Child maltreatment is a serious public health issue and has major consequences for individuals, families, and society as a whole. Every year, 1 in 10 children are neglected or psychologically abused, and 4% to 16% are physically abused in high-income countries such as the United States. In the United States alone, >3 million referrals are received annually that involve >6 million children. Child maltreatment is determined by complex factors related to individuals, families, communities, and cultures. It has lifelong cascading effects on children, negatively altering current and future physical and mental health, education, work, social relationships, and violent behavior. Child maltreatment also imposes an economic burden on individuals and society. Among individual victims of child maltreatment, per-victim lifetime costs can vary from $210 012 to $16.6 million. About $80.3 billion each year is spent in the United States in direct and indirect costs related to cases of child abuse or neglect.
Child-level outcomes can be affected by broader societal structures. Economic factors in the household may directly and indirectly affect child and family health outcomes. Specifically, greater rates of poverty, lower incomes and education levels, and higher unemployment have been positively associated with rates of child maltreatment at the community level. In addition, lower rates of health insurance in a community have been found to increase the risk of a child being placed into out-of-home care. Other socioeconomic characteristics of a community related to economic disadvantages, such as the percentage of female-headed households, have been positively associated with rates of child abuse and maltreatment.
Reports of child maltreatment come in many forms. The 1974 Federal Child Abuse Prevention and Treatment Act requires some individuals to be mandatory reporters of child maltreatment. The list in each state may vary, although the most common groups required to report child maltreatment include social workers, school personnel, health care workers, mental health professionals, child care providers, medical examiners or coroners, and law enforcement officers. In some states, all people are required to report suspected abuse or neglect, regardless of profession. Reporting behavior among professionals versus non-professionals can vary, given that each group of potential reporters is involved in different aspects of a child’s life. While institutions such as schools have clear internal policies and procedures for reporting and handling maltreatment, reporting among the general population is less structured and may be influenced by the relationship to the child or family, community context, perceived level of collective community efficacy, personal experiences with child maltreatment, ethnicity, and culture, among others. In 2019, 21.0% of all reported child maltreatment in the United States was reported by education personnel; 19.1% by legal and law enforcement personnel; 16.3% by social services or mental health personnel; 15.3% by parents, friends, neighbors, or other relatives; and 11.0% by medical personnel.