(Converted as ePoster, See Poster Gallery) Understanding County-Level Relationships between Food Insecurity and Child Maltreatment in the United States, 2009-2018

Background/Purpose:

Evidence about the relationship between food insecurity and child maltreatment is sparse. This study examined the county-level relationship between food insecurity and child maltreatment report rates overall and within urbanicity, demographic and maltreatment type subgroups from 2009–2018 in the United States.

Methods:

County food insecurity rates (i.e., % persons in a food-insecure household) were taken from Map the Meal Gap from Feeding America. This study examined both within-county longitudinal changes and between-county differences in food insecurity and estimated their associations with official child maltreatment report rates using within-between random effects models. All estimates were adjusted for urbanicity and a range of within-county and between-county variables (i.e., median household income, % single parent, % Black, % Latino, % foreign-born, % child, and % moved).

Results:

Between-county food insecurity was significantly associated with maltreatment report rates overall and within most subgroups, with no significant variation by urbanicity. A one-percentage point increase in between-county food insecurity was associated with a 1.27 increase in maltreatment report rates per 1,000 children (coefficient = 1.27, 95% CI = [0.38, 2.20]). This association was also significant within all age (ages 0–5, 6–11, and 12–17) and gender subgroups. For maltreatment type, between-county food insecurity was significantly associated with neglect report rates (0.77, [0.07, 1.48]), but not with physical abuse (-0.09, [-0.34, 0.15]) or sexual abuse (0.05, [-0.04, 0.14]). Regarding race/ethnicity, between-county food insecurity was significantly associated with maltreatment report rates among White children (1.91, [1.26, 2.57]), but not among Black (-0.21, [-1.72, 1.30]) or Latino (0.11, [-0.56, 0.79]) children. Within-county food insecurity was significantly associated with maltreatment report rates neither overall (0.32, [-1.08, 1.81]) nor within subgroups, but this association significantly varied by urbanicity. Compared to the association among rural counties (-0.22, [-1.59, 1.39]), the association among large urban counties was significantly larger, by 1.20 [0.36, 2.09].

Conclusions/Implications:

Even after controlling for socioeconomic, demographic, and residential mobility conditions, counties with higher food insecurity rates had higher child maltreatment report rates, especially higher neglect report rates. This association was also observed in all gender and age subgroups. These findings expand prior individual-level findings in local and high-risk populations to the community-level relationships in the general population. While further research is needed to delineate the community-level mechanisms from food insecurity to maltreatment reporting, attention is warranted for children in food-insecure communities, as well as food-insecure households. During the study years, national maltreatment report rates have increased, especially in rural counties, by as-yet-unknown factors, which might make the within-county associations masked in rural counties and more pronounced in large urban counties. Further research is warranted for this interaction and race/ethnicity-specific community food insecurity.