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Medical Professional Reports and Child Welfare System Infant Investigations: An Analysis of National Child Abuse and
Frank Edwards1, Sarah C M Roberts2, Kathleen S Kenny3
1Rutgers University-Newark, Newark, New Jersey, USA.
Insights
Medical professional reports to child welfare agencies for infant investigations have doubled since 2010. These reports show persistent racial inequities, with Black infants disproportionately affected.
Area of Science:
- Child welfare research
- Pediatric health surveillance
- Public health policy
Background:
- Medical professionals play a crucial role in identifying and reporting child maltreatment.
- Accurate, up-to-date data on reporting rates by medical professionals is essential for effective surveillance.
- Previous estimates of medical professional reporting rates require updating.
Purpose of the Study:
- To estimate the rates of child welfare investigations for infants resulting from reports by medical professionals.
- To analyze trends in these reporting rates from 2000 to 2019.
- To examine race/ethnicity-specific disparities in infant investigations stemming from medical reports.
Main Methods:
- Utilized the National Child Abuse and Neglect Data System (2000-2019).
- Calculated population-adjusted, race/ethnicity-specific rates of infant investigations linked to medical professional reports.
- Adjusted for missing data and integrated with population data for state-year level analysis.
- Conducted sub-analyses on substance use-related investigations.
Main Results:
- Child welfare investigated 2.8 million infants between 2010-2019, with ~26% originating from medical professionals.
- Population-adjusted rates of investigations from medical reports doubled from 2010-2019 (13.1 to 27.1 per 1000 infants).
- Rates from medical professionals increased faster than from other reporters; significant racial disparities persisted, with Black infants most affected.
Conclusions:
- Medical professional reporting leading to infant investigations has significantly increased over the past decade.
- Persistent and notable racial inequities exist in these investigations.
- The findings highlight the need for targeted interventions to address disparities in child welfare reporting.
Background:
Medical professionals are key components of child maltreatment surveillance. Updated estimates of reporting rates by medical professionals are needed.
Methods:
We use the National Child Abuse and Neglect Data System (2000-2019) to estimate rates of child welfare investigations of infants stemming from medical professional reporting to child welfare agencies. We adjust for missing data and join records to population data to compute race/ethnicity-specific rates of infant exposure to child welfare investigations at the state-year level, including sub-analyses related to pregnant/parenting people's substance use.
Results:
Between 2010 and 2019, child welfare investigated 2.8 million infants; ∼26% (n=731,705) stemmed from medical professionals' reports. Population-adjusted rates of these investigations stemming doubled between 2010 and 2019 (13.1-27.1 per 1000 infants). Rates of investigations stemming from medical professionals' reports increased faster than did rates for other mandated reporters, such as teachers and police, whose reporting remained relatively stable. In 2019, child welfare investigated ∼1 in 18 Black (5.4%), 1 in 31 Indigenous (3.2%), and 1 in 41 White infants (2.5%) following medical professionals' reports. Relative increases were similar across racial groups, but absolute increases differed, with 1.3% more of White, 1.7% of Indigenous, and 3.1% of Black infants investigated in 2019 than 2010. Investigations related to substance use comprised ∼35% of these investigations; in some states, this was almost 80%.
Discussion:
Rates of child welfare investigations of infants stemming from medical professional reports have increased dramatically over the past decade with persistent and notable racial inequities in these investigations.
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