The Relationship between Community-Level Safety Net Accessibility and CPS Report Abuse Rates

Background & Purpose:

Child physical and sexual abuse is a common, costly, and preventable cause of morbidity and mortality for children in the United States. Abuse occurs more frequently for children who grow up in poverty. The primary method of addressing poverty in the U.S. is the provision of social services that address concerns such as mental health, job training, substance use, and food insecurity. The effectiveness of these services, also referred to as the safety net, is dependent on their spatial proximity to their targeted population, specifically those dealing with poverty. However, these safety net services underserve the communities that are the most in need of them. It is unknown if the mismatch between safety net accessibility access and need is related to child abuse. The purpose of this study was to assess if community safety net accessibility has a relationship with child physical and sexual abuse rates.

Methods:

Community safety net measures came from the Multi-City Survey of Social Service Providers (MSSSP) study which scored census tracts on service accessibility scores based on about 1,500 telephone surveys with social service agencies in Los Angeles County. The safety net measures were categorized as basic needs, employment services, and mental health and substance use services. CPS physical and sexual abuse report rates were aggregated at the census-tract level and linked with the safety net accessibility scores. Census tracts were categorized as having high, medium, and low rates of CPS reports based on z-scores. Mean safety net accessibility scores were calculated and differences between groups were assessed using Kruskal-Wallis rank tests. Ordinary least square (OLS) regression and spatial error regression models were run. Models were compared for best fit using Bayesian information criterion and testing for spatial autocorrelation.

Results:

Neighborhoods with high rates of CPS reports had lower mean safety net accessibility scores than neighborhoods with lower rates of CPS reports. Specifically, neighborhoods with high CPS report rates had a mean employment services accessibility score of 0.65, whereas neighborhoods with medium rates had scores of 1.10, and those with low CPS report rates had scores of 1.60 (p < 0.001). Similarly, the mean mental health and substance use treatment accessibility scores were lowest for neighborhoods with high CPS report rates (0.93) and highest for neighborhoods with low CPS report rates (1.66, p < 0.001). Spatial autocorrelation was identified by computing Moran’s I for each of the three safety net measures. Spatial error regression models were a better fit for the data than OLS, as indicated by lower BIC scores (15582.8 vs. 16054.9). These models indicated a statistically significant inverse relationship between accessibility scores and CPS report rates, which were further illustrated in bivariate maps of the variables.

Conclusion & Implications:

Communities with lower access to safety net services have higher CPS report rates. Enhancing the alignment between service accessibility and community needs may offer a viable strategy for mitigating child abuse and reducing CPS involvement.