Study: Child maltreatment rates declined overall, but disparities persisted across sex and race – Contemporary Pediatrics

Report on National Trends in Child Maltreatment and Implications for Sustainable Development Goals

Introduction: Child Welfare as a Cornerstone of Sustainable Development

A population-based, cross-sectional study analyzing United States Child Protective Services (CPS) data from 2012 to 2023 reveals critical trends in child abuse and neglect. The findings underscore significant challenges to achieving several Sustainable Development Goals (SDGs), particularly those concerning health, equality, and justice. While confirmed cases of overall child maltreatment have declined, persistent and widening disparities based on race and sex indicate a failure to ensure inclusive progress, directly impacting SDG 3 (Good Health and Well-being), SDG 5 (Gender Equality), SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice and Strong Institutions).

Analysis of Overall Trends in Relation to SDG 16: Peace, Justice and Strong Institutions

The study, which reviewed 7,326,987 confirmed cases and 32,980,613 referrals, provides a metric for evaluating progress toward SDG Target 16.2: “End abuse, exploitation, trafficking and all forms of violence against and torture of children.”

Key Statistical Findings:

• Confirmed Cases: A modest decline was observed in confirmed maltreatment cases, with an average annual percent change (AAPC) of -1.53%. This suggests some progress in reducing substantiated instances of violence against children.
• Referrals: The number of referrals for child maltreatment remained stable throughout the 12-year period. This indicates that community-level reporting and concern for child welfare have not diminished, even as confirmed cases have fallen.

Trends by Maltreatment Subtype:

The data shows varied progress across different forms of violence against children:

1. Emotional Abuse: Showed the most significant decrease (AAPC, -3.42%).
2. Physical Abuse: Declined overall (AAPC, -1.71%).
3. Neglect: Demonstrated a downward trend (AAPC, -1.55%).
4. Sexual Abuse: Rates remained statistically unchanged (AAPC, -0.18%), signaling a critical area of stagnation in child protection efforts.

Persistent Disparities: A Challenge to SDG 10 (Reduced Inequalities)

The report highlights a profound failure to advance SDG Target 10.2, which aims to “empower and promote the social, economic and political inclusion of all, irrespective of…race, ethnicity or other status.” Racial and ethnic disparities in child maltreatment rates remained deeply entrenched between 2012 and 2023.

Racial and Ethnic Disparities:

• Highest Incidence: Black children consistently experienced the highest rates of maltreatment across all subtypes. In 2023, the risk ratio for Black children was 1.83 compared to White children, a figure virtually unchanged from 1.84 in 2012.
• Elevated Risk: American Indian and Alaska Native children also faced elevated rates of overall maltreatment.
• Physical Abuse Disparity: The most significant disparity was observed in physical abuse, where the rate for Black children was more than double that of White children at both the beginning and end of the study period.

These persistent inequalities demonstrate that the benefits of overall declines in maltreatment have not been shared equitably, leaving the most vulnerable populations behind.

Gender-Based Disparities and SDG 5: Gender Equality

The findings present a serious challenge to SDG Target 5.2: “Eliminate all forms of violence against all women and girls.” The study confirms that female children are disproportionately affected by maltreatment, and for certain abuse types, this inequality is worsening.

Key Findings on Sex-Based Differences:

• Overall Incidence: The confirmed maltreatment rate per 10,000 children was significantly higher for girls (87.51) than for boys (78.46).
• Widening Gap in Sexual Abuse: While overall maltreatment rates declined for both sexes, the disparity in sexual abuse cases widened over time. This trend indicates a specific and growing vulnerability for girls that undermines progress toward gender equality.

Implications for Public Health and Achieving the SDGs

The report concludes that achieving the SDGs requires a targeted, equity-focused approach to child protection. The persistent disparities are linked to systemic issues that intersect with other development goals.

Recommendations for an Integrated SDG-Aligned Approach:

1. Address Root Causes (SDG 1: No Poverty): The authors identify poverty as a primary driver of maltreatment. Progress toward SDG 1 is therefore essential for creating protective environments for children. Interventions must address socioeconomic conditions and barriers to accessing public benefits.
2. Strengthen Health Systems (SDG 3: Good Health and Well-being): The public health implications are significant. Clinicians must be equipped with an understanding of these trends to improve screening, provide anticipatory guidance, and collaborate across sectors to support at-risk families and promote child well-being.
3. Prioritize Equity (SDG 10 and SDG 5): Generic interventions are insufficient. Policy and practice must specifically target the racial and gender-based disparities identified in the report. As the authors note, the group “with the most room for improvement experienced none,” highlighting an urgent need to focus resources on communities disproportionately affected by maltreatment.

Analysis of Sustainable Development Goals in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

The article on child maltreatment trends in the United States connects to several Sustainable Development Goals (SDGs) by highlighting issues of violence against children, inequality, gender disparities, and public health.

• SDG 16: Peace, Justice and Strong Institutions

  This goal is directly addressed as the article’s central theme is child maltreatment, which includes abuse and neglect. The study uses data from Child Protective Services (CPS), an institution central to addressing these issues.

• SDG 10: Reduced Inequalities

  The article places a strong emphasis on the persistent disparities in child maltreatment rates across different racial and ethnic groups. It explicitly states that “disparities persisted across the study period, especially among Black children,” directly linking to the goal of reducing inequality within a country.

• SDG 5: Gender Equality

  The findings reveal significant sex-based differences in maltreatment rates. The article notes that “Female children experienced more maltreatment,” particularly in cases of sexual abuse, where the disparity widened over time. This connects to the goal of eliminating all forms of violence against women and girls.

• SDG 3: Good Health and Well-being

  Child maltreatment is framed as a “significant public health concern.” The article discusses various forms of abuse (physical, emotional, sexual) and neglect, all of which have severe, long-term consequences for the physical and mental well-being of children.

2. What specific targets under those SDGs can be identified based on the article’s content?

Based on the issues discussed, the following specific SDG targets can be identified:

1. Target 16.2: End abuse, exploitation, trafficking and all forms of violence against and torture of children.

   This is the most direct target. The entire study is an analysis of “child abuse and neglect,” which are forms of violence against children. The article quantifies different subtypes, including emotional, physical, and sexual abuse, all of which fall under this target.

2. Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.

   The article’s detailed analysis of racial disparities speaks directly to this target. The finding that “Black children had a risk ratio (RR) of 1.84 for overall maltreatment compared with White children” in 2012, which remained high at 1.83 in 2023, demonstrates a lack of social protection and inclusion for a specific racial group.

3. Target 5.2: Eliminate all forms of violence against all women and girls in the public and private spheres, including trafficking and sexual and other types of exploitation.

   The data showing that “Confirmed maltreatment incidence per 10,000 children was 87.51 for girls and 78.46 for boys” directly relates to this target. The specific mention that disparities “were largest and widening over time for sexual abuse” against girls further reinforces this connection.

4. Target 3.4: By 2030, reduce by one third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.

   The article’s focus on “emotional abuse” as a specific subtype of maltreatment connects to the promotion of mental health and well-being. Child maltreatment is a major risk factor for poor mental health outcomes throughout life.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

Yes, the article provides several quantitative and qualitative indicators that can be used to measure progress.

• For Target 16.2:
  • Number of confirmed cases of child maltreatment: The study identified “7,326,987 confirmed cases” over 12 years.
  • Rate of change in maltreatment cases: The article provides the average annual percent change (AAPC) for overall maltreatment (−1.53%) and for subtypes like emotional abuse (−3.42%) and neglect (−1.55%).
  • Number of referrals for child maltreatment: The study notes “32,980,613 referrals,” which remained stable, indicating consistent levels of reporting.
• For Target 10.2:
  • Risk Ratios (RR) for maltreatment by race: The article uses the RR to compare maltreatment rates, stating that for Black children compared to White children, the RR was “1.84 in 2012” and “1.83 in 2023,” indicating persistent inequality.
  • Incidence rates by racial group: The finding that “Black children consistently had the highest incidence across all maltreatment subtypes” serves as a direct indicator of racial disparity.
• For Target 5.2:
  • Incidence rates of maltreatment by sex: The specific figures of “87.51 for girls and 78.46 for boys” per 10,000 children is a clear indicator of gender disparity.
  • Trends in gender-based violence: The observation that the disparity gap for sexual abuse was “widening over time” is a crucial indicator for measuring progress (or lack thereof) in protecting girls.
• For Target 3.4:
  • Trends in emotional abuse cases: The specific tracking of “Emotional abuse” and its AAPC of −3.42% can serve as an indicator for efforts to protect children’s mental well-being.

4. Table of SDGs, Targets, and Indicators

Source: contemporarypediatrics.com