Eleven-year trends in statewide child maltreatment reports and substantiated cases: Associations with policy implementation, Covid-19 and community socioeconomic factors.

BACKGROUND

Child maltreatment remains a critical public health issue with long-term developmental consequences. Understanding how community-level factors and policy changes influence reporting trends is essential for effective prevention and intervention.

OBJECTIVE

This study investigated 11-year trends in statewide child maltreatment reports and substantiations to better understand these trends in connection with county socioeconomic conditions, statewide policy implementation, and the COVID-19 pandemic.

PARTICIPANTS AND

SETTING

County-level rates of reported and substantiated child maltreatment from 2012 to 2023 among all 99 counties in Iowa were linked to county-level socioeconomic indicators.

METHODS

Hierarchical linear and mixed modeling techniques were used to examine temporal trends and the influence of county-level socioeconomic indicators on reporting and substantiation rates.

RESULTS

Trends in reports and substantiation rates were best modeled by curvilinear (cubic) trends with fluctuations related to a state-wide policy change and the COVID-19 pandemic. Results indicated that county-level income (β = 149.18, SE = 66.79, p < .05), unemployment (β = 124.26, SE = 53.90, p < .05), and safety (β = 198.13, SE = 81.41, p < .05) were associated with reporting rates. County-level educational attainment (β = 60.17, SE = 23.88, p < .05), income (β = 53.12, SE = 23.85, p < .05), unemployment (β = 43.58, SE = 19.47, p < .05), and safety (β = 79.72, SE = 29.67, p < .01) were associated with substantiation rates.

CONCLUSIONS

Contrary to expectations from data at the individual and family level, higher levels of income, education, socially supportive environments, and community safety were associated with increased rates of reported and substantiated cases at the county-level. While preliminary, the findings highlight the importance of understanding broad context, community-level surveillance, and institutional capacity beyond the individual and family levels.