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. 2014 Aug;168(8):706-13.
doi: 10.1001/jamapediatrics.2014.410.

The prevalence of confirmed maltreatment among US children, 2004 to 2011

Christopher Wildeman  1 , Natalia Emanuel  2 , John M Leventhal  3 , Emily Putnam-Hornstein  4 , Jane Waldfogel  5 , Hedwig Lee  6
Affiliations

The prevalence of confirmed maltreatment among US children, 2004 to 2011

Christopher Wildeman et al. JAMA Pediatr. 2014 Aug.

Abstract

Importance: Child maltreatment is a risk factor for poor health throughout the life course. Existing estimates of the proportion of the US population maltreated during childhood are based on retrospective self-reports. Records of officially confirmed maltreatment have been used to produce annual rather than cumulative counts of maltreated individuals.

Objective: To estimate the proportion of US children with a report of maltreatment (abuse or neglect) that was indicated or substantiated by Child Protective Services (referred to as confirmed maltreatment) by 18 years of age.

Design, setting, and participants: The National Child Abuse and Neglect Data System (NCANDS) Child File includes information on all US children with a confirmed report of maltreatment, totaling 5,689,900 children (2004-2011). We developed synthetic cohort life tables to estimate the cumulative prevalence of confirmed childhood maltreatment by 18 years of age.

Main outcomes and measures: The cumulative prevalence of confirmed child maltreatment by race/ethnicity, sex, and year.

Results: At 2011 rates, 12.5% (95% CI, 12.5%-12.6%) of US children will experience a confirmed case of maltreatment by 18 years of age. Girls have a higher cumulative prevalence (13.0% [95% CI, 12.9%-13.0%]) than boys (12.0% [12.0%-12.1%]). Black (20.9% [95% CI, 20.8%-21.1%]), Native American (14.5% [14.2%-14.9%]), and Hispanic (13.0% [12.9%-13.1%]) children have higher prevalences than white (10.7% [10.6%-10.8%]) or Asian/Pacific Islander (3.8% [3.7%-3.8%]) children. The risk for maltreatment is highest in the first few years of life; 2.1% (95% CI, 2.1%-2.1%) of children have confirmed maltreatment by 1 year of age, and 5.8% (5.8%-5.9%), by 5 years of age. Estimates from 2011 were consistent with those from 2004 through 2010.

Conclusions and relevance: Annual rates of confirmed child maltreatment dramatically understate the cumulative number of children confirmed to be maltreated during childhood. Our findings indicate that maltreatment will be confirmed for 1 in 8 US children by 18 years of age, far greater than the 1 in 100 children whose maltreatment is confirmed annually. For black children, the cumulative prevalence is 1 in 5; for Native American children, 1 in 7.

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Figures

Figure 1
Figure 1
Proportion of Children Having Ever Experienced Confirmed Maltreatment, 2011
Figure 2
Figure 2
Age–Specific Risk for First Confirmed Maltreatment, 2011
Figure 3
Figure 3
Cumulative Risk of Confirmed Maltreatment by Age 18, 2004–2011
Figure A1
Figure A1
Age–Specific Risk for First Confirmed Maltreatment, 2011
Figure A2
Figure A2
Cumulative Risk of Confirmed Maltreatment by Age 18, 2004–2011
See this image and copyright information in PMC

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