Urban/Rural Differences in the County-Level Relationship between Foreign-Born Residents and Child Maltreatment Report Rates, United States, 2009-2018

Background/Purpose:

Research has shown that children of foreign-born parents have a lower risk of child maltreatment report (CMR) than those of US-born parents, which is frequently explained by cultural protective factors of foreign-born populations. Emerging evidence suggests that larger foreign-born populations in communities may also have a protective effect on CMR rates. However, it remains unclear whether the relationship between the percentage of foreign-born residents (% foreign-born) and CMR rates varies across urban-rural areas, which have distinct socioeconomic and environmental contexts. This study aims to examine the potential urban-rural differences in the county-level relationship between % foreign-born and CMR rates in the United States, 2009-2018.

Methods:

We linked data from the National Child Abuse and Neglect Data System, the Rural Urban Continuum Codes, and Census data at the county level for the entire United States from 2009 to 2018. We utilized within-between random effects models to investigate the associations between both the longitudinal change and the between-county difference in % foreign-born and CMR rates, while exploring potential urban-rural differences in these associations. We controlled for a range of potential confounding variables (e.g., poverty rates).

Results:

We found significant urban-rural differences in the relationship between % foreign-born and CMR rates, for both the longitudinal change and the between-county difference in % foreign-born. The longitudinal increase in % foreign-born (+1 percentage point) was significantly associated with a reduction in CMR rates across all urban-rural areas. However, this relationship was somewhat stronger in large urban areas (a 2.63 per 1,000 decrease in CMR rates) and rural areas (a 2.14 per 1,000 decrease in CMR rates) than in small urban areas (a 0.96 per 1,000 decrease in CMR rates). For the between-county difference, the relationship between % foreign-born and CMR rates was also significant across all urban-rural areas, but weakest in large urban areas, stronger in small urban areas, and strongest in rural areas. Specifically, a 1-percentage-point increase in % foreign-born was associated with a decrease in CMR rates by -0.93 per 1,000 in large urban area, -1.43 per 1,000 in small urban areas, and -2.29 per 1,000 in rural areas.

Conclusions/Implications:

Our study suggests that counties with larger foreign-born populations have lower CMR rates in between-county comparisons. This protective association was observed across all urban-rural areas, with the strongest association seen in rural areas. Prior research has shown that increasing minority populations, especially in rural areas, is associated with decreased CMR rates, which aligns with our findings on the protective association between foreign-born populations and CMR rates. In longitudinal changes, counties with rising foreign-born populations over time experience decreased CMR rates across all urban-rural areas. These within-county findings provide stronger evidence for causality than cross-sectional relationships by controlling for time-invariant confounders. Interestingly, we observed that this protective association was stronger in large urban and rural areas than in small urban areas. Further research is needed to understand the community-level protective mechanisms underlying these differences in the impact of foreign-born populations on CMR rates across urban-rural contexts.