Methods: The study involves data from U.S. counties with populations of at least 1,000 (n = 2,966 in 2015). The dependent variable is the rate of investigated child maltreatment reports per 1,000 children. The social association rate is the number of membership organizations (e.g., religious, labor, and political organizations) per 10,000 county residents, reflecting opportunities for social association. Control variables at the county level include the child poverty rate, percentage rural, and other demographic characteristics. State-level variables include whether the state had expanded Medicaid by 2015. Because counties are nested in states, multi-level regression models with random intercepts were conducted.
Results: Child maltreatment report rates varied widely by county. At a bivariate level there was a weak negative association between the maltreatment report rate and the social association rate (r = -.07, p <.01). In multi-level models accounting for child poverty, demographics, and Medicaid expansion status, the social association rate retained a negative association with child maltreatment reports. When county rurality status was included in the model, however, the association was suppressed, pointing to an interaction effect. Models run separately for rural and nonrural counties illustrated that the social association rate retained a strong negative association with child maltreatment reporting in rural counties but had a positive association in nonrural counties.
Implications: This study adds to literature on social association and child maltreatment by addressing all U.S. counties, including rural counties. General patterns differed in rural and nonrural counties, raising questions about the role of social association in different community contexts. In rural counties, as opportunities for social association were greater, maltreatment report rates were lower, suggesting a protective effect from membership organizations, and perhaps reflecting enhanced bonds of social trust (Putnam, 1995). In nonrural counties, as opportunities for social association were greater, so were maltreatment report rates. In more densely populated areas, opportunities for social association may promote more observation and formal support for struggling families (Klinenberg, 2002), resulting in more maltreatment reports. Hence, social association may have different protective functions in different types of communities. With fewer opportunities for interaction under pandemic social distancing, various protective roles of social association could be hindered.