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Foster Care and Child Maltreatment Mortality Rates in the US
Frank Edwards1, Kelley Fong2, Robert Apel1
1School of Criminal Justice, Rutgers University-Newark, Newark, New Jersey.
Insights
Child maltreatment deaths remain high, with no evidence that increased foster care entry rates reduce child abuse fatalities. This study found no negative association between foster care rates and child maltreatment mortality.
Area of Science:
- Child Welfare
- Pediatric Health
- Public Health Policy
Background:
- Child abuse and neglect result in approximately 2000 deaths annually.
- Foster care aims to protect children but its impact on mortality is unclear.
Purpose of the Study:
- To investigate the association between foster care entry rates and child maltreatment mortality rates.
Main Methods:
- Cross-sectional analysis of US state-level administrative data from 2010-2023.
- Examined 3.4 million foster care records and 24,108 child maltreatment fatalities.
- Assessed state-year rates of foster care entry and child maltreatment deaths.
Main Results:
- No negative association was found between foster care entry rates and child maltreatment mortality rates (β=0.17).
- Higher foster care entry rates did not correlate with decreased child abuse fatalities.
- Child maltreatment mortality rates did not decrease as foster care entry rates increased.
Conclusions:
- The study suggests no significant negative association between foster care entry rates and child maltreatment mortality.
- Findings indicate foster care entry rates do not appear to reduce child abuse and neglect deaths.
- Further research is needed to understand effective interventions for child maltreatment mortality.
Importance:
Approximately 2000 children die each year of child abuse and/or neglect. Foster care is designed as a targeted intervention to reduce harm to children, but its association with child maltreatment mortality is not well understood.
Objective:
To examine whether foster care entry rates are negatively associated with rates of child mortality due to child abuse and/or neglect.
Design, Setting, And Participants:
This cross-sectional study assessed associations between child maltreatment mortality rates and foster care entry rates at the state level using administrative data from all US states from January 1, 2010, to December 31, 2023 (N = 700 state-years). Administrative records on all children in state-supervised foster care and all children whose death was attributed by child welfare agencies to child maltreatment were assessed.
Exposures:
Number of children entering foster care per 1000 child population.
Main Outcomes And Measures:
Number of child fatalities due to child abuse and/or neglect per 100 000 child population.
Results:
The study analyzed 3.4 million records of children in state-supervised foster care from 2010 to 2023 and 24 108 child fatalities that states attributed to child abuse and/or neglect. In 2023, states reported a mean (SD) of 2.62 (1.85) deaths per 100 000 child population and reported a mean (SD) of 3.21 (1.75) entries into foster care per 1000 child population. No evidence was found of a negative association between state-year level foster care entry rates and state-year-level child maltreatment mortality rates (β = 0.17; 95% CI, 0.01-0.34).
Conclusions And Relevance:
In this cross-sectional study, child maltreatment mortality rates did not appear to decrease with higher foster care entry rates or increase with decreasing foster care entry rates. This evidence suggests that there is not a negative association between child maltreatment mortality rates and foster care entry rates.
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