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

Abstract

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.

Keywords: COVID-19; Child abuse and neglect; Public health crisis; Spatiotemporal hot spots; Strong start index.

Fig. 1

Time Trends of Child Abuse and Neglect Incidents Before and After COVID-19. For this study, the COVID-19 pandemic began on the date the first case was recorded in the United States (January 21, 2020). The last day of the study period was July 19, 2020. Vertical lines correspond to the Governor’s declaration of a state emergency in California (March 4, 2020) social distancing orders (March 19, 2020), the distribution date for the stimulus checks (April 15, 2020) and the date that businesses began re-opening (May 8, 2020). The time trends based on a linear model reflect a slight downward trend for both periods. (For interpretation of the references to colour in this figure text, the reader is referred to the web version of this article.)

Fig. 2

(A) Census tract ranking of co-occurring risk factors indicating vulnerable areas of the city of Los Angeles (higher ranks = more vulnerable) and (B) Emerging Hot Spots of child abuse and neglect during the COVID-19 pandemic and locations of child abuse & neglect incidents following the city’s ‘Safer at Home’ order on March 19, 2020.

Fig. 3

Predicted Counts of CAN from the NBR. Notes: The figures show the relationship between each independent variable in the model and exponentiated predicted counts of CAN in new hot and cold spot areas during the COVID-19 pandemic, intensifying hot spots during the COVID-19 pandemic and areas identified as consecutive cold spots throughout the entire period. The minimum and maximum values for the independent variable are plotted along the x-axis and the predicted exponentiated counts of child abuse and neglect are plotted along the y-axis. In each plot the other variables in the model are held constant at their mean values (see Table 4, last column).