Impoverishment and child maltreatment in African American and European American neighborhoods

Race, Poverty, and Foster Care Placement in the United States: Longitudinal and Cross-Sectional Perspectives

Although the connections between race, poverty, and foster care placement seem obvious, the link has not in fact been studied extensively. To address this gap, we view poverty and placement through longitudinal and cross-sectional lenses to more accurately capture how changes in poverty rates relate to changes in placement frequency. The longitudinal study examines the relationship between poverty rate changes and changes in the placement of Black and White children between 2000 and 2015. The cross-sectional study extends the longitudinal analysis by using a richer measure of socio-ecological diversity and more recent foster care data. Using Poisson regression models, we assess the extent to which changes in race-differentiated child poverty rates are correlated with Black and White child placement frequencies and placement disparities. Regardless of whether one looks longitudinally or cross-sectionally, we find that Black children are placed in foster care more often than White children. Higher White child poverty rates are associated with substantially reduced placement differences; however, higher Black child poverty rates are associated with relatively small changes in placement disparity. Black and White child placement rates are more similar in counties with the fewest socio-ecological assets.

Geography of mobility and parenting behavior in low income families

BACKGROUND

The geographic location of birth has implications for low-income children's upward economic mobility, as Chetty, Hendren, Kline, and Saez (2014) found in an examination of millions of income tax records from each county in the US. Additional work indicates that low income children in higher economic mobility counties have higher language scores and fewer behavioral problems (Donnelly et al., 2017). However, the processes by which the geography of opportunity influences parenting are less well-understood.

OBJECTIVE

This study examines whether living in higher intergenerational mobility counties is associated with less harsh parenting, material hardship, household violence and substance use, and low child supervision - parenting behaviors that increase the risk for child maltreatment - for low-income families.

DATA

Data come from the Fragile Families and Child Wellbeing Study, a longitudinal birth cohort of low income families in 20 cities in the U.S (N ~, 2841; 76% lower (household income of $41,994 or less) and 24% higher-income) linked to county level data on intergenerational mobility from the Equality of Opportunity Project.

METHODS

We estimate OLS and Linear Probability regressions of the association between (1) exposure to county-level intergenerational mobility and (2) number of waves of exposure to county intergenerational mobility 1 standard deviation above the mean and maternal parenting behaviors.

RESULTS

A 1 standard deviation increase in county level intergenerational mobility is associated with decreases in harsh parenting, but not indicators of neglect. Longer exposure to high intergenerational mobility areas was associated with decreased maternal harsh parenting and risk for child maltreatment.

CONCLUSIONS

For low-income children, higher intergenerational mobility is associated with decreased risk of harsh parenting, particularly at younger ages, as is longer exposure to high intergenerational mobility areas. That lower-income families are less likely to live in economically mobile geographies may exacerbate inequalities among income groups.

Social Cohesion and Informal Social Control as Mediators Between Neighborhood Poverty and Child Maltreatment

Neighborhoods have profound impacts on children and families. Using structural equation modeling and data from 4,898 children in the Fragile Families and Child Wellbeing Study, the current study examines the direct and indirect effects of neighborhood poverty on the likelihood of being maltreated at age 5. Two neighborhood social processes, social cohesion and informal social control, were examined as mediators. The study found that neighborhood poverty was indirectly related to physical assault and psychological aggression through its impact on social cohesion, and indirectly related to neglect through its impact on informal social control. The results highlight the need to reduce poverty across communities and increase social cohesion and social control as potential pathways for interrupting the impact of neighborhood poverty on maltreatment.

Delineating the developmental sequelae of children's risky involvement in interparental conflict

The present study examined the developmental value of parsing different forms of children's risky involvement in interparental conflict as predictors of children's subsequent psychological adjustment. Participants included a diverse sample of 243 preschool children (M_age = 4.6 years) and their mothers across two measurement occasions spaced 2 years apart. Three forms of risky involvement (i.e., cautious, caregiving, and coercive) were identified using maternal narratives describing children's emotional and behavioral reactivity during and immediately following interparental conflict. Utilizing a multimethod, multi-informant design, findings revealed that each form of involvement prospectively predicted unique configurations of children's developmental outcomes. Greater coercive involvement was associated with higher levels of externalizing problems, callous and unemotional traits, and extraversion. Higher levels of caregiving involvement were linked with greater separation anxiety. Finally, cautious involvement predicted more separation anxiety and social withdrawal.

The Effect of Home Foreclosures on Child Maltreatment Rates: A Longitudinal Examination of Neighborhoods in Cleveland, Ohio

Foreclosure rates have been linked to increased levels of neighborhood stress. Neighborhood stressors can impact a number of interpersonal and familial dynamics, including child maltreatment. Despite this, little research has examined the relationship between neighborhood foreclosure rates and aggregate trends in child maltreatment. Using substantiated child maltreatment cases, foreclosure, and census data at the neighborhood level in Cleveland, Ohio we find that home foreclosures are a significant predictor of neighborhood rates of child maltreatment. Importantly, this effect is durable and is not impacted by the housing crisis. Furthermore, this is a direct effect and is not shaped by other neighborhood conditions like poverty, as found in prior research. From a policy perspective, this suggests that policy makers need to be cognizant of the effect of foreclosures on child maltreatment regardless of the historical and economic contexts of the neighborhood.

How does neighborhood affect child maltreatment among immigrant families?

BACKGROUND

Child maltreatment in immigrant families is understudied, although research suggests that they are at higher risk of child abuse and neglect. While the limited studies on the etiology of child maltreatment among immigrant families have mainly focused on children and their caregivers, this study breaks new ground by examining the neighborhood as an environmental context for child maltreatment among immigrant families.

METHODS

Following social disorganization theory, this study explores the mechanisms by which neighborhood structural characteristics and social processes affect the maltreatment of children in immigrant families, using the Fragile Families and Child Wellbeing Study (N = 372).

RESULTS

Structural equation modeling revealed that negative neighborhood structural characteristics were positively associated with higher physical assault (β = 0.42, p < .001), higher psychological aggression (β = 0.29, p < .001), and higher neglect (β = 0.19, p < .001) among immigrant families. Conversely, positive neighborhood social processes were associated with lower physical assault (β = -0.37, p < .001) and lower psychological aggression (β = -0.31, p < .001) among immigrant families. In addition, neighborhood social processes mediated the relationship between neighborhood structural characteristics and child physical assault (β = -0.09, p < .001) among immigrant families.

CONCLUSIONS

The findings of this study highlighted the positive role of neighborhood social processes in reducing child physical assault among immigrant families, even in neighborhoods with negative structural characteristics.

Rural Child Maltreatment: A Scoping Literature Review

TOPIC OF REVIEW

The current study sought to review the state of existing knowledge on rural maltreatment.

METHOD OF REVIEW

We conducted a scoping literature review to answer two research questions: (1) Is maltreatment higher in rural areas compared to urban areas? and 2) Are there unique correlates of maltreatment in rural areas?

NUMBER OF RESEARCH STUDIES MEETING THE CRITERIA FOR REVIEW

This review included studies that compared child maltreatment in rural and urban areas in the United States (9) and predictors of maltreatment in rural areas (7).

CRITERIA FOR INCLUSION

Studies that compared child maltreatment in rural and urban areas in the United States were included. For our second research question, related to understanding maltreatment in rural areas, we included those studies that exclusively examined rural areas, when maltreatment was the outcome variable.

HOW RESEARCH STUDIES WERE IDENTIFIED

Studies were reviewed from relevant databases (Annual Reviews, PsychINFO, PubMed, Web of Science) between 1975 and 2019.

MAJOR FINDINGS

Findings were mixed on whether rates of maltreatment were higher or lower in rural areas. While five studies reported higher rates of maltreatment in rural areas, four reported higher rates in urban areas. Overall, child maltreatment rates tended to be higher in urban areas among people of color and higher in rural areas among White people. One study found that community economic factors were not related to maltreatment in a rural area, in stark contrast to robust findings from urban areas.

Older Neighbors and The Neighborhood Context of Child Well-Being: Pathways to Enhancing Social Capital for Children

Drawing on Coleman's concept of social capital, researchers have investigated how the quality of neighborhood social networks influences child development and well-being. The role of non-kin older neighbors in advancing child well-being through the enhancement of social capital, however, has been under-studied. Our objective was to delineate specific pathways through which non-kin older neighbors contribute to neighborhood quality for children and families and potentially advance child well-being. We examined open-ended interview data from 400 parents who cared for at least one child under 18 years of age and resided in 20 neighborhoods in Cleveland, Ohio. A subsample of 113 parents connected older neighbors to neighborhood quality for families and children in their narratives. Our analysis identified three primary pathways through which parents positively linked older neighbors to neighborhood quality: older neighbors support parents and children, promote neighborhood safety, and contribute to neighborhood residential stability. These contributions are evidence of intergenerational closure, reciprocated exchange, and informal social control working together to create social capital in neighborhoods for children. It is by enhancing social capital that older neighbors potentially improve child well-being. We discuss the implications of our findings for neighborhood research and practice.

A spatiotemporal analysis of the impact of COVID-19 on child abuse and neglect in the city of Los Angeles, California

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) has created an urgent need to identify child abuse and neglect (CAN) and efficiently allocate resources to improve the coordination of responses during a public health crisis.

OBJECTIVE

To provide unique insights into the spatial and temporal distribution of CAN in relation to COVID-19 outcomes and identify areas where CAN has increased or decreased during the pandemic.

PARTICIPANTS

Children under 18 years old reported to the Los Angeles Police Department for CAN.

SETTING

CAN incidents in the city of Los Angeles.

METHODS

Negative binomial regression was used to explore associations between the implementation of social distancing protocols and reported CAN during COVID-19. Spatiotemporal analysis identified locations of emerging hot and cold spots during the pandemic. Associations between neighborhood structural factors (e.g., school absenteeism, poverty, unemployment, housing insecurity and birth assets) and hot and cold spot patterns were explored.

RESULTS

There was a statistically significant decline in reports of CAN during the COVID-19 pandemic but no significant trends following the implementation of social distancing measures (e.g. safer at home orders, school closures). Compared to consecutive cold spots, severe housing burden, the number of assets children have at birth, poverty, school absenteeism and labor force participation were significantly associated with new and intensifying hotspots of CAN during the COVID-19 pandemic.

CONCLUSIONS

Our findings reinforce the utility of developing intervention strategies that minimize harm to children by targeting resources to specific challenges facing families enduring the COVID-19 experience.

Social determinants of health and child maltreatment: a systematic review

BACKGROUND

Child maltreatment causes substantial numbers of injuries and deaths, but not enough is known about social determinants of health (SDH) as risk factors. The aim of this study was to conduct a systematic review of the association of SDH with child maltreatment.

METHODS

Five data sources (PubMed, Web of Science Core Collection, SCOPUS, JSTORE, and the Social Intervention Research and Evaluation Network Evidence Library) were searched for studies examining the following SDH: poverty, parental educational attainment, housing instability, food insecurity, uninsurance, access to healthcare, and transportation. Studies were selected and coded using the PICOS statement.

RESULTS

The search identified 3441 studies; 33 were included in the final database. All SDH categories were significantly associated with child maltreatment, except that there were no studies on transportation or healthcare. The greatest number of studies were found for poverty (n = 29), followed by housing instability (13), parental educational attainment (8), food insecurity (1), and uninsurance (1).

CONCLUSIONS

SDH, including poverty, parental educational attainment, housing instability, food insecurity, and uninsurance, are associated with child maltreatment. These findings suggest an urgent priority should be routinely screening families for SDH, with referrals to appropriate services, a process that could have the potential to prevent both child maltreatment and subsequent recidivism.

IMPACT

SDH, including poverty, parental educational attainment, housing instability, food insecurity, and uninsurance, are associated with child maltreatment. No prior published systematic review, to our knowledge, has examined the spectrum of SDH with respect to their associations with child maltreatment. These findings suggest an urgent priority should be routinely screening families for SDH, with referrals to appropriate services, a process that could have the potential to prevent both child maltreatment and subsequent recidivism.

Social determinants of health, personalized medicine, and child maltreatment

This review begins with a brief summary of the importance of child maltreatment as a major public health problem, given its prevalence and the substantial human and economic costs involved. The focus then shifts to consideration of personalized medicine and child maltreatment, including genetic and genomics factors, as well as the role of social determinants of health. Research on epigenetics related to child abuse and neglect is presented, followed by that pertaining to a few specific social factors, such as poverty, parental depression and substance use, and domestic (or intimate partner) violence. The review ends with a discussion of interventions to help address social determinants of health with brief descriptions of several model programs, and thoughts concerning the role of personalized medicine in addressing child maltreatment in the foreseeable future. IMPACT: This paper synthesizes knowledge on social determinants of health and advances in genetics and genomics related to the prevention of child maltreatment. It provides examples of model approaches to addressing the prevention of child maltreatment in primary care practices.

Variability and stability in child maltreatment risk across time and space and its association with neighborhood social & housing vulnerability in New Mexico: A bayesian space-time model

BACKGROUND

Modeling the spatio-temporal characteristics of substantiated child maltreatment risk has significant implications for child welfare policy.

OBJECTIVE

This study quantifies the spatiotemporal risk of child abuse and neglect in New Mexico at the census tract level over 9 years, identifies areas of increased risk, and evaluates the role of multiple measures of social and housing insecurity on substantiated child maltreatment referrals.

PARTICIPANTS AND SETTING

Child maltreatment substantiation data across 499 census tracts from 2007 to 2015 were obtained from the New Mexico Department of Public Health.

METHODS

Substantiated referral counts were analyzed within census tracts with Bayesian hierarchical space-time models using Laplace approximation. Standardized incidence ratios, spatial risk, and probability exceedances were calculated and mapped.

RESULTS

Multiple neighborhood structural factors were associated with an increased risk of substantiated child maltreatment, including the eviction rate (Incidence Density Ratio [IDR] = 1.09 [95 % CrI = 1.01-1.12]), rent burden (IDR = 1.11 [95 % CrI = 1.01-1.13]), urban tracts (IDR = 1.36 [95 % CrI = 1.05-1.77]), food desert tracts (IDR = 1.21 [95 % CrI = 1.04-1.41]), low income tracts (IDR = 1.27 [95 % CrI = 1.09-1.49]), percent of households with no vehicle access ([IDR] = 1.27 [95 % CrI = .247-6.47]), and percent of persons with a disability (IDR = 1.05 [95 % CrI = 1.03-1.06]). The racial/ethnic diversity ratio, however, was associated with lower incidence of child maltreatment allegation risk (IDR = .988 [95 % CrI = .982-.995]).

CONCLUSIONS

Population-based child abuse and neglect prevention and intervention efforts should be aided by the characteristics of neighborhoods that demonstrate strong spatial patterns of household and housing vulnerability, particularly in low income, racially segregated neighborhoods.

Examining Spatial Regimes of Child Maltreatment Allegations in a Social Vulnerability Framework

The present research examines child maltreatment allegations (CMAs) in San Diego County, California, exploring spatial patterns of Child Protective Services involvement and multiple, multidimensional measures of neighborhood social vulnerability. Results showed significant patterns of spatial clustering (i.e., hot and cold spots) of CMAs across the county (Moran's I = .316, p < .001). A geographically weighted regression (GWR) was implemented to examine the relationship between CMAs and social vulnerability at the census-tract level, thereby overcoming the deficiencies of global models. Nonstationarity was detected across four indices of vulnerability (socioeconomic status, race/ethnicity, household composition, and health vulnerability) as well as proximity to on-premise alcohol outlets, percentage of residents in each census tract affected by food deserts, and population density, in some cases showing countervailing effects depending on spatial location. A hierarchical clustering was performed on the GWR coefficients to identify spatial regimes, or clusters, across the county. The results yielded six spatial regimes of social vulnerability differentially related to CMA rates. The present study demonstrates the novelty of GWR in combination with a hierarchical cluster analysis for exploring how local contextual processes influence child maltreatment reporting rates across the county.

The Geography of Child Maltreatment: A Spatiotemporal Analysis Using Bayesian Hierarchical Analysis With Integrated Nested Laplace Approximation

This study quantifies the spatiotemporal risk of child abuse and neglect in Los Angeles at the census tract level over a recent 4-year period, identifies areas of increased risk, and evaluates the role of structural disadvantage in substantiated child maltreatment referrals. Child maltreatment data on 83,379 child maltreatment cases in 1,678 census tracts spanning 2006-2009 were obtained from the Los Angeles County Department of Children and Family Services. Substantiated referral counts were analyzed across census tracts with Bayesian hierarchical spatial models using integrated nested Laplace approximations. Results showed that the unadjusted yearly rate of child abuse and neglect held fairly steady over the study period decreasing by only 2.57%. However, the temporal term in the spatiotemporal model reflected a downward trend beginning in 2007. High rates of abuse and neglect were predicted by several neighborhood-level measures of structural burden. Every 1-unit decrease in the social vulnerability index reduced the risk of child abuse and neglect by 98.3% (95% CrI = 1.869-2.1042) while every 1-unit increase in the Black-White dissimilarity index decreased child abuse and neglect risk by 70.6%. The interaction of these variables demonstrated the protective effect of racial heterogeneity in socially vulnerable neighborhoods. No such effect was found in neighborhoods characterized by low levels of vulnerability. Population-based child abuse and neglect prevention and intervention efforts should be aided by the characteristics of neighborhoods that demonstrate strong spatial patterns even after accounting for the role of race and place.

Community-level social capital, parental psychological distress, and child physical abuse: a multilevel mediation analysis

PURPOSE

The purpose of this study was to investigate the association between community-level social capital and physical abuse towards children, and the mediating effect of parental psychological distress by multilevel mediation analyses.

METHODS

We analyzed data from a population-based study of first-grade elementary school children (6-7 years old) in Adachi City, Tokyo, Japan. The caregivers of first-grade students from all elementary schools in Adachi City (N = 5355) were asked to respond to a questionnaire assessing parents' self-reported physical abuse (beating and hitting) and neighborhood social capital. Among them, 4291 parents returned valid responses (response rate 80.1%). We performed multilevel analyses to determine the relationships between community-level parental social capital and physical abuse, and further multilevel mediation analyses were performed to determine whether parental psychological distress mediated the association.

RESULTS

Low community-level social capital was positively associated with physical abuse (both beating and hitting) after adjustment for other individual covariates (beating: middle, OR = 1.54, 95% CI 1.11-2.13; low, OR = 1.33, 95% CI 0.94-1.88; and hitting: middle, OR = 1.35, 95% CI 1.02-1.80; low, OR = 1.16, 95% CI 0.86-1.57). Multilevel mediation analyses revealed that community-level parental psychological distress did not mediate the association (indirect effect ß = 0.10, 95% CI - 0.10 to 0.29, p = 0.34 for beating; ß = 0.03, 95% CI - 0.16 to 0.23, p = 0.74 for hitting).

CONCLUSIONS

Fostering community-level social capital might be important for developing a strategy to prevent child maltreatment, which may have a direct impact on abusive behavior towards children.

First-time maltreatment in children ages 2-10 with and without specific birth defects: A population-based study

Children with disabilities are at an increased risk for maltreatment. However, little is known about the risk of maltreatment in children with specific types of birth defects. This study was conducted to determine whether the risk and predictors of maltreatment in children 2 to 10 years of age differ between those without and with specific birth defects: Down syndrome, cleft lip with/without cleft palate, and spina bifida. State administrative and United States Census data were linked to identify study groups, variables of interest, and outcome measures. Kaplan-Meier and multivariate Cox proportional hazard analyses were used to identify study groups and variables associated with an increased risk for maltreatment. The prevalence of substantiated maltreatment was consistently highest among children with cleft lip with/without cleft palate. After adjusting for birth-level factors, children with Down syndrome and cleft lip with/without cleft palate were 34% and 26% more likely to have been maltreated than those without birth defects, respectively. In all three birth defect groups, the risk of medical neglect was higher (relative risks ranged from 3 to 11) than in the unaffected group. The factors associated with increased risk for maltreatment were similar across all groups. Of note, parity, maternal education, and maternal Medicaid use at birth were all associated with greater than 2-fold increased risk for maltreatment. Our findings suggest that the families of children with birth defects may need support services throughout early childhood to help families cope with the needs of their children and reduce the risk of maltreatment.

How might neighborhood built environment influence child maltreatment? Caregiver perceptions

RATIONALE

Child maltreatment remains a serious but potentially preventable public health concern in the United States. Although research has examined factors associated with child maltreatment at the neighborhood level, few studies have explicitly focused on the role of the neighborhood built environment in maltreatment.

OBJECTIVE

We begin to address these gaps by investigating caregivers' own perceptions of mechanisms by which neighborhood built environments may affect child maltreatment.

METHOD

Utilizing a grounded theory approach, we examined open-ended interview data from 400 adult residents residing in 20 different Cleveland, Ohio neighborhoods (census tracts) and caring for at least one child under 18 years of age.

RESULTS

Our analysis revealed three primary pathways through which caregivers linked the neighborhood built environment to potential child maltreatment: housing density, physical neighborhood space as shaping family relations, and the internalization of the surrounding neighborhood-built environment.

CONCLUSIONS

Our findings suggest that aspects of the neighborhood built environment, such as the presence of abandoned houses or the lack of recreational centers, can be stressors themselves and may also critically alter families' thresholds for navigating other everyday pressures. Conversely, aspects of the neighborhood built environment, such as housing density, may work to mitigate the risk of maltreatment, either by promoting social support or by increasing the likelihood that maltreatment is reported to authorities. Additional research, both qualitative and quantitative, is integral to building and testing models of these separate but related pathways by which the neighborhood built environment may link to child maltreatment.

A Secondary Spatial Analysis of Gun Violence near Boston Schools: a Public Health Approach

School neighborhood violence continues to be a major public health problem among urban students. A large body of research addresses violence at school; however, fewer studies have explored concentrations of violence in areas proximal to schools. This study aimed to quantify the concentration of shootings near schools to elucidate the place-based dynamics that may be focal points for violence prevention. Geocoded databases of shooting and school locations were used to examine locational patterns of firearm shootings and elementary, middle, and high schools in Boston, Massachusetts. Analyses utilized spatial statistics for point pattern data including distance matrix and K function methodology to quantify the degree of spatial dependence of shootings around schools. Results suggested that between 2012 and 2015, there were 678 shooting incidents in Boston; the average density was 5.1 per square kilometer. The nearest neighbor index (NNI = 0.335 km, p < .001, O = 0.95 km, E = 0.28 km) and G function analysis revealed a clustered pattern of gun shooting incidents indicative of a spatially non-random process. The mean and median distance from any school to the nearest shooting location was 0.35 and 0.33 km, respectively. A majority (56%, 74/133) of schools in Boston had at least one shooting incident within 400 m, a distance that would take about 5 min to walk if traveling by foot. The bivariate K function indicated that a significantly greater number of shootings were clustered within short distances from schools than would be expected under a null hypothesis of no spatial dependence. Implications for students attending schools in racially homogenous neighborhoods across all income levels are discussed.

The relationship between childhood trauma and alcohol use initiation in Black and White adolescent girls: considering socioeconomic status and neighborhood factors

PURPOSE

To assess whether the higher prevalence of childhood trauma exposure but lower prevalence of alcohol use in Black vs. White adolescent girls reflects a lower magnitude of association between trauma and alcohol use initiation in Black girls; and additionally, whether low socioeconomic status (SES) and neighborhood factors account in part for the link between trauma and early alcohol use.

METHODS

Data were drawn from annual interviews conducted with an urban sample of girls and their primary caregivers from ages 5-8 (baseline) through age 17 (n = 2068, 57.7% Black, 42.3% White). Cox proportional hazards regression analyses using race and childhood trauma to predict alcohol use initiation were conducted in two stages, with SES and neighborhood factors added in the second stage.

RESULTS

Childhood trauma was more prevalent (29.0 vs. 17.5%) and alcohol use initiation less prevalent (37.7 vs. 54.4%) in Black vs. White girls, but we found no evidence for differences in liability conferred by trauma. However, significant changes in hazards ratios (HRs) from the unadjusted to adjusted models were observed for Black race (HR = 0.57, CI 0.50-0.65 to HR = 0.66, CI 0.54-0.80) and childhood trauma (HR = 1.70, CI 1.46-1.99 to HR = 1.34, CI 1.05-1.71).

CONCLUSIONS

Findings indicate that childhood trauma is an equally potent risk factor for early drinking onset for Black and White girls; the risk for early alcohol use in Black girls who have experienced traumatic events should not be underestimated. Results further indicate that low SES and neighborhood factors contribute to the associations of childhood trauma and race with alcohol use initiation.

Mapping child maltreatment risk: a 12-year spatio-temporal analysis of neighborhood influences

Background

‘Place’ matters in understanding prevalence variations and inequalities in child maltreatment risk. However, most studies examining ecological variations in child maltreatment risk fail to take into account the implications of the spatial and temporal dimensions of neighborhoods. In this study, we conduct a high-resolution small-area study to analyze the influence of neighborhood characteristics on the spatio-temporal epidemiology of child maltreatment risk.

Methods

We conducted a 12-year (2004–2015) small-area Bayesian spatio-temporal epidemiological study with all families with child maltreatment protection measures in the city of Valencia, Spain. As neighborhood units, we used 552 census block groups. Cases were geocoded using the family address. Neighborhood-level characteristics analyzed included three indicators of neighborhood disadvantage—neighborhood economic status, neighborhood education level, and levels of policing activity—, immigrant concentration, and residential instability. Bayesian spatio-temporal modelling and disease mapping methods were used to provide area-specific risk estimations.

Results

Results from a spatio-temporal autoregressive model showed that neighborhoods with low levels of economic and educational status, with high levels of policing activity, and high immigrant concentration had higher levels of substantiated child maltreatment risk. Disease mapping methods were used to analyze areas of excess risk. Results showed chronic spatial patterns of high child maltreatment risk during the years analyzed, as well as stability over time in areas of low risk. Areas with increased or decreased child maltreatment risk over the years were also observed.

Conclusions

A spatio-temporal epidemiological approach to study the geographical patterns, trends over time, and the contextual determinants of child maltreatment risk can provide a useful method to inform policy and action. This method can offer a more accurate description of the problem, and help to inform more localized prevention and intervention strategies. This new approach can also contribute to an improved epidemiological surveillance system to detect ecological variations in risk, and to assess the effectiveness of the initiatives to reduce this risk.

The Cultural Adaptation of a Community-Based Child Maltreatment Prevention Initiative

A unique primary prevention effort, Strong Communities for Children (Strong Communities), focuses on changing attitudes and expectations regarding communities' collective responsibilities for the safety of children. Findings from a 6-year pilot of the initiative in South Carolina have shown promise in reducing child maltreatment, but efforts to adapt the initiative to different cultural contexts have been lacking. No models exist for adapting an initiative that takes a community-level approach to ensuring children's safety. Thus, this article addresses the gap by providing an overview of the original initiative, how the initiative was adapted to the Israeli context, and lessons learned from the experience. Building on conceptualizations of cultural adaptation by Castro et al. (Prevention Science, 5, 2004, 41) and Resnicow et al. (Ethnicity and Disease, 9, 1999, 11), sources of nonfit (i.e., sociodemographic traits, political conflict, government services, and the presence and role of community organizations) were identified and deep and surface structure modifications were made to the content and delivery. Ultimately, this article describes the adaption and dissemination of a community-based child maltreatment prevention initiative in Tel Aviv, Israel, and addresses researchers' calls for more publications describing the adaptation of interventions and the procedures that need to be implemented to achieve cultural relevance.

Community Poverty and Child Abuse Fatalities in the United States

BACKGROUND AND OBJECTIVE

Child maltreatment remains a problem in the United States, and individual poverty is a recognized risk factor for abuse. Children in impoverished communities are at risk for negative health outcomes, but the relationship of community poverty to child abuse fatalities is not known. Our objective was to evaluate the association between county poverty concentration and rates of fatal child abuse.

METHODS

This was a retrospective, cross-sectional analysis of child abuse fatalities in US children 0 to 4 years of age from 1999 to 2014 by using the Centers for Disease Control and Prevention Compressed Mortality Files. Population and poverty statistics were obtained from US Census data. National child abuse fatality rates were calculated for each category of community poverty concentration. Multivariate negative binomial regression modeling assessed the relationship between county poverty concentration and child abuse fatalities.

RESULTS

From 1999 to 2014, 11 149 children 0 to 4 years old died of child abuse; 45% (5053) were <1 year old, 56% (6283) were boys, and 58% (6480) were white. The overall rate of fatal child abuse was 3.5 per 100 000 children 0 to 4 years old. In the multivariate model, counties with the highest poverty concentration had >3 times the rate of child abuse fatalities compared with counties with the lowest poverty concentration (adjusted incidence rate ratio, 3.03; 95% confidence interval, 2.4-3.79).

CONCLUSIONS

Higher county poverty concentration is associated with increased rates of child abuse fatalities. This finding should inform public health officials in targeting high-risk areas for interventions and resources.

Environmental and individual attributes associated with child maltreatment resulting in hospitalization or death

Maltreatment continues to be a leading cause of death for young children. Researchers are beginning to uncover which neighborhood attributes may be associated with maltreatment outcomes. However, few studies have been able to explore these influences while controlling for individual family attributes, and none have been able to parse out the most severe outcomes-injuries resulting in hospitalization or death. This study utilizes a retrospective, case-control design on a dataset containing both individual and environmental level attributes of children who have been hospitalized or died due to maltreatment to explore the relative influence of attributes inside and outside the household walls. Binary conditional logistic regression was used to model the outcome as a function of the individual and environmental level predictors. Separate analyses also separated the outcome by manner of maltreatment: abuse or neglect. Finally, a sub-analysis included protective predictors representing access to supportive resources. Findings indicate that neighborhood attributes were similar for both cases and controls, except in the neglect only model, wherein impoverishment was associated with higher odds of serious maltreatment. Dense housing increased risk in all models except the neglect only model. In a sub-analysis, distance to Family Resource Centers was inversely related to serious maltreatment. In all models, variables representing more extreme intervention and/or removal of the victim and/or perpetrator from the home (foster care or criminal court involvement) were negatively associated with the risk of becoming a case. Medi-Cal insurance eligibility of a child was also negatively associated with becoming a case. Government interventions may be playing a critical role in child protection. More research is needed to ascertain how these interventions assert their influence.

Interactions with community members and institutions: Preventive pathways for child maltreatment

Parents interact with their environment in important ways that may impact their ability to parent their children positively. The current study uses data from the age 3 wave of the Fragile Families and Child Wellbeing study to investigate whether neighborhood processes and community participation relate to internal control, and whether these three variables are associated with child maltreatment behaviors. Using structural equation modeling, the direct and indirect effects of the environment (neighborhood disorder, social control, and social cohesion) and community participation on child maltreatment are tested. The mediating variable tested is internal control. The results show that neighborhood processes and community participation are associated with child neglect, physical child abuse, and psychological aggression but that these associations are driven through their effect on internal control.

Foster home placements and the probability of family reunification: Does licensing matter?

The concept of foster care has been widely studied in child welfare. The literature is well developed with regard to the risk of initial placement, length of stay in care, placement stability, exits to permanency, and emancipation. Yet, the literature is woefully underdeveloped when it comes to understanding if variations in the types and characteristics of foster homes impact important child welfare outcomes. The current study utilizes entry cohorts pulled from statewide administrative data (N=17,960) to investigate the association between types of foster care and the probability of reunification. We focus specifically on the licensing status of foster homes. Reflecting federal benchmarks, we examined the odds of reunification at one- and two-year intervals. Propensity score analysis was used to reduce selection bias. Adjusted logistic regression models revealed that youth placed in licensed relative care (LRC) homes were the least likely to achieve reunification compared with youth placed in licensed non-relative care (LNC) homes and unlicensed relative care (URC) homes. Conversely, youth placed in URC homes were more likely to achieve reunification as compared with youth placed in LRC and LNC homes. These findings will help states to efficiently target scarce resources to specific types of foster homes that may be impacting federal reunification benchmarks.

Mechanisms of change: Testing how preventative interventions impact psychological and physiological stress functioning in mothers in neglectful families

The present study applies a multilevel approach to an examination of the effect of two randomized preventive interventions with mothers in neglectful families who are also contending with elevated levels of impoverishment and ecological risk. Specifically, we examined how participation in either child-parent psychotherapy (CPP) or psychoeducational parenting intervention (PPI) was associated with reductions in maternal psychological parenting stress and in turn physiological stress system functioning when compared to mothers involved in standard community services as well as a demographic comparison group of nonmaltreating mothers. The resulting group sizes in the current investigation were 44 for CPP, 34 for PPI, 27 for community services, and 52 for nonmaltreating mothers. Mothers and their 13-month-old infants were randomly assigned to intervention group at baseline. Mothers completed assessments on stress within the parenting role at baseline and postintervention. Basal cortisol was sampled at postintervention and 1-year follow-up. Latent difference score analyses examined change in these constructs over time. Results suggested that mothers within the CPP intervention experienced significant declines in child-related parenting stress, while mothers in the PPI intervention reported declines in parent-related parenting stress. In turn, significant decreases in stress within the CPP mothers were further associated with adaptive basal cortisol functioning at 1-year postintervention. The results highlight the value of delineating how participation in preventive interventions aimed at ameliorating child maltreatment in neglectful families within the context of poverty may operate through improvements in psychological and physiological stress functioning. Findings are discussed with respect to the importance of multilevel assessments of intervention process and outcome.

Clarifying Associations between Childhood Adversity, Social Support, Behavioral Factors, and Mental Health, Health, and Well-Being in Adulthood: A Population-Based Study

Previous studies have shown that socio-demographic factors, childhood socioeconomic status (CSES), childhood traumatic experiences (CTEs), social support and behavioral factors are associated with health and well-being in adulthood. However, the relative importance of these factors for mental health, health, and well-being has not been studied. Moreover, the mechanisms by which CTEs affect mental health, health, and well-being in adulthood are not clear. Using data from a representative sample (n = 12,981) of the adult population in Tromsø, Norway, this study examines (i) the relative contribution of structural conditions (gender, age, CSES, psychological abuse, physical abuse, and substance abuse distress) to social support and behavioral factors in adulthood; (ii) the relative contribution of socio-demographic factors, CSES, CTEs, social support, and behavioral factors to three multi-item instruments of mental health (SCL-10), health (EQ-5D), and subjective well-being (SWLS) in adulthood; (iii) the impact of CTEs on mental health, health, and well-being in adulthood, and; (iv) the mediating role of adult social support and behavioral factors in these associations. Instrumental support (24.16%, p < 0.001) explained most of the variation in mental health, while gender (21.32%, p < 0.001) explained most of the variation in health, and emotional support (23.34%, p < 0.001) explained most of the variation in well-being. Psychological abuse was relatively more important for mental health (12.13%), health (7.01%), and well-being (9.09%), as compared to physical abuse, and substance abuse distress. The subjective assessment of childhood financial conditions was relatively more important for mental health (6.02%), health (10.60%), and well-being (20.60%), as compared to mother's and father's education. CTEs were relatively more important for mental health, while, CSES was relatively more important for health and well-being. Respondents exposed to all three types of CTEs had a more than two-fold increased risk of being mentally unhealthy (RR Total Effect = 2.75, 95% CI: 2.19-3.10), an 89% increased risk of being unhealthy (RR Total Effect = 1.89, 95% CI: 1.47-1.99), and a 42% increased risk of having a low level of well-being in adulthood (RR Total Effect = 1.42, 95% CI: 1.29-1.52). Social support and behavioral factors mediate 11-18% (p < 0.01) of these effects. The study advances the theoretical understanding of how CTEs influence adult mental health, health, and well-being.

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OBJECTIVES

The objectives of this study were to 1) map the geographic distribution of rates of children reported to Montreal child protective services by ethnocultural group (Black, other visible minorities, not from visible minorities) and 2) estimate the relative contribution of different territorial characteristics to the rates for those groups.

METHOD

The study covered the 505 Montreal-area census tracts for which complete data were available. The reporting rates by group (dependent variables) and various territorial characteristics such as poverty (independent variables) were mapped and subjected to multiple linear regression and geographically weighted regression. The results of the geographically weighted regression were then mapped.

RESULTS

The geographic distribution and reporting rates varied greatly by group, with the Black children having the highest rates. Although territorial characteristics explained 51% of variance for the children who were not members of visible minorities, they were clearly less effective in predicting rates in the case of Black children (18%) and other minorities (18%).

CONCLUSION

Already well-known territorial risk factors are at work in Montreal, but their influence is not equally strong in all census tracts nor, especially, in all ethnocultural groups. Therefore, when only the distribution and prediction of reports for all children as a whole are examined, important differences are underestimated. Access to and appropriateness of services offered to vulnerable families, including those of visible minorities, could, however, be improved with a better understanding of local dynamics.

Maltreatment of Children Under Age 2 With Specific Birth Defects: A Population-Based Study

BACKGROUND AND OBJECTIVES

Children with disabilities are at an increased risk for maltreatment. However, the risk of maltreatment is unknown for children with specific types of birth defects. This study was conducted to determine whether the risk and predictors of maltreatment differ between children with and without 3 birth defects: Down syndrome, cleft lip with/without cleft palate, and spina bifida.

METHODS

This population-based study of substantiated childhood maltreatment was conducted in Texas from 2002 to 2011. Linked data were used to describe the risk and types of maltreatment that occurred before age 2 years in children with and without specific birth defects. Poisson regression was used to identify predictors of maltreatment and assess differences in those predictors between children with and without these specific birth defects.

RESULTS

The risk of maltreatment (any type) in children with cleft lip with/without cleft palate and spina bifida was increased by 40% and 58%, respectively, compared with children with no birth defects. The risk of any maltreatment was similar between children with Down syndrome and unaffected children. Across birth defect groups, the risk of medical neglect was 3 to 6 times higher than in the unaffected group. Child-, family-, and neighborhood-level factors predicted maltreatment in children with and without birth defects.

CONCLUSIONS

The overall risk of substantiated maltreatment was significantly higher for some but not all birth defect groups. The factors associated with increased risk were similar across groups. Enhancement of existing maltreatment prevention and early intervention programs may be effective mechanisms to provide at-risk families additional support.

A multilevel prediction of physiological response to challenge: Interactions among child maltreatment, neighborhood crime, endothelial nitric oxide synthase gene (eNOS), and GABA(A) receptor subunit alpha-6 gene (GABRA6)

Physiological response to stress has been linked to a variety of healthy and pathological conditions. The current study conducted a multilevel examination of interactions among environmental toxins (i.e., neighborhood crime and child maltreatment) and specific genetic polymorphisms of the endothelial nitric oxide synthase gene (eNOS) and GABA(A) receptor subunit alpha-6 gene (GABRA6). One hundred eighty-six children were recruited at age 4. The presence or absence of child maltreatment as well as the amount of crime that occurred in their neighborhood during the previous year were determined at that time. At age 9, the children were brought to the lab, where their physiological response to a cognitive challenge (i.e., change in the amplitude of the respiratory sinus arrhythmia) was assessed and DNA samples were collected for subsequent genotyping. The results confirmed that complex Gene × Gene, Environment × Environment, and Gene × Environment interactions were associated with different patterns of respiratory sinus arrhythmia reactivity. The implications for future research and evidence-based intervention are discussed.

Understanding the Interplay Between Neighborhood Structural Factors, Social Processes, and Alcohol Outlets on Child Physical Abuse

This article seeks to understand the relative influence of neighborhood structural characteristics (e.g., disadvantage) and social processes (e.g., interactions between residents) on child physical abuse. Using multilevel modeling in a sample of 3,023 parents in 194 zip codes, structural characteristics of factor scores representing residential stability and foreign-born Latino males were negatively related to child physical abuse. High proportions of naturalized and Asian/Pacific Islander families were positively related to the frequency of physical abuse. Higher levels of neighborhood social disorder were related to more frequent physical abuse, while higher levels of collective efficacy were related to less frequent physical abuse. Programs designed to alleviate disorder and increase neighborly interactions may be effective at reducing physical abuse. By understanding the relative importance of the demographic characteristics of neighborhoods and the actions and interactions of residents within the neighborhoods, policy and practice can be tailored more effectively to prevent maltreatment.

Parenting and proximity to social services: Lessons from Los Angeles County in the community context of child neglect

Using a sample of 438 parents in Los Angeles County, CA, this study examines the role of proximity to social services in child neglect. In an extension of social disorganization theory, it seeks to understand the potential sources of support in neighborhoods for families. It uses ordinary least squares regression to examine driving distance from parents' residences to four types of services (child care, domestic violence, mental health/substance abuse, and poverty). The results show an association between proximity to mental health and substance abuse services and parents' self-reported neglectful behaviors. Additionally, higher levels of socioeconomic disadvantage (poverty, unemployment, and low education), having older children, respondents being male, and respondents being older parents are associated with higher levels of child neglect, while being white is associated with lower levels. Overall, the findings suggest a potentially protective role of geographic access to mental health and substance abuse services in child maltreatment. Additional research on the pathways through which proximity to services influences child neglect is needed.

Community characteristics, social service allocation, and child maltreatment reporting

This study expands research on the relationship between community (defined here as a locality) characteristics and child maltreatment. Research in this field is not new, but it is scarce. Our study is unique by examining changes between two periods rather than focusing on one point in time. Furthermore, our study examines structural conditions in small and medium size localities in Israel, a non-Western and non-Christian society. We compare our results with those from studies on inner-city and suburban neighborhoods in Western countries and earlier studies in Israel. We collected data on 169 Israeli localities, ranging from small ones (with as few as 1,500 residents) to medium size localities (i.e., towns) (with as many as 50,000 residents) in which approximately 34% of the Israeli child population resides. Our study tested four hypotheses: (1) Socioeconomic characteristics of the locality will be negatively correlated with the availability of social services; (2) Reported child maltreatment rates will be negatively correlated with the socioeconomic characteristics of the locality; (3) The availability of social services will be positively correlated with reported child maltreatment rates; and (4) Overall reported child maltreatment rates will be negatively correlated with the overall status of the localities. We have supported our second and third hypothesis in full, and partially supported our first and fourth hypothesis. In particular we have demonstrated that while demographics play a different role in Israel than in other countries in regard to child maltreatment, social, economic and cultural context are crucial for understating reported rates of child maltreatment.

Culture and context in understanding child maltreatment: Contributions of intersectionality and neighborhood-based research

In the early 1990s, the U.S. Advisory Board on Child Abuse and Neglect commissioned a series of reviews that appeared as the edited volume, Protecting Children from Abuse and Neglect (Melton & Barry, 1994). Using the 1994 review "Sociocultural Factors in Child Maltreatment" (Korbin, 1994) as a background, this article reconsiders culture and context in child maltreatment work. Since 1994, conditions promoting research and practice attention in this area include immigration-driven global increases in diverse, multicultural societies where different beliefs and practices meet (and clash); expanding purview of the human rights discourse to children; and the disproportionate and disparate representation of cultural, ethnic, and racial groups in child-welfare systems. Although research on child maltreatment has advanced in many ways over 20 years, the complexity of child maltreatment leaves many critical questions demanding further attention, culture and context among them. To help address these questions, we propose two approaches for future maltreatment research: intersectionality - the simultaneous examination of multiple identities (such as gender, race, and socioeconomic status) - as a framework for understanding the complexity of cultural factors; and neighborhood-based research as a means for understanding the context of child maltreatment from the perspective of an ecological framework.

Social disorganization and the profile of child welfare: Explaining child welfare activity by the community-level factors

This article addresses the question of the structure of local child welfare activities in light of community-level factors. It poses the following research questions: how are different community-level factors related to child welfare client structures in communities and what is the extent to which these factors explain structural differences? The applied theoretical framework is based on social disorganization and strain theories as well as human developmental approach. The data has been collected from two Finnish national databases and it consists of variables containing 257 Finnish municipalities. The method of analysis is multinomial logistic regression. The results suggest that the local child welfare structures are tied to social disorganization, policing and culture as well as to the intensity of control in the communities. In general, the more fragile the communal structures, the more last-resort child welfare there is in the community. Combining fragile communal structures with weak dependency ratio and high proportion of social workers, the more intense the level of child welfare statistics indicated. The results indicate that the theoretical framework for the application of child welfare activity analysis is justified, but they also suggest that it requires further development through both context-bound reflection and application.

Neighborhood alcohol outlet density and rates of child abuse and neglect: moderating effects of access to substance abuse services

This study investigates the relationship between concentrations of on- and off-premises alcohol outlets and rates of child abuse and neglect. Additionally, the study seeks to locate protective features of a neighborhood's built environment by investigating the potentially moderating role that access to substance abuse treatment and prevention services plays in the relationship between alcohol outlet density and child maltreatment. Using a cross-sectional design, this ecological study utilized data from 163 census tracts in Bergen County, New Jersey, on reports of child abuse and neglect, alcohol outlets, substance abuse treatment and prevention facilities, and the United States Census to investigate the linkages between socioeconomic structure, alcohol availability, and access to substance abuse service facilities on rates of child abuse and neglect. Findings indicate areas with a greater concentration of on-premises alcohol outlets (i.e., bars) had higher rates of child neglect, and those with easier access to substance abuse services had lower rates of neglect, controlling for neighborhood demographic and socioeconomic structure. Additionally, the relationship between on-premises alcohol outlet density and rates of child neglect was moderated by the presence of substance abuse service facilities. A greater concentration of off-premises outlets (i.e., liquor stores) was associated with lower rates of physical abuse. Findings suggest that the built environment and socioeconomic structure of neighborhoods have important consequences for child well-being. The implications for future research on the structural features of neighborhoods that are associated with child well-being are discussed.

The Moderating Effect of Substance Abuse Service Accessibility on the Relationship between Child Maltreatment and Neighborhood Alcohol Availability

This study investigates how the relationship between dense concentrations of alcohol retailers and high rates of child maltreatment may be moderated by the presence of substance abuse service facilities. Using a cross-sectional design, the study utilized data from Bergen County, New Jersey on child maltreatment reports, alcohol-selling retailers, substance abuse service facilities, and the United States Census. Findings indicate child maltreatment rates were higher in neighborhoods with lower socioeconomic status and those with greater alcohol outlet density. Neighborhoods with easily accessed substance abuse service facilities had lower rates of child maltreatment. Additionally, the relationship between child maltreatment and alcohol outlet density was moderated by the presence of substance abuse service facilities. The study findings highlight the relevance of making primary prevention approaches readily available and using multi-sector collaboration to reduce child maltreatment.

Barriers to caregiver involvement in a child safety intervention in South Africa

Injuries are a global threat to children’s health and are disproportionately prevalent in Sub-Saharan Africa. Despite the rates of childhood injuries, research into prevention and the community and family conditions required for such interventions have been largely under-researched. This article reviews international work highlighting caregiver involvement in the implementation of interventions in a number of sectors, including the health, education, and safety domains. This work, based largely on experiences in high-income countries, indicates that there are considerable challenges inhibiting caregiver involvement in such interventions. This article explores caregiver understandings of the personal, familial, and contextual barriers to their participation in child safety initiatives. It highlights the obstacles to involvement in a community-centred child safety promotion intervention that was implemented in a low-income setting in the Western Cape. A narrative approach was employed with study data captured in individual interviews and analysed using guidelines for conducting narrative analysis. In total, 11 caregivers were interviewed. Caregiver understandings of the impediments to greater involvement in safety interventions included the multifaceted nature of their personal and social difficulties. These included the prioritisation of work opportunities; conflict and estrangement from partners, family, and the community; and adverse living conditions. In such situations, many reported constrained personal choices and disengagement from many aspects of community relationships. Despite this stance, caregivers recognised the community connectedness, belonging, and responsibility needed to achieve a safer and healthier community.

The impact of neglect on initial adaptation to school

This study examined the impact of child neglect during the first 4 years of life on adaptation to school during kindergarten and first grade in the context of neighborhood poverty (NP). Processes related to the development of school competencies were examined, including the mediational role of cognitive functioning and ego-resiliency (ER) in shaping children's school outcomes. A total of 170 low-income urban children were followed prospectively for 2 years (ages 4-6). Results indicated that neglected children had significantly lower scores on kindergarten classroom behavior and first-grade academic performance than nonneglected children. Children's cognitive performance at age 4, controlling for maternal intelligence quotient, mediated the relation between severity of neglect and children's behavior in kindergarten as well as their academic performance in first grade. Moreover, severity of neglect was related to children's ER at age 4. However, additional ecological adversity in the form of NP moderated the link between ER and classroom behavior, such that at lower levels of poverty, ER mediated the relation between severity of neglect and school adaptation. Conversely, when NP was extreme, the effects of ER were attenuated and ER ceased to predict behavioral performance in kindergarten. The implications of these findings for prevention and intervention are discussed.

Child neglect and the development of externalizing behavior problems: associations with maternal drug dependence and neighborhood crime

Given the high prevalence of child neglect among maltreatment subtypes, and its association with exposure to additional environmental adversity, understanding the processes that potentiate child neglect and link neglect to subsequent child externalizing psychopathology may shed light on key targets for preventive intervention. Among 170 urban low-income children (ages 4-9) and their mothers, this 5-year prospective study examined the effects of early neglect severity and maternal substance abuse, as well as neighborhood crime, on children's later externalizing behavior problems. Severity of child neglect (up to age 6 years) mediated the relation between maternal drug dependence diagnosis (MDDD), determined at children's age of 4 years, and children's externalizing behavior problems at age 9. Rates of neighborhood crime mediated the link between presence of child neglect and children's externalizing behavior problems. The roles of MDDD, child neglect, and community violence in the development of child psychopathology are discussed in terms of their implications for intervention.

Child maltreatment reports in Israel: the intersection between community socioeconomic characteristics and ethnicity

The authors examined the relationship between community characteristics and child maltreatment reports in Israel, comparing Jewish and Arab localities both in terms of maltreatment reports and the responses of the social services to these reports. Administrative data were obtained from the protective services and the Central Bureau of Statistics for 231 local authorities in Israel (covering 98% of children in Israel). Jewish communities showed significantly more reports of sexual abuse and physical abuse than Arab communities. Reporting rates also showed different associations with socioeconomic and demographic variables. In Jewish localities, demographic, economic, and educational factors were all correlated with the reporting of child maltreatment, whereas in Arab localities, only median age (young) of the local population was associated with a greater rate of child maltreatment reporting. No differences in the responses of the protective services were found. Implications of the results for future policy are discussed.

Childhood maltreatment and illicit drug use in middle adulthood: the role of neighborhood characteristics

This paper examined whether childhood maltreatment increases the risk of living in neighborhoods with less desirable characteristics (i.e., more disorder and disadvantage, less social cohesion, social control and advantage, and fewer resources) in middle adulthood and whether these neighborhood characteristics influence subsequent illicit drug use. Using a prospective cohort design study, court documented cases of childhood abuse and neglect and matched controls (n = 833) were first interviewed as young adults (mean age = 29 years) from 1989 to 1995 and again in middle adulthood from 2000 to 2002 (mean age = 40 years) and 2003 to 2005 (mean age = 41 years). In middle adulthood, individuals with histories of childhood abuse and neglect were more likely to live in neighborhoods with more disorder and disadvantage and less social cohesion and advantage compared to controls and to engage in illicit drug use during the past year. Path analyses showed an indirect effect on illicit drug use via neighborhood disorder among maltreated children, even after accounting for drug abuse symptoms in young adulthood, although this was sex specific and race specific, affecting women and Whites. Overall, child abuse and neglect places children on a negative trajectory that dynamically influences negative outcomes at multiple levels into middle adulthood.

Substitute care entry: the relationship between race or ethnicity and levels of county organization

OBJECTIVE

Past studies demonstrate a relationship between race and the likelihood of children entering state custody subsequent to a maltreatment investigation. Research also shows that community structural characteristics such as poverty and residential mobility are correlated with entry rates. The combined effect, however, of race and community characteristics on substitute care entry is unclear. We analyzed 3 years of Illinois child welfare administrative and county-level structural data to assess the combined effect of child characteristics and level of community organization on substitute care entry.

METHODS

Based on county indicators of crime, socioeconomic status, residential mobility, and child care burden, a latent profile analysis classified Illinois counties into three levels of social organization (high, moderate, and low). To test the relationship between community and child level predictors of substitute care entry, a dichotomous variable representing substitute care entry was regressed onto county level and individual covariates (child age, race or ethnicity, gender, and allegation). To test the combined relationship of community and individual level characteristics, interactions between county level of organization and race were explored.

RESULTS

Like previous studies, results showed that individual factors of race, age, and allegation were associated with the decision to place children in substitute care. Also consistent with past research, they revealed a general trend in which decreasing levels of social organization were associated with relatively higher odds of entry to care. The magnitude of this effect at each level of social organization, however, varied by race, with African American children in disorganized communities experiencing the greatest risk of removal.

CONCLUSIONS

These findings suggest that efforts to understand the decision to place a child in substitute care may need to be community specific. In particular the level of community organization may influence the response of the system to maltreatment investigations. In communities with different characteristics and across racial groups, child welfare systems may need to examine decision making processes regarding children's removal from parental care.

Adapting systems of care for child welfare practice with immigrant Latino children and families

Recent reform efforts in the child welfare system have called for child welfare agencies to provide community-based services and to increase the involvement of external stakeholders in identifying and developing services within the community. At the same time, child welfare agencies are faced with the challenge of providing services to an increasingly diverse population of children and families. As a result, there is a need for evidence-based practice models that respond to these challenges and promote positive outcomes for children and families. This paper describes the development of a program designed to train child welfare staff on the application of an existing evidence-based framework, systems of care, to practice with immigrant Latino children and families as a means of responding to these multiple calls for systems change and practice improvement. Immigrant Latino children and families represent the largest and fastest-growing population in the United States, and thus require the attention of child welfare systems and the development of evidence-based practices designed to respond to the unique needs of this population. Recommendations for program planners and evaluators on the application of systems of care to child welfare practice with immigrant Latino children and families are provided.

Socioeconomic correlates of rates of child maltreatment in small communities

This study expands the research on neighborhood effects and child maltreatment by examining the structural conditions, including religion and nationality, in small towns in Israel. The results are compared with those in inner-city and suburban neighborhoods in Western countries. Five community structural variables were statistically correlated with investigated cases of child maltreatment: adults' unemployment rate, rate of new immigrants, rate of children in single-parent families, population gain or loss, and the community's location in relation to a central city. A multivariate regression analysis of these variables explained 44% of the variance.

Race and child maltreatment reporting: Are Blacks overrepresented?

This paper uses Census and child welfare report data from Missouri (1999, 2000 & 2001) to determine if Whites and Blacks are reported for child maltreatment at similar or different rates while controlling for poverty and racial homogeneity. We do not find evidence for high levels of racial disproportionality once poverty is controlled. Poverty is generally associated with higher rates of reporting for both races. We found some evidence of differential sensitivity, with the relationship between poverty and report rate being somewhat stronger for Whites than for Blacks.

Self-rated health and trust in low-income Mexican-origin individuals in Texas

The evidence suggests that trust is an important determinant of health. Trust tends to be lower in low-income and minority individuals, who already suffer from worse health. Therefore, it is particularly important to investigate the predictors of trust in disadvantaged individuals. In this article we use multilevel models to investigate the individual and neighborhood predictors of trust in Mexican-Americans living in low-income neighborhoods (defined as census block groups) in Texas. Detailed survey data on 1754 Mexican-origin respondents provided information on self-rated health and individual characteristics including sociodemographic and sociocultural personal characteristics (frequency of association with people of other races/ethnicities, social support, perceived racism, perceived personal opportunity, and religiosity). Neighborhood heterogeneities and socioeconomic status, computed from census data, were supplemented by community social characteristics (collective efficacy and public disorder) obtained from survey data. Trust was a significant predictor of self-rated health in our sample. This study suggests that Mexican-Americans tend to trust more those with whom there is likely to be a personal acquaintance than other Mexican-Americans. Furthermore, while the results of this study support that people tend to trust more those who are like themselves, for Mexican-Americans, the identification of who is more alike is not based exclusively on racial/ethnic identity, but is a complex process based also on linguistic and socioeconomic similarities. In our sample, linguistic fragmentation, but not racial/ethnic diversity nor neighborhood impoverishment, correlated with trust. Ease of communication seemed to be more important than racial/ethnic homogeneity in encouraging interpersonal trust among Mexican-Americans at the neighborhood level. The findings in this study imply it may be possible to develop neighborhood level interventions, focusing on encouraging social interaction in racially/ethnically and linguistically diverse communities, with the aim of promoting trust to improve health outcomes.