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Family-level social determinants of child and adolescent maltreatment

Julia Kobulsky1, June-Yung Kim2, Brittany Schuler1

  • 1Temple University, College of Public Health, School of Social Work, 1301 W. Cecil B. Moore, Philadelphia, PA 19122, United States of America.

Child Abuse & Neglect
|December 12, 2025
PubMed

Insights

Child maltreatment (CM) prevention requires addressing interconnected social risks. Poverty, homelessness, substance use, and externalizing behaviors predict official reports of CM, but not self-reports.

Area of Science:

  • Child development and public health research.
  • Social determinants of health.
  • Child maltreatment (CM) and its prevention.

Background:

  • Child maltreatment (CM) is influenced by material, psychosocial, biologic, and behavioral risk factors, alongside healthcare access.
  • Existing research has not fully explored the interplay of these social risks in relation to child and adolescent CM, hindering the development of effective prevention strategies.

Purpose of the Study:

  • To apply the World Health Organization's intermediary social determinants of health (I-SDH) framework to create a comprehensive model of family-level risk and protective factors.
  • To prospectively examine the relationship between these multidimensional family factors and the occurrence of CM in childhood and adolescence.

Main Methods:

  • Utilized data from the Longitudinal Studies for Child Abuse and Neglect (N=1354).
  • Measured CM types (physical, supervisory neglect) during middle childhood (7-12 years) and adolescence (13-16 years) using Child Protective Services (CPS) reports and youth self-reports.
  • Regressed CM occurrences on family-level I-SDH domains assessed during early (0-6 years) and middle childhood.

Main Results:

  • Unadjusted analyses showed all I-SDH domains related to CM.
  • Post-False Discovery Rate (FDR) adjustment, poverty and homelessness/eviction were linked to CPS-reported physical and supervisory neglect in middle childhood.
  • Child externalizing problems and household substance use were associated with CPS-reported CM in both middle childhood and adolescence.
  • No significant associations were found between I-SDH and self-reported CM after FDR adjustment.

Conclusions:

  • Findings underscore the necessity for multifaceted interventions and policies targeting I-SDH to prevent involvement with Child Protective Services (CPS).
  • The lack of association with self-reported CM raises questions about the broader impact of I-SDH-focused strategies and suggests potential biases in CPS reporting.
  • Future research should differentiate between CM measures and their antecedents to better inform prevention efforts.
Abstract

Keywords:
Access to healthcareChild behavioral problemsChild maltreatmentDepressionFood insecurityHousing instabilityIntimate partner violencePovertySocial determinantsSocial supportSubstance use

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