black children have the highest lifetime prevalence of maltreatment investigations at 53.0% (52.8%-53.2%), followed by Hispanics at 32.0% (31.8%-32.1%), Whites at 28.2% (28.1%-28.3%), Native Americans at 23.4% (22.9%-24.0%), and Asian/Pacific Islanders at 10.2% (9.9%-10.4%). Females had a slightly higher lifetime prevalence at 37.6% (37.5%-37.7%) than males at 36.5% (36.4%-36.6%).

Conclusions and Implications:

Our estimate suggests that being the subject of a maltreatment investigation is a commonplace occurrence (37%). This is three times the lifetime prevalence of estimates based on substantiated maltreatment (12%) and many times the rate of familiar “past year” estimates (4%). Our estimates, however, comport well with retrospective survey data, showing similar (30-40%) rates. Our findings highlight the pressing need for more preventative, perhaps even universal services to deal with the serious and widespread problem of child maltreatment.