Homeworks academic service


A study of child abuse in america

Fatality rates are calculated annually as deaths per 100 000 children 0 to 4 years old. Discussion This study demonstrates increased rates of child abuse fatalities for young children in communities of higher poverty concentration compared with those living in less impoverished areas. There were also racial differences, with higher child abuse fatality rates for African American children compared with white children across all poverty concentrations.

Page not available

The effects of poverty on children are wide-reaching. Health disparities exist for children in poverty, ranging from increased lead levels, increased revisit rates after tonsillectomy, structural differences in brain development, as well as fatalities from unintentional injuries.

These results suggest that the economic atmosphere where a child lives may be associated with their risk of suffering a fatal abusive injury. Theories to explain the relationship between community poverty and child abuse cite lack of community resources, environmental stressors, differential reporting thresholds, and presence of factors related to economic success.

This suggests that, for fatal child abuse, there are implications for child health and safety even in the middle poverty categories, where most children in the United States reside. Ideally, this will allow public health officials to target high-risk areas for prevention and resources, rather than rely on post hoc responses to a particular tragedy.

  1. The collector of the original data, the funding agency, NDACAN, Cornell University, and the agents or employees of these institutions bear no responsibility for the analyses or interpretations presented here. Previous studies have reported increased rates of child abuse in minority children, 2 , 35 , 40 and African American children have also had higher reported risks for infant mortality, preterm birth, and low birth weight, suggesting increased risk for several poor health outcomes.
  2. Our results suggest that even in communities of low poverty concentration, African American children have higher rates of child abuse fatalities than white children who live in communities of high poverty concentration.
  3. In counties with high child poverty, increases in income inequality resulted in higher victim rates throughout the range of values of the Gini index.

Our results suggest that even in communities of low poverty concentration, African American children have higher rates of child abuse fatalities than white children who live in communities of high poverty concentration. With this data set, we cannot determine if an individual child victim was living in an impoverished neighborhood within a more affluent county. The specific effects of community poverty concentration by race on abuse fatality risk is worthy of additional exploration.

Previous studies have reported increased rates of child abuse in minority children, 23540 and African American children have also had higher reported risks for infant mortality, preterm birth, and low birth weight, suggesting increased risk for several poor health outcomes.

  • Given the mixed evidence in the literature, a replication of the moderating effect of income we report here is warranted;
  • Our findings contribute to the growing literature linking greater income inequality to a range of poor health and well-being outcomes in infants and children;
  • This serves to qualify the overall nonlinear effect of income inequality on child maltreatment, with the attenuation of the inequality effect much more evident in counties with low child poverty levels;
  • A review of mostly US research from 1997 through 2003, 6 however, showed that studies that used the strongest multilevel designs to adjust for individual income still showed substantial evidence for worse health outcomes among adults in states with higher levels of inequality, although not all studies show this effect;
  • Therefore, the death counts are most likely an underestimate of all child abuse fatalities;
  • The predicted relationship of income inequality to the natural log of the maltreatment victim rate depends on child poverty.

This study contributes new findings to previous research by using a national data source to obtain fatality data. The 2011 Government Accountability Office report on child fatalities from maltreatment stated that there are many challenges to obtaining data on child maltreatment fatalities. The National Incidence Study relies on a nationally representative sample of 122 counties. Our study used the CDC CMF, which provides national data from death certificates and, therefore, does not rely on CPS reporting practices or on data extrapolated from representative counties.

Income Inequality and Child Maltreatment in the United States

The 2011 Government Accountability Office report suggests that incorporating data on child maltreatment fatalities from additional sources like death certificates can better inform government agencies.

Additionally, our study demonstrates the ability to use ICD-10 cause of death codes to target similar populations previously studied by using ICD-9.

The CMF is an administrative database with potential for misclassification, and the data analysis is limited by the included variables. As a result, our study focused only on physical child abuse fatalities, and not on other forms of maltreatment, such as neglect eg, malnutrition, medical neglectwhich are not comprehensively captured with ICD-9 and ICD-10 external cause of injury codes. Our data are comparable to previous NCANDS results when examining physical abuse fatalities, but not overall fatality rates, which include victims of neglect.

The use of death certificate data, although a strength of this work, is also a limitation because it requires the medical examiner to identify the child as a victim of fatal assault.

Therefore, the death counts are most likely an underestimate of all child abuse fatalities. Racial bias has been noted in death certificate review when medical examiners are more likely to record the victim of a homicide as African American than white.

  1. Our findings contribute to the growing literature linking greater income inequality to a range of poor health and well-being outcomes in infants and children.
  2. Ideally, this will allow public health officials to target high-risk areas for prevention and resources, rather than rely on post hoc responses to a particular tragedy.
  3. Further research on the impact of inequality measured at different levels of geographic aggregation is needed. A review of mostly US research from 1997 through 2003, 6 however, showed that studies that used the strongest multilevel designs to adjust for individual income still showed substantial evidence for worse health outcomes among adults in states with higher levels of inequality, although not all studies show this effect.

Researchers have also found census tracts to be more sensitive to economic differences than counties or zip codes. As a result, the county poverty concentration is a combination of its communities, which may underestimate the association of community poverty to a health outcome. Therefore, any interplay between the socioeconomic status of the individual child and other factors like race and ethnicity cannot be explored with this data set, limiting the analysis for Hispanic children and the interpretation of increased fatality rates seen in African American children in counties of different poverty concentrations.

Finally, as an ecological study, we can report an association between community poverty concentration and child abuse fatalities, but we cannot demonstrate causation.

Crisis and support contacts For Child Abuse

Although additional studies are needed to additionally evaluate the complex interplay between poverty and child safety, the findings in this study highlight for pediatricians and community leaders the vulnerabilities faced by children in impoverished communities.

Conclusions By analyzing the association of community poverty and child abuse fatality rates from a source of national death data, we found that counties with high poverty concentration were consistently associated with higher child abuse fatality rates across more than a decade of study.

Community leaders, child advocates, public health officials, and health care professionals must consider community poverty when developing efforts to prevent child abuse deaths. Footnotes Accepted February 14, 2017.

Address correspondence to Caitlin A.

Community Poverty and Child Abuse Fatalities in the United States

The authors have indicated they have no financial relationships relevant to this article to disclose. Drs Christian and Wilson provide medical legal expert work in child abuse cases; the other authors have indicated they have no potential conflicts of interest to disclose.

A companion to this article can be found online at www.