Maternal and Child Health Journal

, Volume 18, Issue 9, pp 2202–2208 | Cite as

Longitudinal Association of County-Level Economic Indicators and Child Maltreatment Incidents

  • Sarah Frioux
  • Joanne N. WoodEmail author
  • Oludolapo Fakeye
  • Xianqun Luan
  • Russell Localio
  • David M. Rubin


To evaluate the association between economic indicators (unemployment and mortgage foreclosure rates) and volume of investigated and substantiated cases of child maltreatment at the county level from 1990 to 2010 in the Commonwealth of Pennsylvania. County-level investigated reports of child maltreatment and proportion of investigated cases substantiated by child protective services in the Commonwealth of Pennsylvania were compared with county-level unemployment rates from 1990 to 2010, and with county-level mortgage foreclosure rates from 2000 to 2010. We employed fixed-effects Poisson regression modeling to estimate the association between volume of investigated and substantiated cases of maltreatment, and current and prior levels of local economic indicators adjusting for temporal trend. Across Pennsylvania, annual rate of investigated maltreatment reports decreased through the 1990s and rose in the early 2000s before reaching a peak of 9.21 investigated reports per 1,000 children in 2008, during the recent economic recessionary period. The proportion of investigated cases substantiated, however, decreased statewide from 33 % in 1991 to 15 % in 2010. Within counties, current unemployment rate, and current and prior-year foreclosure rates were positively associated with volume of both investigated and substantiated child maltreatment incidents (p < 0.05). Despite recent increases in investigations, the proportion of investigated cases substantiated decreased by more than half from 1990 to 2010 in Pennsylvania. This trend suggests significant changes in substantiation standards and practices during the period of study. Economic indicators demonstrated strong association with investigated and substantiated maltreatment, underscoring the urgent need for directing important prophylactic efforts and resources to communities experiencing economic hardship.


Child safety Child maltreatment Child abuse Unemployment Foreclosure 



Abusive head trauma


Child protective services


National Child Abuse and Neglect Data System



Dr. Joanne Wood’s institution has received payment for expert witness court testimony that Dr. Wood has provided in cases of suspected child abuse when subpoenaed to testify. Dr. Wood has received salary funding from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (Grant: 1K23HD071967-01).


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Sarah Frioux
    • 1
  • Joanne N. Wood
    • 2
    • 3
    Email author
  • Oludolapo Fakeye
    • 2
  • Xianqun Luan
    • 2
  • Russell Localio
    • 2
    • 4
  • David M. Rubin
    • 2
    • 3
  1. 1.Tripler Army Medical CenterHonoluluUSA
  2. 2.PolicyLab, Division of General PediatricsThe Children’s Hospital of PhiladelphiaPhiladelphiaUSA
  3. 3.Department of PediatricsPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA
  4. 4.Department of Biostatistics and EpidemiologyPerelman School of Medicine at the University of PennsylvaniaPhiladelphiaUSA

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