Understanding Dynamics of Neighborhoods with Unusual Patterns of Child Maltreatment Referrals: A Multi-Methods Study

Background: Child maltreatment is a highly place-based phenomenon that affects neighborhood areas. The aims of this study were to: 1) examine spatial variation in child maltreatment referrals replicating work from other regional geographic studies in two large California counties that have not been studied previously; 2) estimate the frequency of neighborhood areas with unusual risk for or protection from child maltreatment referrals after controlling for population characteristics; and 3) explore social dynamics and resources of local community environments that may explain variations in maltreatment referrals above and beyond known population characteristics. 

Methods: Maltreatment referral data from Los Angeles and San Diego Counties in 2013 were linked with American Community Survey data from the US Census to map community areas at the census tract level that show unusual rates of risk for and/or protection from child maltreatment. Linear regression models estimated referral rates per 100 children in each census tract. Unusual areas of risk and protection were defined as census tracts with maltreatment referral rates either 3 or more referrals per 100 children above or below predicted levels based on local population characteristics. Areas were checked for year-to-year consistency in unusual rates. Semi-structured interviews were conducted with community professionals in 20 census tracts with unusual referral rates to understand additional community-level forces that may contribute to risk of/protection from maltreatment.

Results: Regression models showed that the child poverty rate and adult education levels were the strongest predictors of referral rates, collectively explaining approximately 47% of the variance in tract level referral rates. Approximately 7% of tracts had higher/lower referral rates than predicted. Qualitative analyses revealed 3 overarching themes that stakeholders perceive to influence maltreatment behaviors, as well as reporting patterns, in areas with unusually high and low rates of referrals, revolving around housing situations, community norms and values, and supportive resources and services. For example, community characteristics described to protect communities from child maltreatment include neighborhood cohesion and positive community norms around parenting, high levels of home ownership, and the presence of supportive resources in churches, schools, social services, and youth activities. Participants also discussed factors that may increase community risk of maltreatment, as well as the incidence of reporting of maltreatment.

Conclusions: Results of this study expand knowledge of social-environmental dynamics that may explain variations in risk for and protection from child maltreatment. Directions for ongoing research and possible implications for community-focused child maltreatment prevention strategies will be discussed.