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America's Children in Brief: Key National Indicators of Well-Being, 2020

Child Maltreatment

Child maltreatment includes physical, sexual, and psychological abuse, as well as neglect (including medical neglect). Maltreatment in general is associated with various negative outcomes for children, including developmental delay, lower school achievement, juvenile delinquency, substance abuse, and mental health problems. Many of these problems can follow maltreated children into adulthood.16 Certain types of maltreatment can result in long-term physical, social, and emotional problems—even death. For example, abusive head trauma can result in mental retardation, cerebral palsy, or paralysis.17 Please note that the calculation of child maltreatment changed recently and is not comparable with data presented in editions prior to America's Children, 2017. Specifically, rates are now based on unduplicated counts, and alternative response victims are no longer included.

Figure 4: Rate of substantiated maltreatment of children ages 0–17 by metropolitan status, 2018
Rate of substantiated maltreatment of children ages 0–17 by metropolitan status, 2018

NOTE: The data in this figure are rates of maltreatment based on investigations and assessments by Child Protective Services (CPS) that found the child to be a victim of one or more types of maltreatment. The rates are based on unique counts of victims of maltreatment. A unique count includes each child only one time regardless of the number of times the child was determined to be a victim. Maltreatment includes the dispositions of substantiated or indicated. Data may include state resubmissions and may not match previously published data. Rates are based on the number of states submitting data to the National Child Abuse and Neglect Data System (NCANDS) each year; states include the District of Columbia and the Commonwealth of Puerto Rico. The number of states reporting may vary slightly from year to year: not all states report on all measures, and not all states report in all years. Additional technical notes are available in the annual reports titled Child Maltreatment. These reports are available at https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment. The Justice for Victims of Trafficking Act of 2015 included an amendment to the Child Abuse Prevention and Treatment Act under Title VIII—Better Response for Victims of Child Sex Trafficking by adding a requirement to collect and report sex trafficking data. States began reporting sex trafficking as a maltreatment type to NCANDS with their Federal fiscal year 2018 data submissions as required by a change in the law. For this first year of reporting, 27 states submitted data about victims of sex trafficking to NCANDS; as a result, sex trafficking rates underrepresent the true national rate, and rates for 2018 are not directly comparable with previous years. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. Metropolitan status calculations do not include Puerto Rico. Counties were classified based on the county of the child's residence at the time of the alleged abuse. If the child was in out-of-home care at the time of the report, the county of the facility or foster home should be used. This county may or may not be the county where the abuse occurred and may or may not be the county in which the CPS response occurred.

SOURCE: Administration for Children and Families, National Child Abuse and Neglect Data System.

  • Maltreatment rates were substantially lower in metropolitan areas (8.1 per 1,000 children) than in micropolitan areas (12.1 per 1,000 children) and rural areas (13.0 per 1,000 children) in 2018.

Figure 5: Percentage of substantiated maltreatment of children ages 0–17 by maltreatment type and metropolitan status, 2018
Figure 5: Percentage of substantiated maltreatment of children ages 0–17 by maltreatment type and metropolitan status, 2018

NOTE: This figure represents a duplicated count of maltreatments, based on a unique count of victims. Bars may total to more than 100% because a single child may be the victim of multiple kinds of maltreatment. Substantiated maltreatment includes the dispositions of substantiated or indicated. Additional technical notes are available in the annual reports titled Child Maltreatment. These reports are available at https://www.acf.hhs.gov/cb/research-data-technology/statistics-research/child-maltreatment. The Justice for Victims of Trafficking Act of 2015 included an amendment to the Child Abuse Prevention and Treatment Act under Title VIII—Better Response for Victims of Child Sex Trafficking by adding a requirement to collect and report sex trafficking data. States began reporting sex trafficking as a maltreatment type to NCANDS with their Federal fiscal year 2018 data submissions as required by a change in the law. For this first year of reporting, 27 states submitted data about victims of sex trafficking to NCANDS; as a result, sex trafficking rates underrepresent the true national rate, and rates for 2018 are not directly comparable with previous years. The U.S. Office of Management and Budget classifies counties as within a metropolitan or a micropolitan statistical area. The remaining counties are not classified and are considered rural in this report. Rural counties may include small urban areas, as well as completely rural areas. Nonmetropolitan counties include counties in micropolitan statistical and rural areas. Metropolitan status calculations do not include Puerto Rico. Counties were classified based on the county of the child's residence at the time of the alleged abuse. If the child was in out-of-home care at the time of the report, the county of the facility or foster home should be used. This county may or may not be the county where the abuse occurred and may or may not be the county in which the Child Protective Services response occurred.

SOURCE: Administration for Children and Families, National Child Abuse and Neglect Data System.

  • Neglect is by far the most common form of maltreatment, with three-fourths of all maltreated children found to have been neglected and nearly identical percentages across metropolitan, micropolitan, and rural areas. The percentage of reports involving physical (18%) and sexual (9%) abuse also were similar across geographic areas, with only slightly lower percentages in metropolitan areas compared with micropolitan and rural areas. Rates of physical abuse were 17% in metropolitan areas and 19% in micropolitan and rural areas. Rates of sexual abuse were 9% in metropolitan areas and 10% in micropolitan and rural areas.

table icon Brief3 HTML Table, Brief4 HTML Table

16 Child Welfare Information Gateway. (2013). Long-term consequences of child abuse and neglect. Washington, DC: U.S. Department of Health and Human Services, Children's Bureau. Retrieved from https://www.childwelfare.gov/pubpdfs/long_term_consequences.pdf

17 Christian, C. W., Block, R., & the Committee on Child Abuse and Neglect. (2009). Abusive head trauma in infants and children. Pediatrics, 123, 1409–1411.