Understanding the Role of Rurality in Child Welfare in Illinois: From Child Maltreatment Reports to Placement Outcomes

Background/Purpose:

Child maltreatment remains a pressing issue in the United States, with geographic context playing a critical role in shaping child welfare outcomes. While factors such as poverty and race have been widely studied, urban-rural disparities have received comparatively less attention. This study examines how rurality relates to each stage of the Child Protective Services (CPS) continuum—from child maltreatment reports (CMRs) to CPS decisions and placement outcomes—using statewide data from Illinois data spanning 2003-2023.

Methods:

We compiled longitudinal CPS data from Illinois CPS (2003-2023), tracking children from birth to avoid left censoring. Tract-level control variables were drawn from the American Community Survey, and rural/urban classifications were based on the U.S. Department of Agriculture definitions. Areas were categorized into large urban, small urban, and rural groups. We first assessed tract-level CMR rates by rurality in 2021 using linear regression. Then, using individual-level logistic regression, we examined urban-rural differences in CPS decisions—substantiations, Intact Family Service (IFS) openings, and foster care (FC) entries—and future CPS involvement among reported children in 2021. We also examined whether placement outcomes among children who entered FC in 2021 varied by rurality.

Results:

Before adjusting for neighborhood factors, children in small urban and rural areas had CMR rates 36.9 and 49.8 per 1,000 higher, respectively, than those in large urban areas. After controlling for socioeconomic, demographic, and neighborhood stability factors, these gaps narrowed but remained significant—17.1 higher for small urban and 25.5 higher for rural areas. In terms of CPS decisions and future involvement, children in small urban and rural areas were significantly more likely to experience substantiation (15% and 12%), immediate IFS opening (28% and 57%), FC entry (67% and 94%), rereporting (47% and 81%), future IFS opening (40% and 80%), and future FC entry (94% and 119% higher, respectively). These disparities remained significant even after adjusting for additional risk factors. Regarding placement outcomes, children from small urban and rural areas were 36% and 22% less likely, respectively, to be initially placed with relatives or kin, and 77% to 81% more likely to experience termination of parental rights. Rural children were also 57% more likely to be placed over 20 miles from family. However, both small urban and rural children were 38% less likely to experience three or more placement disruptions per year, and children in small urban areas were 21% more likely to achieve permanency than those in large urban areas. These differences mostly remained significant even after accounting for other risk factors.

Conclusions/Implications:

Children in small urban and rural Illinois communities face elevated report rates, more frequent and intense CPS interventions, and greater challenges in placement outcomes, such as being placed with strangers, facing termination of parental rights, and being placed far from family. These findings underscore the urgent need for place-based policy solutions and resource investments tailored to the unique challenges of rural and small urban communities to ensure equitable child welfare outcomes across geographic contexts.