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Child Maltreatment: A Comparison of Wisconsin Children Identified in Health Care and Child Protective Services (CPS)
1Population Health Institute, University of Wisconsin-Madison and Wisconsin Division of Public Health, Madison, Wisconsin (Ms Imm) and Sandra Rosenbaum School of Social Work and Institute for Research on Poverty, University of Wisconsin-Madison, Madison, Wisconsin (Dr Pac).
Insights
Linking child protective services (CPS) reports and health records reveals distinct demographic and maltreatment profiles. This data can inform targeted interventions and support for at-risk children.
Area of Science:
- Public Health
- Child Welfare
- Health Informatics
Background:
- Child maltreatment is a significant public health issue.
- Child Protective Services (CPS) reports and health records are key data sources for identifying child maltreatment.
- Currently, these data sources are not linked at state or national levels, limiting comprehensive analysis.
Purpose of the Study:
- To compare children identified with maltreatment through health records (using ICD-10-CM codes) and/or CPS reports.
- To understand the demographic characteristics and types of maltreatment across different data source combinations.
Main Methods:
- A study was conducted in Wisconsin involving children with maltreatment codes in health records and/or CPS-investigated reports between 2018-2019.
- Three mutually exclusive groups were created: 1) health record code & CPS report, 2) health record code only, 3) CPS report only.
- Descriptive statistics and significance tests were used to analyze demographic and maltreatment differences.
Main Results:
- Children in Group 1 (health record code & CPS report) were significantly younger.
- Children in Group 2 (health record code only) were significantly more female.
- Black children were disproportionately represented across all groups, particularly in Group 1.
Conclusions:
- CPS and healthcare providers serve overlapping and distinct child populations experiencing maltreatment.
- Interventions should consider specific maltreatment types and child characteristics.
- Linking health and CPS data can identify at-risk children and families for timely support and intervention.
Context:
Child Protective Services (CPS) reports and health records (hospital inpatient and emergency department visits) are the primary data sources to measure child maltreatment; yet, they are not linked at the state or national level. Linking provides novel insight into the demographic characteristics of the populations served by one or both agencies, thus informing opportunities for prevention and intervention.
Objective:
This study compares children identified as maltreated in health records (based on International Classification of Diseases, Tenth Revision, Clinical Modification [ ICD-10-CM ] codes indicating suspected or confirmed child maltreatment) and/or CPS reports.
Design:
Three mutually exclusive comparison groups were created: group 1- children with a nonfatal hospitalization and/or emergency department visit with a maltreatment ICD-10-CM code and an investigated CPS report; group 2- children with a maltreatment ICD-10-CM code in a health record without an investigated CPS report; and group 3- children with an investigated CPS report without a health record with a maltreatment ICD-10-CM code. Descriptive statistics and tests for statistically significant differences were conducted.
Setting And Participants:
Wisconsin children with maltreatment ICD-10-CM code in health record and/or CPS-investigated report from 2018 to 2019.
Main Outcome Measure:
Demographic and maltreatment type differences between groups.
Results:
Group 1 children were significantly younger than those in other groups ( P <. 001), and group 2 children were significantly more female (69.6%; P < .001). Black children were overrepresented in all groups and most disproportionate among group 1 (39.5%; P < .001). Maltreatment type also differed significantly across groups.
Conclusions:
CPS staff and health providers encounter overlapping and nonoverlapping populations of children experiencing different types of maltreatment. Although interventions may be tailored toward the type of maltreatment and other relevant child characteristics, all populations could benefit from referrals and access to supportive social services. Agency contact provides an opportunity to intervene and support at-risk children and families.
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