Family-level social determinants of child and adolescent maltreatment.

BACKGROUND

Research highlights the roles of material, psychosocial, biologic and behavioral risk factors, as well as access to healthcare in the etiology of child maltreatment (CM). However, research has yet to comprehensively examine these interrelated social risks in relation to child and adolescent CM, making optimal CM prevention strategies unclear.

OBJECTIVE

Applying the World Health Organization intermediary social determinants of health (I-SDH) framework, this study operationalized a holistic, multidimensional framework of family-level risk and protective factors, and examined their prospective relationship to CM in childhood and adolescence.

PARTICIPANTS &

SETTING

Data were drawn from the Longitudinal Studies for Child Abuse and Neglect (N = 1354).

METHOD: CM types during middle childhood (7-12 years) and adolescence (13-16 years) were measured by Child Protective Services (CPS) report and youth self-report. CM during middle childhood and adolescence were regressed on the multidomain domains of family-level I-SDH during early (0-6 years) and middle childhood, respectively.

RESULTS

All domains of I-SDH were related to CM in unadjusted analyses. Following false discovery rate (FDR) adjustment, poverty and homelessness/eviction were related to CPS-reported physical and supervisory neglect in middle childhood. Child externalizing problems and household substance use were related to CPS-reported CM in middle childhood and adolescence. I-SDH were unrelated to self-reported CM following FDR adjustment.

CONCLUSIONS

Findings support the need for multifaceted I-SDH-focused interventions and policies to prevent CPS involvement. The lack of robust findings for self-reported CM, however, calls into question whether such strategies would substantially reduce CM more broadly and suggests biases in CPS report. Future research should distinguish CM measures and their antecedents to effectively guide CM prevention.