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The prevalence of confirmed maltreatment among US children, 2004 to 2011
Christopher Wildeman1, Natalia Emanuel2, John M Leventhal3
1Department of Sociology, Yale University, New Haven, Connecticut.
Insights
Child maltreatment affects 1 in 8 US children by age 18, a cumulative prevalence far exceeding annual estimates. This study highlights significant disparities, with Black and Native American children facing disproportionately higher risks of confirmed maltreatment.
Area of Science:
- Public Health
- Child Welfare
- Epidemiology
Background:
- Child maltreatment is a significant risk factor for adverse health outcomes across the lifespan.
- Previous estimates of child maltreatment in the US relied on retrospective self-reports, potentially underestimating prevalence.
- Official records typically provide annual counts, not cumulative lifetime exposure to confirmed maltreatment.
Purpose of the Study:
- To estimate the cumulative proportion of US children experiencing confirmed child maltreatment (abuse or neglect) by age 18.
- To analyze cumulative prevalence by demographic factors including race/ethnicity and sex.
Main Methods:
- Utilized the National Child Abuse and Neglect Data System (NCANDS) Child File, encompassing 5,689,900 children with confirmed maltreatment reports from 2004-2011.
- Developed synthetic cohort life tables to calculate the cumulative prevalence of confirmed maltreatment by age 18.
Main Results:
- At 2011 rates, an estimated 12.5% of US children face confirmed maltreatment by age 18.
- Cumulative prevalence was higher for girls (13.0%) than boys (12.0%).
- Significant racial disparities observed: Black (20.9%), Native American (14.5%), and Hispanic (13.0%) children had higher prevalence than White (10.7%) or Asian/Pacific Islander (3.8%) children. Risk was highest in early childhood.
Conclusions:
- Annual confirmed maltreatment rates significantly underestimate the cumulative burden on children.
- Approximately 1 in 8 US children experience confirmed maltreatment by age 18, a stark contrast to the 1 in 100 estimated annually.
- Cumulative prevalence for Black children is 1 in 5, and for Native American children, it is 1 in 7, indicating critical disparities in child protection.
Importance:
Child maltreatment is a risk factor for poor health throughout the life course. Existing estimates of the proportion of the US population maltreated during childhood are based on retrospective self-reports. Records of officially confirmed maltreatment have been used to produce annual rather than cumulative counts of maltreated individuals.
Objective:
To estimate the proportion of US children with a report of maltreatment (abuse or neglect) that was indicated or substantiated by Child Protective Services (referred to as confirmed maltreatment) by 18 years of age.
Design, Setting, And Participants:
The National Child Abuse and Neglect Data System (NCANDS) Child File includes information on all US children with a confirmed report of maltreatment, totaling 5,689,900 children (2004-2011). We developed synthetic cohort life tables to estimate the cumulative prevalence of confirmed childhood maltreatment by 18 years of age.
Main Outcomes And Measures:
The cumulative prevalence of confirmed child maltreatment by race/ethnicity, sex, and year.
Results:
At 2011 rates, 12.5% (95% CI, 12.5%-12.6%) of US children will experience a confirmed case of maltreatment by 18 years of age. Girls have a higher cumulative prevalence (13.0% [95% CI, 12.9%-13.0%]) than boys (12.0% [12.0%-12.1%]). Black (20.9% [95% CI, 20.8%-21.1%]), Native American (14.5% [14.2%-14.9%]), and Hispanic (13.0% [12.9%-13.1%]) children have higher prevalences than white (10.7% [10.6%-10.8%]) or Asian/Pacific Islander (3.8% [3.7%-3.8%]) children. The risk for maltreatment is highest in the first few years of life; 2.1% (95% CI, 2.1%-2.1%) of children have confirmed maltreatment by 1 year of age, and 5.8% (5.8%-5.9%), by 5 years of age. Estimates from 2011 were consistent with those from 2004 through 2010.
Conclusions And Relevance:
Annual rates of confirmed child maltreatment dramatically understate the cumulative number of children confirmed to be maltreated during childhood. Our findings indicate that maltreatment will be confirmed for 1 in 8 US children by 18 years of age, far greater than the 1 in 100 children whose maltreatment is confirmed annually. For black children, the cumulative prevalence is 1 in 5; for Native American children, 1 in 7.
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