Racial, Ethnic, and Gender Disparities in Substantiated Child Maltreatment: A State-Level Analysis of U.S. Incidence Rates

Abstract

The scope of the problem of child maltreatment warrants more nuanced epidemiologic investigation. Our study examined state-level rates of child maltreatment (i.e., child physical abuse, child sexual abuse, neglect) by race, ethnicity, and gender. We used 3,972,565 million cases of child physical and sexual abuse and neglect from the 2018 U.S. National Child Abuse and Neglect Data System. Disparity ratios and raw differential representation values were calculated for racial and ethnic groups by gender as compared with White or non-Latine children within the same gender category. Within child physical abuse cases, Black and multiracial children were more likely to have cases substantiated compared with White children. Conversely, neglect cases were generally associated with lower rates of substantiation for Black girls and boys in most states. Substantiation rates were also lower for Black girls within child sexual abuse cases in most states. Latine boys were typically less likely to have physical abuse cases substantiated and Latine girls were typically more likely to have sexual abuse cases substantiated; rates of neglect were not consistently differentiated compared with non-Latine children. Findings demonstrate the importance of including race, ethnicity, and gender in child abuse and neglect case dispositions. Consistent patterns in disparities were evident across many states, which may have important implications for state-level policies and disparity reduction strategies. Future research should extend and replicate successful efforts, and develop and test promising new methods, to prevent disparities in child abuse and neglect case processing.

In 2018, approximately 7.8 million children were reported to child protective services (CPS) for child maltreatment in the United States. Experiences of child abuse and neglect are associated with long-lasting consequences that can lead to serious psychological and economic burdens for individuals and society (Hillis et al., 2017; Letourneau et al., 2018; Widom, 2014), thus services rendered following CPS investigations matter. It is now widely documented that rates of child abuse and neglect reports (Kim & Drake, 2018; Lanier et al., 2014; A Luken et al., 2021) and substantiation (Drake et al., 2011) differ by child race and ethnicity. And following substantiation, Black children are subjected to home removal and foster care placement significantly more than White children (Maguire-Jack et al., 2021). Regardless of factors contributing to disparities in child welfare system representation and systemic responses, the harm that systemic involvement causes Black children and their families (Dettlaff & Boyd, 2020) is a critical public health problem.

Incidence estimates of child abuse and neglect present an opportunity to better understand the scope of the problem for professionals whose work impacts responses to child abuse and neglect. Trends in child abuse and neglect reports from 2015 to 2016 by subtype indicate a decline in neglect, stagnation of child sexual abuse (CSA), and substantial increases in child physical abuse (CPA) and fatality due to abuse and neglect (Finkelhor et al., 2018). There is not a one-size-fits-all way states respond to child abuse and neglect. Each state adopts different policies and uses different preventive and after-the-fact interventions to address child abuse and neglect. Therefore, more nuanced data including child race, ethnicity, and gender are needed at each state level to ultimately inform policy adoption and intervention selection. And while a recent publication by LaBrenz et al. (2023) examined disparities by Black versus White children, no known study to date has examined multiple racial groups or ethnic groups alongside gender. The current study focused on filling this gap in the field.

1.1. Race and Ethnicity and Child Abuse and Neglect Substantiation

In the United States, there are racial and ethnic group disparities in rates of reported and substantiated child abuse and neglect (Drake et al., 2011; Fix & Nair, 2020; LaBrenz et al., 2022; Lanier et al., 2014). For example, Black and Hispanic/Latine youth are consistently more likely to be referred to CPS for child abuse and neglect (Fix & Nair, 2020; Lanier et al., 2014), as are multiracial children (Luken et al., 2021). Racial disparities in child abuse and neglect reporting or substantiation can present in multiple ways including through perceived and real child risk characteristics, racial bias (e.g., in reporting or assessment), characteristics of the caregiver and person accused of engaging in child abuse and neglect, or other county-level or state-level variables like racially biased policies and practices (Dettlaff et al., 2011; Fix & Nair, 2020; Putnam-Hornstein et al., 2013).

Researchers have observed racial bias and biases about economic insecurity/poverty can confound interpretation of ethnoracial disparities in handling of child abuse and neglect cases (Najdowski & Bernstein, 2018). Moreover, it may be that biases and structural racism influence risk factors such as poverty (Drake et al., 2011), further driving racial disparities in CPS involvement (Dettlaff & Boyd, 2020). Indeed, it could be argued that both poverty and racial disparities observed in the child welfare system stem from racism (Dettlaff et al., 2021).

1.2. Gender and Child Abuse and Neglect Substantiation

Globally and in the US, there are consistent gender differences in incidence estimates of CSA, whereas gender is less consistent concerning other subtypes of child abuse and neglect (Moody et al., 2018). More specifically, girls are consistently being overrepresented among reported and substantiated cases of CSA (Fix & Nair, 2020; Graham et al., 2018). Further, research suggests that intersectional identities of child race, ethnicity, and gender influenced CPA and CSA case outcomes even after accounting for child and caregiver risk factors (Fix & Nair, 2020). And a recent systematic review of the literature noted an paucity of studies that included gender when assessing for ethnoracial disparities (Cénat et al., 2021).

1.3. Current Study

Experts agree that the first step in preventing racial bias in child abuse and neglect case reporting and substantiation is to obtain comprehensive information on the scope and characteristics of abuse and neglect (Jud et al., 2016). Despite recognition of racial, ethnic, and gender differences in child abuse and neglect rates and substantiation, there is a paucity of research work simultaneously examining these characteristics at the state level by abuse and neglect subtype. Research characterizing child abuse and neglect in this manner could prove indispensable to understanding the effectiveness of the CPS system and more clearly identify who are most vulnerable. These data could inform policies and development and implementation of culturally informed interventions focused on primary prevention (‘true’ maltreatment prevention that is implemented before any maltreatment has occurred) and tertiary prevention (after-the-fact efforts to address reoccurrences of maltreatment). The current study tested for disparities in CPA, CSA, and neglect substantiation by race, ethnicity, and gender in each U.S. state, the District of Columbia, and Puerto Rico.

2. Methods

2.1. Participants and Procedure

Data were from the National Child Abuse and Neglect Data System (NCANDS). NCANDS is federally funded, gathering data on child abuse and neglect cases reported to CPS agencies across the US. Established following the 1988 amendments to the Child Abuse Prevention and Treatment Act (CAPTA), NCANDS collects data that play a crucial role in multiple research and practice initiatives within the child welfare field. For our study, data from NCANDS included 3,972,565 individual CPS reports from all 50 states in the U.S., the District of Columbia, and Puerto Rico with dispositions found between October 1, 2017 to September 30, 2018. Reports could contain multiple instances for the same child, thus the same child could appear in multiple reports for more than one subtype_¹.

2.2. Measures

2.2.1. Demographic Factors

Measured races included monoracial Black, Asian American, Pacific Islander and Native Hawaiian, Native North American/American Indian and Alaska Native, multiracial, and White, representing both Latine and non-Latine children. We created a multiracial category for cases involving a child identified as belonging to two or more racial groups, regardless of ethnicity. Ethnicity was separately coded as Latine or non-Latine. Child gender was categorized dichotomously in the dataset as girl or boy. Cases without ethnoracial identity were excluded from analyses.

2.2.2. Reported Abuse and Neglect and Substantiation

In the NCANDS, substantiated CPA, CSA, or neglect indicated that an investigation by CPS rendered the disposition of the case as having occurred by state law. State laws differ in how they classify CPS responses. In response, we used the NCANDS coding protocol and therefore coded cases as substantiated if the investigation disposition was classified as indicated or substantiated._² We divided the data into three separate datasets for each of the three_³ child abuse and neglect subtypes that we focused on in the current study so that children with reports for multiple abuse and neglect types may appear in each respective dataset.

2.3. Data Analysis

Our analytic sample includes both state- and county-administered child welfare systems. We did not exclude states which are known to have unique data collection and reporting structures (Child Welfare Information Gateway, 2018; Huggins-Hoyt et al., 2019). For instance, in Pennsylvania, only Child Protective Services (CPS) cases are reported to NCANDS, omitting General Protective Services (GPS) cases_⁴ that comprise most investigations but that do not meet the definition of maltreatment (Rizvi et al., 2023). As such, while these states were retained in our dataset because we wanted to present overarching patterns of disparities across the U.S., we did not disaggregate or compare findings at the state level, and we interpreted national patterns with caution. We also did not compare outcomes between state- and county-administered systems due to our focus on state-level characteristics only. We do indicate whether a state is county administered or hybrid (i.e., partially administered by the state and partially by counties) on Tables 1–3.

Table 1.

Neglect Substantiation Racial and Ethnic Group Disparity Ratios by Gender within each U.S. State

	Male/Boy						Female/Girl
State	Native	Asian	Black	Multiracial	NHPI	Latino	Native	Asian	Black	Multiracial	NHPI	Latina
US	1.24	1.05	0.95	1.1	1	1.19	1.24	1.05	0.95	1.1	0.95	1.19
AK	1.4	1.6	0.67	1.47	1.53	0.62	1.53	0.87	0.73	1.33	1.53	0.76
AL	0.83	0.83	0.76	1	1.72	1	1.67	1.1	0.7	0.93	--	1.04
AR	1.26	0.89	0.95	1	0.58	0.74	1	0.5	0.94	1.06	0.5	0.83
AZ	1.24	0.52	0.92	1	1.04	1.17	1.29	0.83	1	1	0.92	1.17
CA*	0.86	0.79	0.82	0.96	0.79	1.43	0.81	0.85	0.85	0.96	0.85	1.39
CO*	1.63	1	1.04	1.19	1.33	1.12	1.62	1	1.04	1.23	1.12	1.12
CT	1.32	1.18	1.03	1.08	1.18	0.97	1.49	1.1	1.03	1.18	0.69	1.03
DC	1.61	3.23	1.26	1.97	--	0.95	0.82	1.25	0.98	1.55	0.42	0.8
DE	--	0.69	0.77	1.31	--	1.36	--	--	0.86	0.79	--	1.31
FL	1.47	1	0.8	1.2	0.8	0.94	1.53	0.8	0.8	1.27	1.27	0.88
GA	0.44	0.33	0.67	1.11	0.44	0.75	0.38	0.5	0.75	1.12	0.5	0.86
HI	--	1.47	1.18	1.76	2.24	1.43	1.61	1.45	0.55	0.9	1.32	0.97
IA	1.29	1.06	1	1.11	1.49	1.03	1.34	1.11	0.94	0.97	0.8	1.06
ID	1.91	1.82	1.45	1.55	2	1.64	1.55	2	1.09	1.73	2.18	1.36
IL	1.76	0.76	1	1.14	1.1	0.93	0.93	0.69	1.03	1.17	0.72	0.97
IN	0.77	0.46	1	1.08	1.23	1	0.75	0.67	1.08	1.17	0.67	1
KS	0.2	1.3	1	1	3	0.9	--	0.36	0.82	0.82	1.09	1
KY	1.73	0.46	0.77	1.08	0.65	1	0.74	0.59	0.81	1	0.33	1
LA	0.28	1	0.9	1.05	1.28	0.71	0.8	1.02	0.87	1.05	1.77	1.08
MA	1	0.83	1.02	1.04	1.13	1.11	0.89	0.93	1.07	1	1.28	1.13
MD	0.6	0.88	1	1.44	1	1.24	0.54	0.58	1	1	0.92	1.21
ME	0.82	1.79	0.89	0.89	0.89	1.31	0.93	1.52	0.72	1.31	--	1
MI	0.91	0.83	1	1.09	0.91	1.13	1.09	0.87	0.96	1.09	0.91	1.09
MN*	1.6	2.07	1.2	1.33	0.53	1.24	1.44	2.12	1.31	1.31	--	1
MO	1.08	1.08	1.02	0.84	1.08	1.04	1.05	1.05	0.99	0.83	--	0.99
MS	0.87	1.39	0.7	1.04	--	1.25	0.67	1	0.81	1.48	0.33	1
MT	1.3	0.75	0.75	2	--	1.18	1.38	0.9	0.9	1.71	0.81	1.26
NC*	1.5	0.5	0.81	1	0.44	0.8	1.38	0.44	0.81	1.06	0.19	0.8
ND*	1.28	0.69	0.9	1.03	1.14	1.1	1.22	0.37	1.19	1.19	2.37	1.41
NE	1.57	0.64	0.79	0.86	5.0	1.07	1.93	1.07	0.86	1	0.79	1.13
NH	0.89	0.78	0.44	1.11	2.78	0.89	0.78	1.56	0.89	1.22	--	0.89
NJ	0.43	0.71	1	1.29	1	1	1	0.57	1	1.29	0.57	0.86
NM	1.3	0.37	0.85	1.26	1.37	1	1.46	0.19	1.15	1.27	0.42	0.93
NV^	1.25	0.92	0.96	1.08	0.92	1.09	0.79	0.88	0.92	1.08	1.13	1.04
NY*	1	1.07	1.18	1.07	0.82	1.2	0.96	1.14	1.21	1.07	1.25	1.23
OH*	0.58	0.47	0.74	0.95	1	0.89	0.26	0.32	0.74	0.95	0.37	1
OK	1.22	0.57	0.78	0.96	0.35	1	1.26	0.83	0.83	0.96	0.61	0.96
OR	1.14	0.67	0.62	1.38	1	1	1.1	0.71	0.81	1.14	1.43	1.04
PA*	--	--	1.5	0.92	--	0.79	--	0.58	1.67	1.25	--	1.14
PR	1	2.29	1.23	1.26	--	0.51	1.26	1.43	1.34	1.23	--	1.06
RI	0.85	1.33	0.7	1.04	--	1	0.96	1.58	0.88	1.04	--	1.07
SC	1.24	0.62	0.97	1.21	0.76	1.07	1.2	0.63	0.97	1.07	0.87	0.97
SD	1.33	1.33	0.97	1.12	3.03	1.51	1.31	1.88	0.97	1.22	1.88	1.22
TN	--	0.75	0.75	1.5	0.75	0.71	3	--	0.75	1.5	--	0.86
TX	0.83	0.78	1.09	1.13	0.83	0.96	0.57	0.87	1.04	1.13	0.87	0.96
UT	1.42	0.58	0.81	1.28	0.97	1.06	0.97	1	0.77	1.14	0.86	1.06
VA*	--	1.25	1	1	0.83	1.09	1.82	0.82	1.09	1.36	0.73	1.09
VT	--	--	--	--	--	--	--	--	--	--	--	--
WA	1	0.88	0.76	1.18	1.47	1.11	0.83	0.72	0.78	1.06	1.28	0.9
WI^	1.08	1.23	0.54	1.08	1.54	0.75	1.15	0.69	0.62	1.08	0.85	0.67
WV	--	--	0.73	1	--	0.55	--	--	0.55	0.64	--	0.91
WY	1.19	--	1.1	0.76	--	1.14	0.91	4.35	1.35	1.39	4.35	1.08

Note.

^*= state is county administered;

^{^}= state is hybrid, partially administered by the state and partially by counties.

Disparity ratios equal to 1 infer equal risk of substantiation for a given racial or ethnic group of boys or girls relative to White boys or girls; ratios below 1 indicate lower risk for substantiation of the indicated group, and values above 1 indicate greater risk for substantiation of the indicated group. Bolded text indicates significant over- or underrepresentation of a group compared with White or non-Latine children from the same gender category.

Table 3.

Child Sexual Abuse Substantiation Racial and Ethnic Group Disparity Ratios by Gender within each U.S. State

	Male/Boy						Female/Girl
State	Native	Asian	Black	Multiracial	NHPI	Latino	Native	Asian	Black	Multiracial	NHPI	Latina
US	0.79	0.86	0.93	0.93	0.50	0.71	0.84	1	0.92	0.92	1.16	1
AK	1.14	--	--	1.57	--	1	0.82	1.94	1.18	0.82	1.06	1.06
AL	--	1.88	0.94	1.28	--	0.84	0.55	0.5	0.92	0.75	0.57	1.18
AR	--	--	0.96	0.64	--	0.89	--	1.43	0.89	0.83	1.54	1.3
AZ	--	2.43	0.57	2	--	0.86	1.19	1.29	0.67	0.86	0.33	1.16
CA*	0.67	0.5	0.5	1	1.17	1.2	0.73	1	0.8	0.87	2	1.5
CO*	--	--	0.8	1.67	2.2	1.13	0.34	0.79	0.72	1.07	0.59	1.23
CT	--	--	1.33	--	--	0.61	2.86	1.43	1.14	0.91	--	1.28
DC	--	--	--	--	--	2	5.56	--	0.56	3.72	--	2
DE	--	--	1	--	--	1.33	--	1.13	0.73	0.33	--	1.83
FL	--	2.27	0.91	1.36	--	1.27	0.91	1	0.82	0.95	1.73	1.19
GA	--	1.94	0.94	0.24	--	1.81	--	1.63	0.96	1	2.08	1
HI	--	--	--	--	--	--	--	1.43	0.71	1.31	1.06	1.1
IA	0.8	1.13	1.13	1.07	--	0.6	1.08	1.2	1.04	0.6	1.52	1.29
ID	--	--	--	--	--	1	1	--	1	--	1	1
IL	--	0.65	0.87	0.65	--	1.5	0.77	1.04	1	0.85	--	1.43
IN	--	0.73	0.55	0.91	--	1	1.47	0.94	0.71	0.82	--	1.19
KS	--	--	0.38	0.77	--	1.36	0.6	1.15	0.65	0.85	2.5	1.22
KY	--	--	0.56	1.33	--	1.94	--	0.41	0.97	1.09	2.94	1.24
LA	--	--	0.77	0.35	--	1.09	--	2.09	0.97	0.41	--	1.35
MA	--	1.25	0.75	--	--	1.67	1.25	1.72	0.97	0.91	--	1.03
MD	1.39	1.11	1.25	0.78	--	0.95	1.39	1.07	1.09	1	0.61	1.21
ME	1.67	6.67	0.53	1.07	--	0.65	2.17	4.35	--	2	--	2.12
MI	--	1.13	0.67	1.2	--	0.86	1.08	1.44	0.8	0.96	2	1.48
MN*	1.05	1.52	1.33	1.1	--	1.32	0.97	1.58	0.97	0.97	3.23	1.37
MO	1.08	1.08	1.01	0.86	--	1.04	1.03	1.03	1.02	0.99	1.03	0.97
MS	--	--	1.07	2.14	--	--	0.92	1.72	0.96	1.04	2	0.8
MT	1.71	--	--	--	--	2	1.22	2.78	--	0.92	--	1.5
NC*	1.15	--	0.81	0.81	--	1.22	1.03	3.23	0.87	1.06	0.29	1.1
ND*	--	--	2.7	--	--	--	0.63	3.7	1.56	1.22	--	0.69
NE	1.75	--	0.5	3.25	--	1.2	1.5	1.31	0.94	1.06	--	1.33
NH	--	--	--	--	--	2	0	--	0.44	1.11	--	0.2
NJ	--	--	1	0.75	--	1.29	0	0.68	0.74	0.84	0.42	1.57
NM	0.87	--	1.2	--	--	0.76	0.65	2.17	0.87	1.04	2.61	0.92
NV^	--	1.07	0.44	0.37	1.22	2	0	1.47	0.65	0.76	1.41	1.72
NY*	--	1.36	0.71	0.86	--	1.23	0.83	1.17	1.17	0.65	1.43	1.45
OH*	--	0.28	0.76	0.79	--	1.07	--	0.43	0.77	0.89	0.91	1
OK	1	6	0.3	1.1	--	0.8	0.81	1.27	0.35	0.92	1.92	1.08
OR	1.11	0.74	0.32	0.89	--	1.6	0.74	0.84	0.58	0.9	0.71	1.27
PA*	--	0.67	0.89	0.78	--	0.94	3.7	1.37	1.07	0.93	1.85	1.35
PR	--	--	--	5.56	--	--	1.19	--	1.76	--	--	--
RI	--	--	1.11	0.61	--	1	--	0.88	1.33	1.61	--	1.41
SC	2.27	1.41	0.77	1.09	--	2.1	3.07	1.41	0.89	0.81	1.22	1
SD	--	--	--	--	--	--	1.38	--	--	1.38	--	1.18
TN	--	--	0.6	0.6	6.67	1.31	0.46	1.04	0.96	1	--	1.25
TX	0.75	1.25	1.25	1.25	1.25	0.8	1.41	0.94	0.82	0.76	1.53	1.29
UT	0.83	1.1	1.6	0.7	0.57	0.97	1	1.18	0.95	0.85	0.82	1.21
VA*	--	--	0.61	0.61	--	1.13	0.69	0.53	0.81	0.83	0.69	1.57
VT	--	--	--	3.05	--	--	--	1.72	0.52	3.45	--	2.39
WA	--	2.2	0.5	0.5	--	0.9	1.11	1	0.82	1.07	1.39	1.22
WI^	1.13	2.2	0.93	0.6	--	0.93	0.67	1.25	0.71	1.08	0.58	1.29
WV	--	3	--	0.36	--	--	--	1.94	0.65	0.65	--	1.06
WY	6.25	--	--	--	--	--	1.72	--	2	2	--	1.3

Note.

^*= state is county administered;

^{^}= state is hybrid, partially administered by the state and partially by counties;

-- = an insufficient number of cases in the NCANDS database or in the community to calculate DRs.

Disparity ratios equal to 1 infer equal risk of substantiation for a given racial or ethnic group of boys or girls relative to White boys or girls; ratios below 1 indicate lower risk for substantiation of the indicated group, and values above 1 indicate greater risk for substantiation of the indicated group. Bolded text indicates significant over- or underrepresentation of a group compared with White or non-Latine children from the same gender category.

2.3.1. Racial and Ethnic Group Disparities

We calculated risk ratio indices, disparity ratios, and raw differential representation of children identified as Black, Asian American, Native North American, Hawaiian Native/Pacific Islander, and multiracial compared to children identified as White by gender (Girvan et al., 2019). We calculated similar values for ethnicity by gender. All racial comparisons included White children as the reference group, whereas ethnicity calculations compared Latine with non-Latine populations.

Risk Ratio Index.

The risk ratio index represents the proportion of substantiated children out of all total reports for children identified as a specific race group, ethnic group, or gender within a state. Equation 1 shows the specific calculation. As an example, Alaska substantiated 98 Native North American cases out of 533 reports involving Native North Americans-identified boys for CPA, resulting in a risk index of 0.18.

$$\mathit{\text{Risk Ratio Index}}=\frac{\#\mathit{\text{of substantiated children for a specific race,ethnicity}},\mathit{\text{and sex within a state}}}{\#\mathit{\text{of reported children for same race}},\mathit{\text{ethnicity}},\mathit{\text{and sex within a state}}}$$ (1)

Risk ratios are not reported but were used to calculate the raw differential representation.

Disparity Ratio.

In the child abuse and neglect literature, disparity ratio (DR) often involves the ratio of children from a given racial or ethnic group (by gender) reported or substantiated out of the general population compared to the same proportion for White or non-Latine children (by gender). In our study, we compare the risk index of Black, Asian American, Native North American, Hawaiian Native/Pacific Islander, and multiracial groups by gender and state to the respective risk index of White children (Equation 2). For ethnicity, this was the ratio of the Latine risk index to the non-Latine risk index.

$$\mathit{\text{Disparity Ratio}}=\frac{\mathit{\text{risk index of target group for a specific gender and state}}}{\mathit{\text{risk index of respective White gender and state}}}$$ (2)

A disparity ratio equal to 1 infers equal risk of substantiation across the two racial groups, values below 1 (or with the conservative cutoff described below of 0.90) indicate the Black, Asian American, Native North American, Hawaiian Native/Pacific Islander, or multiracial group has lower risk for substantiation than the White group, and values above 1 suggest that the Black, Asian American, Native North American, Hawaiian Native/Pacific Islander, or multiracial group has greater risk for substantiation than the White group. To account for inflation and to be conservative, we expanded the equal category to include disparity ratios between 0.90 and 1.10. For example, in Alaska, the CPA risk index for Native North American-identified boys (0.18) divided by the CPA risk index for White boys (0.11) produces a disparity ratio of 1.64 (0.18/0.11), suggesting that Native North American boys are more than one and half times as likely to be substantiated for CPA compared to White boys in Alaska.

Raw Differential Representation.

The raw differential representation (RDR) highlights the excess number of children identified as Black, Asian American, Native North American, Hawaiian Native/Pacific Islander, or multiracial if the probability of substantiation was equal to that of White children.

$$RDR=\#of\text{substantiated}\text{BIPOC}\text{children}-\frac{\#\mathit{\text{of substantiated BIPOC children}}}{\mathit{\text{disparity ratio}}}$$ (3)

For example, in Alaska, if the probability of substantiated Native North American-identified boys was equal to that of White boys for CPA, we would expect 38 fewer substantiated cases for Native North American-identified boys rather than the observed 98 (98 - (98/1.64) = 38). Another way to understand this interpretation is to consider if the disparity ratio was 1, meaning that the risk of substantiation was equal for both the Black, Asian, Native North American, Hawaiian Native/Pacific Islander, or multiracial group and White children. If this were the case, for the same example, the formula would be (98 - (98/1) = 0), meaning that the number of observed Black, Asian American, Native North American, Hawaiian Native/Pacific Islander, or multiracial cases equals the number of expected cases for White children. In the case of negative RDRs, we would expect that many more substantiated cases, indicating that the racial group is substantiated less frequently than White children. Positive RDRs indicate we would expect that many fewer substantiated cases if the risk index was constant across racial/ethnicity groups.

The RDR, however, is related to the number of children and is not standardized, making comparisons across racial groups, gender, and state difficult. To control for state-level reporting, we can divide the RDR by the total number of reports and multiply by 100 to produce a standardized RDR per 100 children.

$${\text{RDR}}_{100}=\left(\frac{RDR}{\#\mathit{\text{of reports for all children of respective sex in the state}}}\right)\times 100$$

For example, the RDR₁₀₀ for Native North American-identified boys in Alaska for CPA is 38/(533 reports for Native North American-identified boys + 22 reports for Asian American-boys + 61 Black-identified boys + 247 multiracial girls + 56 Pacific Islander-identified girl + 469 White girls) = 2.76 greater substantiated cases per 100 reports involving boys in Alaska. In comparison, the RDR₁₀₀ for Native North American-identified girls in Alaska for CPA is 3.62, so we can conclude that CPA substantiation occurs more frequently for Native North American girls. Comparing the RDR without standardization could lead to erroneous conclusions due to differences in the number of reported children within states and gender.

To reliably estimate disproportionality using disparity ratios (DR) and raw differential representation (RDR and RDR₁₀₀), we collectively examined number of substantiated reports along with these two metrics for each of the six racial categories and the dichotomous ethnicity variable within each state for both genders. DR values are provided in Tables 1–3; RDR₁₀₀ values are presented in supplemental Tables 1–3); select RDR values and related numbers of reported and substantiated cases are reported in text below. For all calculated values, when DR<1 and RDR was negative, a particular group was underrepresented among substantiated cases; conversely, when DR was >1.1 and RDR was positive, a particular group was classified as overrepresented among substantiated cases (in comparison with White girls or boys). Calculations were conducted in R version 4.0.0. Figures 1 and 2 represent disparities by Black race, Latine ethnicity, and Asian American race.

Figure 1.

Chloropleth maps of the United States displaying substantiation disparities for Black girls, Latine girls, and Asian girls. Alaska, Washington DC, Puerto Rico, and Hawaii are displayed at the bottom.

Note. CPA = child physical abuse; CSA = child sexual abuse. Colors indicate overrepresentation (yellow, orange, red, maroon), no difference or calculation unavailable due to too few cases (green), or underrepresentation (light blue, blue, dark blue) relative to White girls and non-Latine girls.

Figure 2.

Chloropleth maps of the United States displaying substantiation disparities for Black boys, Latine boys, and Asian boys. Alaska, Washington DC, Puerto Rico, and Hawaii are displayed at the bottom.

Note. CPA = child physical abuse; CSA = child sexual abuse. Colors indicate overrepresentation (yellow, orange, red, maroon), no difference or calculation unavailable due to too few cases (green), or underrepresentation (light blue, blue, dark blue) relative to White boys and non-Latine boys.

3. Results

3.1. Child Neglect

3.1.1. Black children.

From the observed DR and RDR, reports were slightly less frequently substantiated among Black-identified children throughout the U.S. compared to White-identified children: DR=0.95 meaning Black boys were less likely to have cases substantiated, and RDR=−3,291 meaning about 3,291 fewer cases were substantiated compared with what would be expected if their rates were equal to those for White children. Findings were similar for girls: DR=0.95, RDR=−3,150. In 23 states there were fewer substantiated reports for both Black girls and boys compared with White girls and boys, respectively. In two states (New Mexico, North Dakota), there were fewer substantiated reports for boys only, and fewer substantiated reports for girls only in two states (Hawaii and Kansas). These patterns were not consistent across all states. For example, Black-identified children had more substantiated reports than White children in four states (Minnesota, New York, Pennsylvania, and Wyoming) and Puerto Rico. Black children were not over- or underrepresented in 16 states, namely: Arkansas, Colorado, Connecticut, Iowa, Illinois, Indiana, Massachusetts, Maryland, Missouri, Nevada, New Jersey, South Carolina, South Dakota, Texas, and Virginia.

3.1.2. Multiracial children.

The overall frequency of child neglect report substantiation was higher in the U.S. for Multiracial children compared to the White-identified children, with DR=1.1 and RDR=1,606 for boys; and DR=1.1 and RDR=1,569 for girls. For eleven states (Alaska, Colorado, Florida, Georgia, Idaho, Illinois, Minnesota, Montana, New Hampshire, New Jersey, New Mexico, Oregon, South Dakota, Tennessee, Texas, and Utah) and Puerto Rico and DC, there were more substantiated reports for Multiracial girls and boys in comparison with White girls and boys, respectively. Significant overrepresentation was only observed for boys but significant underrepresentation of girls in Delaware, Hawaii, and Iowa; whereas in Maryland, South Carolina, and Washington, Multiracial boys were overrepresented and Multiracial girls were not over- or underrepresented. In five states (Connecticut, Indiana, Mississippi, North Dakota, Pennsylvania, and Virginia), only Multiracial girls were overrepresented and Multiracial boys were not over- or underrepresented. In Maine and Wyoming, Multiracial girls were overrepresented among reported cases and Multiracial boys were underrepresented. Multiracial children were not over- or underrepresented in 14 states: Alabama, Arizona, California, Kentucky, Louisiana, Massachusetts, Michigan, Nevada, New York, North Carolina, Ohio, Oklahoma, Rhode Island, and Wisconsin.

3.1.3. Native North American children:

There was a higher frequency of report substantiation for Native North American boys: DR=1.24, RDR=1,002; and girls DR=1.24, RDR=974 compared with White children. Specifically, in 17 states (Alaska, Arizona, Colorado, Connecticut, Florida, Iowa, Idaho, Minnesota, Montana, North Carolina, North Dakota, Nebraska, New Mexico, Oklahoma, Oregon, South Carolina, and South Dakota) there were more substantiated neglect cases for Native North American girls and boys compared with White girls and boys. In addition, there were fewer substantiated reports of neglect involving Native North American children (girls and boys) compared with White children in nine states: California, Georgia, Indiana, Louisiana, Maryland, Mississippi, New Hampshire, Ohio, and Texas. Native North American children were not over- or underrepresented in the states of Michigan, Missouri, and New York among substantiated cases of neglect.

3.1.4. Asian children.

Overall, there was a comparable frequency of neglect case substantiation for Asian children compared with White children: DR=1.05, RDR=132 for boys; and DR=1.05, RDR=132 for girls. Still, there were fewer substantiated reports for Asian children compared with White children in 20 states for both girls and boys (Arkansas, Arizona, California, Georgia, Illinois, Indiana, Kentucky, Maryland, Michigan, Montana, North Carolina, North Dakota, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, South Carolina, Texas, and Washington). And in Massachusetts, Asian boys were overrepresented among substantiated cases of neglect whereas Asian girls were overrepresented among substantiated cases of neglect in four states: Alaska, Kansas, Virginia, and Wisconsin. The reverse was true (with Asian girls being overrepresented and Asian boys being underrepresented) in Alabama and New Hampshire. Both Asian girls and boys were overrepresented among substantiated cases of neglect in nine states: Hawaii, Idaho, Maine, Minnesota, Rhode Island, South Dakota, Wyoming, Washington DC, and Puerto Rico.

3.1.5. Disparities in neglect case substantiation by ethnicity.

Overall, substantiation for Latine children was at a higher frequency compared to non-Latine children, with DR=1.19 and RDR=7,891 for boys; and DR=1.19, RDR=7,903 for girls. Latine children were overrepresented in ten states: Arizona, California, Colorado, Delaware, Massachusetts, Maryland, Montana, North Dakota, New York, and South Dakota. Conversely, underrepresentation of substantiated cases was observed in seven states for both genders: Alaska, Arizona, Georgia, North Carolina, New Hampshire, Tennessee, and Wisconsin. N/A in 16 states: Alabama, Connecticut, Iowa, Illinois, Indiana, Kentucky, Missouri, Nevada, New Mexico, Oklahoma, Oregon, Rhode Island, South Carolina, Texas, Utah, and Virginia.

3.2. Child Physical Abuse

3.2.1. Black children.

Reports of CPA were substantiated at a higher overall frequency for Black children in the U.S. compared with White children: DR=1.15, RDR=2,200 for boys; DR=1.15, RDR=1,985 for girls. Overrepresentation of Black children was particularly the case within 13 states for both girls and boys (Arizona, California, Colorado, Illinois, Louisiana, Minnesota, Minnesota, Nebraska, New Hampshire, New Jersey, New York, Pennsylvania, and Virginia). In two states (Maryland and South Dakota) and Washington DC, Black boys were overrepresented among CPA cases compared with White boys, while Black girls were underrepresented among CPA cases compared with White girls. The reverse was observed in Hawaii, Indiana, and Puerto Rico for Black versus White girls. In contrast, there were fewer substantiated reports for Black girls and boys compared with White children in seven states (Alabama, Kentucky, Ohio, Oregon, Tennessee, Utah, and West Virginia). There were four states (Missouri, Mississippi, Oklahoma, and South Carolina) with no observed over- or underrepresentation for Black children and CPA report substantiation.

3.2.2. Multiracial children.

Overall, for multiracial children, reports were substantiated at a higher frequency in the U.S. compared with White children. Boys’ substantiation disparities were DR=1.15 and RDR=531; girls’ were similar (DR=1.15, RDR=456). Rates were higher in 18 states and DC for both girls and boys (Alaska, Arkansas, Colorado, Georgia, Hawaii, Iowa, Illinois, Massachusetts, Mississippi, Montana, North Dakota, New Jersey, Nevada, South Dakota, Tennessee, Texas, Virginia, and Washington, and Washington DC).

In California and Vermont, boys were overrepresented while girls were underrepresented. And the opposite was true in Kansas, Nebraska, Pennsylvania, Wisconsin, and Puerto Rico, with girls overrepresented while boys were underrepresented. In five states–namely Ohio, Oklahoma, Oregon, Rhode Island, and South Carolina–Multiracial girls and boys were not over- or underrepresented.

3.2.3. Native North American children.

Overall CPA report substantiation in the U.S. was higher for Native North American boys (DR=1.23, RDR=123) and girls (DR=1.15, RDR=73) compared with White-identified children. Native North American girls and boys were overrepresented among substantiated cases of CPA compared with their White counterparts in fifteen states (Alaska, Arizona, Colorado, Idaho, Massachusetts, Minnesota, Mississippi, Nebraska North Carolina, North Dakota, New Mexico, South Dakota, Utah, Washington, and Wisconsin). In contrast, there were only three states (Illinois, Ohio, Texas) plus Puerto Rico in which Native North American girls and boys were underrepresented among substantiated cases of CPA. Arkansas and New York were the only states in which boys were overrepresented and girls were underrepresented; and girls were overrepresented, whereas boys were underrepresented, in five states: California, Florida, Iowa, Montana, and South Carolina. Lastly, Oklahoma was the only state in which we did not observe disparities in CPA case substantiation for Native North American girls and boys.

3.2.4. Asian children.

The overall substantiation rates of CPA for Asian boys was lower (DR=0.69, RDR=−274) among boys and also lower among girls (DR=0.69, RDR=−235) compared with rates for White girls and boys, respectively. In 18 states (Alaska, Alabama, Arkansas, Connecticut, Illinois, Kansas, Michigan, North Carolina, Nevada, New Jersey, New Mexico, Ohio, Oklahoma, Oregon, South Carolina, Texas, Utah, and West Virginia), Asian children were underrepresented among those with a substantiated case of CPA.

Asian boys were overrepresented while Asian girls were underrepresented in the six states of Arizona, Colorado, Florida, Hawaii, Iowa, Kentucky; conversely, Asian girls were overrepresented while Asian boys were underrepresented in four states: Mississippi, Rhode Island, Vermont, and Virginia. There were no differences in representation of substantiated cases of CPA among Asian children compared with White children in California or Missouri.

3.2.5. Disparities by ethnicity.

The overall substantiation for Latine children compared to the non-Latine children was lower among Latine boys, with a DR=0.80 and RDR=−2,097 compared with non-Latine boys. Substantiation rates for Latine girls were comparably lower relative to non-Latine girls (DR=0.80, RDR=−1902). Disparities by Latine ethnicity were mixed, as in eight states (Alaska, Alabama, Delaware, Florida, Illinois, Michigan, South Carolina, and West Virginia) both girls and boys were underrepresented among substantiated CPA cases. And in nine states: California, Hawaii, Iowa, Kentucky, Massachusetts, Montana, New York, and Washington, and Washington DC, both Latine girls and boys were overrepresented. There were no discernable disparities in six states, namely Georgia, Missouri, New Jersey, Oklahoma, Pennsylvania, and Utah.

3.3. Child Sexual Abuse

3.3.1. Black children.

Overall, reports of CSA in the U.S. were substantiated at a slightly lower frequency for Black Children compared with White children: DR=0.93, RDR=−163 for boys; and DR=0.92, RDR=−734 for girls. Rates of CSA substantiation were lower in 14 states for Black girls and boys, namely: Arizona, California, Colorado, Indiana, Kansas, Michigan, Nevada, North Carolina, Ohio, Oklahoma, Oregon, South Carolina, Virginia, and Washington. Overrepresentation of Black girls and boys in CSA cases only occurred in four states: Connecticut, Minnesota, North Dakota, and Rhode Island. In New Mexico and Texas, Black boys were overrepresented while Black girls were underrepresented relative to White girls and boys for substantiation of CSA cases. And only in New York were Black girls overrepresented while Black boys were underrepresented. We observed comparable rates of substantiation for Black and White girls and boys in four states: Alabama, Georgia, Missouri, and Mississippi.

3.3.2. Multiracial children.

Reports were substantiated at a slightly lower overall frequency for multiracial children compared with White children in the U.S. More specifically, boys had a DR=0.93 and RDR=−43. Girls had a DR=0.92, RDR=−187. Multiracial girls and boys were underrepresented compared with White girls and boys in 11 states with data from both Multiracial girls and boys: Arkansas, Illinois, Kansas, Louisiana, Nevada, New Jersey, New York, Ohio, Utah, Virginia, and West Virginia. Multiracial girls and boys were only overrepresented among substantiated cases of CSA in the state of Vermont.

3.2.4. Asian children.

The overall substantiation rates of CSA for Asian boys was lower (DR=0.86, RDR=−200) among boys and did not among girls (DR=1.00, RDR=0) compared with rates for White girls and boys, respectively. Of note, there were too few Asian girls with CSA reports in 7 states to calculate a DR and too few boys in 25 states to calculate a DR; DRs were not calculated for Asian girls or boys in Washington DC or Puerto Rico, either. Overall, Asian girls were substantially overrepresented in 29/43 states: Alaska, Arizona, Arkansas, Connecticut, Delaware, Georgia, Hawaii, Iowa, Kansas, Louisiana, Massachusetts, Maine, Michigan, Minnesota, Mississippi, Montana, Nevada, New Mexico, New York, North Carolina, North Dakota, Nebraska, Oklahoma, Pennsylvania, South Carolina, Utah, Vermont, Wisconsin, and West Virginia. Asian boys were underrepresented in six states: California, Illinois, Indiana, Ohio, Oregon, Pennsylvania. But Asian Boys were overrepresented in 17/25 states (i.e., Alabama, Arizona, Florida, Georgia, Iowa, Maine, Maryland, Massachusetts, Michigan, Minnesota, New York, South Carolina, Texas, Utah, Washington, West Virginia, Wisconsin). Commensurate rates of substantiation between Asian boys and White boys was observed in two states (Missouri and Nevada); for girls commensurate rates of CSA cased substantiation was observed in nine states (California, Florida, Illinois, Indiana, Maryland, Missouri, Texas, Utah, and Washington).

3.3.3. Latine ethnicity.

We observed lower rates of substantiation among Latine boys compared with non-Latine boys nationally (DR=0.71, RDR=−779). The national rate of CSA report substantiation was comparable for Latine and non-Latine girls. Latine girls and boys were overrepresented in 16 states (California, Colorado, Delaware, Florida, Kansas, Kentucky, Minnesota, Montana, North Carolina, Nebraska, Nevada, New Jersey, New York, Oregon, Tennessee, and Virginia) and in Washington DC. Rates of CSA substantiation were lower for Latine boys and higher for Latine girls in seven states: Alabama, Arkansas, Arizona, Connecticut, Iowa, Maine, and Washington. And there were no observed differences in rates of CSA substantiation by ethnicity in four states (Alaska, Idaho, Missouri, and Ohio).

4. Discussion

Ethnoracial ethnic group disparities in child maltreatment dispositions–namely substantiation of reports–have been observed in previous research (Fix & Nair, 2020; A Luken et al., 2021). Our study builds on existing literature testing for racial and ethnic group disparities at the state level using nationwide data from the United States, and was the first to measure (1) racial and ethnic group disparities by gender, and (2) racial and ethnic group disparities within three categories: neglect, child physical abuse, and child sexual abuse. Altogether, results demonstrated pronounced racial and ethnic group disparities that at times differed by child gender within each type of child abuse and neglect. Overall, our results suggest the most pronounced ethnoracial disparities in report substantiation rates appeared to occur within states that had a greater proportion of each historically oppressed ethnoracial population. While there were states in which there were no disparities for each racial group or Latine children, this phenomenon was relatively rare. And though we did not identify any distinct patterns or differences between states with state-level administration, county-level administration, and hybrid administration approaches, findings should be interpreted recognizing that there is statewide variation in administration of child welfare systems, with most states using a state-level approach, some using a county-level approach, and a couple using a hybrid approach.

4.1. Overarching Findings Concerning Substantiation Disparities

We observed racial and ethnic group-based disparities among cases of neglect, CPA, and CSA. Patterns of both over- and underrepresentation by gender (e.g., girls from a specific ethnoracial group being overrepresented while boys from the same group were underrepresented) emerged in several, highlighting the complexity of these disparities across most ethnoracial groups. These patterns reflect a multifaceted story likely shaped by the interplay of structural racism, social stratification, and systemic inequities that culminate in ethnoracial health disparities (Bailey et al., 2021; Bailey et al., 2017; Dettlaff & Boyd, 2020). Moreover, such disparities persist regardless of the administrative structural approach of the child welfare system (e.g., state-level) indicating that deeply rooted structural and institutional factors may transcend governance models and require systemic, equity-oriented reform.

There are many reasons these disparities are present in the US at large; disproportionalities in child welfare system involvement and substantiation more specifically are theorized to originate from structural and institutional racism within the child welfare system and society as a whole (Dettlaff & Boyd, 2020). As noted in existing literature, responses to child abuse and neglect depend in part on child characteristics, namely their race and family economic security (Najdowski & Bernstein, 2018). And even the believability of the survivor, concern and empathy for the survivor, and perceptions of culpability of the person who was accused of maltreatment can be muddled by social identifiers including the child’s race (Atkinson et al., 2023; Falligant et al., 2017; Fix & Nair, 2020), likely culminating in these observed disparities.

The differentiated rates of substantiation by type of abuse and neglect merits further examination. Observed racial and ethnic group trends in substantiation – higher rates for CPA, and lower rates for neglect and CSA among Black and Multiracial children relative to White children –might reflect the dehumanization of Black and multiracial children in the United States in particular (Goff et al., 2014). Moreover, people may view Black and Multiracial children as capable of handling more maltreatment while garnering less sympathy based on experimental research concerning physical pain and other negative experiences (Hudson et al., 2019; Neumann et al., 2013).

4.2. Child Abuse and Neglect Disparities

We observed consistent patterns of over- or underrepresentation of substantiated cases of neglect among boys and girls within US states. Altogether, Native North American, Multiracial, and Latine children were overrepresented among substantiated neglect cases relative to White children. At the state-level, there were also some robust levels of underrepresentation of different ethnoracial groups among substantiated neglect cases, particularly Black and Asian children.

Concerning cases involving substantiated CPA, Black and Multiracial children were overrepresented. In contrast, Asian and Latine children were underrepresented among substantiated cases of CPA. Conversely, for CSA cases, rates of substantiation tended to be lower for Black and Multiracial children. Lower substantiation rates were particularly robust for Black girls in CSA cases, which is an interesting finding given previous research examining disparities in reports of CSA indicated an overrepresentation of Black children in CSA cases (Luken et al., 2021).

Our findings illuminate disparities that result from myriad interacting social systems and structures. Perhaps our findings reflect actual rates of abuse and neglect. Or perhaps they reflect racism at many levels, including individual bias among mandated reporters (e.g., teachers, law enforcement) or CPS investigators. Indeed, such individuals may be influenced by parenting standards or norms based on White middle-class families (Bell, 1965; Dettlaff & Boyd, 2020). And research has demonstrated racial bias among practitioners and professionals working in the child welfare, education, medical, and legal systems concerning child maltreatment (Dettlaff & Rycraft, 2010; Hymel et al., 2018; Krase, 2015).

Further, findings may in part reflect the institutional mistrust harbored by families of color who have been historically harmed by the child welfare system (Dettlaff et al., 2023; Merritt, 2021; Roberts, 2022). For example, researchers have observed patterns in which Black families are subjected to more disrespectful treatment, cultural misunderstandings, and harsher judgments of their parenting (Berkman et al., 2022; Merritt, 2021; Miller et al., 2012). Finally, these influential factors must be considered alongside systemic racism (Cénat et al., 2021; Dettlaff et al., 2023; Dettlaff & Boyd, 2020). In sum, systemic racism may further impact families as they work to navigate the child welfare system and in their decision-making processes to report child abuse or neglect or to cooperate during investigations of child maltreatment. More research is needed to unpack ethnoracial and gender disparities in reports and substantiation of child abuse and neglect.

Addressing Disparities in Child Abuse and Neglect Substantiation

Broadly speaking, findings emphasize the importance of considering child ethnoracial and gender identity when evaluating dispositions following CPS investigations of child abuse and neglect cases. The child welfare system functions to intervene with families impacted by child abuse and neglect after the fact. More funding must be dedicated to primary prevention (or preventing harm from occurring in the first place). Indeed, primary prevention practices in select contexts can reduce maltreatment rates, but these interventions often have limited uptake (Jones Harden et al., 2020). Furthermore, there is a paucity of evidence-based policy and research work focused on primary prevention approaches to neglect (Briar-Lawson et al., 2021; Bullinger et al., 2020; Cancian et al., 2013). Interventions that have demonstrated success include early childhood education programming and home visitation (for families who are not yet at risk for maltreatment). Still, reviews of the literature demonstrate prevention programming in primary care settings is lacking (Viswanathan et al., 2024). Thus, more work is needed both to address child maltreatment through primary prevention and to promote ethnoracial equity.

Understanding for whom services are being provided is key to targeted and effective prevention responses. For instance, tertiary prevention programs – namely parental management interventions – are associated with reductions in child abuse and neglect (Jones Harden et al., 2020). Targeted programming specific to family-level interventions appear most effective as prevention interventions (at all prevention tiers) based on reviews of the literature (Chen & Chan, 2016; Gubbels et al., 2019).

In addition to interventions centered around primary prevention of child maltreatment, growing evidence suggests change through policy reformation and development offers promise. Policy change can reduce the risk of neglect and other forms of child maltreatment. As an example, research suggests that providing families with additional financial resources can reduce child abuse and neglect (Bullinger et al., 2020; Cancian et al., 2013; Dettlaff et al., 2021). Research consistently points to a need for policies that enhance economic stability and resources to promote housing and food security for historically oppressed communities in particular (Feely et al., 2020; Klika et al., 2022). Moreover, there are calls by some experts in the field of child welfare to radically transform the system (Dettlaff et al., 2023; Roberts, 2022). Many recommendations argue for collectively reimagining and rigorously testing policies and practices that can simultaneously strengthen families while promoting child safety.

4.1. Limitations and Future Directions

Although the NCANDS is a rich source of data on cases of abuse and neglect nationwide in the United States, there are also some limitations of available NCANDS data and the study more broadly that should be addressed moving forward. First, available data were limited to what is provided by each state₂. Of particular relevance to follow-up research, the race, ethnicity, and gender of the person who was accused of engaging in child abuse and neglect is just as important for prevention purposes if not more (Assini-Meytin et al., 2020; Atkinson et al., 2021). In addition, data used in the current study (NCANDS) are collected by caseworkers or provided by the hotline reporter and needed for follow-up by the CPS investigator. Human biases, as noted throughout this manuscript, are inherent in these data collection practices, as well. While available data allowed us to test where child abuse and neglect case substantiation disparities occurred, we were unable to examine whether child race, ethnicity, and gender were associated with case outcomes beyond caregiver and/or perpetrator race, ethnicity, and gender.

Second, while it is important to consider other factors such as prior history of maltreatment within a household (Fix & Nair, 2020) or like family structure factors in follow-up research, that focus fell outside of the scope of our current study. We do encourage researchers interested in furthering the field to account for such characteristics. Indeed, family factors like caregiver disability (Fix & Nair, 2020) and sibling maltreatment (Kisely et al., 2021) should be considered alongside other risk and protective factors in future studies.

We also did not focus on county-level disparities (Ards et al., 2003) in the current study but encourage such examination in follow-up research to better understand presenting needs at a more local level as well as the impact of local policies on substantiation. Researchers need county-level data to examine more local trends because the current system only typically allows for analyses at the state level or within large counties but not within small counties.

It is also important to acknowledge that data in the present study represent a brief snapshot of children’s experiences in the United States’ CPS system – focused on one year in time. Given that previous research observed recent changes in rates of CPA and neglect (Finkelhor et al., 2018), follow-up research should be conducted to test for changes in racial, ethnic, and gender disparities in reported and substantiated CPA, CSA, and neglect over time. Moreover, we did not test whether there were racial, ethnic, or gender disparities in outcomes following disposition (e.g., residential care, foster care system, family therapy referrals), yet such a line of inquiry would be informative. Finally, there is no standardized definition of child abuse and neglect nor of each subtype of child abuse and neglect, reducing ability to accurately estimate incidence of each. This lack of a standardized definition likely also perpetuates racial and ethnic group bias–and gender biasin reporter recognition and action in responding to suspected child abuse and neglect.

Finally, these data and data from other research on disparities in reports of child abuse and neglect (Luken et al., 2021) suggest policy evaluation research is warranted. Future studies should examine how policies relevant to child abuse and neglect like those impacting health care access and economic insecurity influence child abuse and neglect reports and substantiation by race, ethnicity, and gender. Local-level policies and practices may best prevent child abuse and neglect or help provide best practices in response to realized child abuse and neglect; future research should also focus on elucidating more local (e.g., county-level) disparities, as evidence asserts disparities remain at the county-level and a more nuanced understanding can be captured through such examination (Maguire-Jack et al., 2021).

4.2. Conclusion

Understanding patterns in child abuse and neglect is critical to provide effective primary prevention (‘true’ prevention of maltreatment) and tertiary prevention (after-the-fact efforts) of child abuse and neglect. The current study is the first to identify how racial, ethnic, and gender group/categorization influence child abuse and neglect case substantiation dispositions in the United States, including the District of Columbia and Puerto Rico. It is also the first study to examine racial, ethnic, and gender disparities in substantiation broken down by child abuse and neglect type, namely child physical abuse, neglect, and child sexual abuse. Results demonstrated the need for such examination at the state level and suggest that future research and policy makers should test for racial, ethnic, and gender disparities at the county level.

Table 2.

Child Physical Abuse Substantiation Racial and Ethnic Group Disparity Ratios by Gender within each U.S. State

	Male/Boy						Female/Girl
State	Native	Asian	Black	Multiracial	NHPI	Latino	Native	Asian	Black	Multiracial	NHPI	Latina
US	1.23	0.69	1.15	1.15	1.15	0.8	1.15	0.69	1.15	1.15	1.08	0.8
AK	1.64	0.45	0.73	1.91	2.09	0.55	1.82	0.55	1	2	1.18	0.67
AL	0.94	0.32	0.84	1.1	0.65	0.77	1.5	0.5	0.9	1	0.73	0.9
AR	1.69	0.31	1.06	1.19	1.19	0.76	0.6	0.27	0.93	1.2	0.47	0.93
AZ	1.11	1.22	1.22	1.22	0.44	1	1.22	0.78	1.11	1	0.89	1.25
CA*	0.83	1	1.33	1.5	1.67	1.33	1.33	1	1.33	0.83	1.17	1.33
CO*	1.46	1.38	1.15	1.38	2.46	1	1.17	0.83	1.17	1.33	0.5	1.17
CT	--	0.25	1.08	0.67	1.42	0.83	--	0.78	1.33	1.78	7.44	0.91
DC	--	8.25	1.25	3	--	2.2	--	--	0.62	1.25	--	1.17
DE	--	5.5	1	1	--	0.67	--	--	1.2	0.4	--	0.5
FL	0.6	1.2	1.6	1.4	--	0.86	1.6	0.6	1	1.2	--	0.83
GA	1.09	0.18	1.09	1.27	--	0.92	--	1	1.5	1.62	2.5	1
HI	--	2	0.88	1.38	1.38	1.14	--	0.71	1.79	1.5	1.14	1.94
IA	0.71	1.47	0.82	1.29	0.47	1.38	2.8	0.27	1.07	1.27	1.27	1.13
ID	1.9	5	1	0.7	0	1.4	1.56	11.11	0.78	--	--	0.9
IL	0.27	0.67	1.27	1.27	1.13	0.82	0.87	0.73	1.33	1.13	--	0.76
IN	3	0.6	0.8	1	--	1	--	1	1.25	1	--	0.8
KS	1	0.14	1	0.86	--	0.71	1.17	0.33	1.17	1.5	4.83	1.33
KY	--	1.27	0.82	1	1.09	1.27	5	0.8	0.9	1.2	--	1.4
LA	0.5	1	1.2	1.3	--	0.78	1.39	1.28	1.33	1	--	1.05
MA	2.37	0.84	1.05	1.11	2	1.28	1.47	1	1.24	1.24	--	1.28
MD	1.67	1	1.13	1.2	--	0.94	--	0.77	1.08	0.92	1.54	1.31
ME	0.9	1.84	0.94	1.26	2.16	1.57	2.21	2.94	0.59	1	0.97	1.06
MI	0.94	0.61	1.5	1.22	1.83	0.9	0.89	0.28	1.5	1.22	1.11	0.9
MN*	1.22	1.78	1.78	1.67	--	1	1.75	2.62	2.25	2	4.12	1.17
MO	1.06	1.06	1.04	0.9	0.71	1.05	--	1.04	0.98	0.9	1.04	0.96
MS	1.21	0.86	1	1.36	--	0.79	2.07	2.07	0.93	1.36	--	1.08
MT	0.86	--	1.73	1.73	--	1.43	1.42	--	--	4.32	--	1.32
NC*	1.52	0.68	0.8	1.12	0.36	1.13	1.45	0.5	0.91	1.09	0.27	1
ND*	1.5	--	1	1.2	--	1.2	1.33	--	0.75	1.33	3.33	1
NE	2.25	1.42	1.25	0.67	--	0.93	2	--	1.36	1.45	3	1.08
NH	16.67	--	1.33	1.33	--	1.33	--	1.67	2	0.67	--	1
NJ	1.25	0.5	1.25	1.5	0.75	1	--	0.33	1.33	1.67	--	1
NM	1.69	0.81	1.06	1.5	1.38	0.94	1.43	0.86	1.71	0.93	--	0.88
NV^	2.5	0.71	1	1.14	1.43	0.8	1.06	0.62	0.81	1.38	0.31	0.94
NY*	1.93	1.43	1.43	1.07	1	1.25	0.85	1.31	1.62	1.23	1.54	1.31
OH*	0.53	0.58	0.89	1	0.16	1.11	0.32	0.79	0.89	0.95	1.42	0.95
OK	1.07	0.4	1	1.07	--	1	1	0.21	1.07	1	2.36	1.07
OR	1.36	0.71	0.64	0.93	1.5	1.13	1.08	0.69	0.77	1	1.15	1.07
PA*	--	1	1.17	0.83	--	1	--	1.17	1.17	1.33	--	1
PR	0.76	2.63	0.89	0.63	--	0.76	0.68	1.61	1.42	1.26	--	--
RI	2.73	0.32	0.91	1.09	1.5	0.79	--	1.82	1.14	1.05	--	0.92
SC	0.68	0.59	0.97	1.05	0.32	0.89	1.54	0.59	1	1	0.49	0.82
SD	1.87	2.2	1.8	2.4	--	0.58	1.2	--	0.8	1.2	--	1
TN	--	0.22	0.78	1.33	--	0.93	1.22	--	0.78	1.22	0.44	0.92
TX	0.6	0.5	1.1	1.1	0.8	0.91	0.6	0.5	1	1.1	0.7	1
UT	1.64	0.5	0.86	1.29	1.18	1	1.4	0.9	0.83	0.93	1.13	1.03
VA*	--	0.82	1.36	1.36	0.91	0.77	--	1.4	1.2	1.6	2.3	1
VT	--	0.59	1.12	2.94	--	1.59	--	1.72	1.06	0.61	--	1.39
WA	1.36	1.27	1.27	1.18	2.09	1.08	1.27	1	1	1.36	2.36	1.08
WI^	1.25	0.5	1	0.88	--	0.75	2	1	1.17	1.5	--	1
WV	--	0.5	0.69	1.19	3.12	0.69	--	0.88	0.88	0.94	--	0.82
WY	--	--	--	17	--	2	--	--	10	--	--	1

Note.

^*= state is county administered;

^{^}= state is hybrid, partially administered by the state and partially by counties;

-- = an insufficient number of cases in the NCANDS database or in the community to calculate DRs.

Disparity ratios equal to 1 infer equal risk of substantiation for a given racial or ethnic group of boys or girls relative to White boys or girls; ratios below 1 indicate lower risk for substantiation of the indicated group, and values above 1 indicate greater risk for substantiation of the indicated group. Bolded text indicates significant over- or underrepresentation of a group compared with White or non-Latine children from the same gender category.