School of Social Work, University Illinois at Urbana-Champaign, Urbana, IL, USA.
Baylor University, Waco, TX, USA.
J Interpers Violence. 2023 Jan;38(1-2):NP262-NP287. doi: 10.1177/08862605221080148. Epub 2022 Mar 25.
Current literature suggests that food insecurity increases child maltreatment risk. Yet, existing evidence is limited to individual-level associations among low-income, high-risk populations based on local, mostly urban data. This study aims to generalize prior findings to community-level associations in general populations, using national data including all urban-rural areas. We examined, for the first time, if food insecurity rates increase child maltreatment report (CMR) rates at the county level after controlling for potential confounders. We examined both within-community longitudinal changes (i.e., within-effects) and inter-community differences (i.e., between-effects) of food insecurity rates and their associations with CMR rates. We also examined differences by age, sex, race/ethnicity, maltreatment type, and urbanicity. We constructed longitudinal county-level data by linking multiple national databases, including all substantiated and unsubstantiated CMR records, the Map the Meal Gap's community food insecurity estimates, and Census data. The data covered over 96% of U.S. counties from 2009 to 2018. For analysis, we used within-between random effects models. Regarding between-effects, we found that in inter-community comparisons, higher food insecurity rates were significantly associated with increased CMR rates. This association was consistent by age, sex, maltreatment type, and urbanicity. For within-effects, we found that the association between longitudinal changes of food insecurity rates and CMR rates significantly differed by urbanicity. Specifically, longitudinal increases of food insecurity rates significantly increased CMR rates among large urban counties, but not among small urban and rural counties. Study findings highlight the importance of conducting further research to better understand the mechanisms through which food insecurity impact child maltreatment at both individual and community levels. Our community-level findings from general populations especially have significant implications for community-based programs and large-scale policies to achieve population-level impact on child well-being.
当前的文献表明，粮食不安全会增加儿童受虐风险。然而，现有证据仅限于基于当地、主要是城市数据的低收入、高风险人群的个体层面关联。本研究旨在将先前的发现推广到一般人群的社区层面关联，使用包括所有城乡地区的全国性数据。我们首次检验了在控制潜在混杂因素后，县一级的粮食不安全率是否会增加儿童虐待报告（CMR）率。我们同时检验了粮食不安全率的社区内纵向变化（即，内效应）和社区间差异（即，间效应）及其与 CMR 率的关联。我们还按年龄、性别、种族/族裔、虐待类型和城市性进行了差异检验。我们通过链接多个国家数据库构建了纵向县级数据，包括所有已证实和未证实的 CMR 记录、Map the Meal Gap 的社区粮食不安全估计数以及人口普查数据。这些数据涵盖了 2009 年至 2018 年美国 96%以上的县。在分析中，我们使用了社区内-间随机效应模型。关于间效应，我们发现，在社区间比较中，较高的粮食不安全率与较高的 CMR 率显著相关。这种关联在年龄、性别、虐待类型和城市性方面是一致的。对于内效应，我们发现粮食不安全率的纵向变化与 CMR 率之间的关联在城市性方面存在显著差异。具体来说，粮食不安全率的纵向增加显著增加了大城市县的 CMR 率，但在小城市和县没有增加。研究结果强调了进一步研究的重要性，以便更好地理解个体和社区层面粮食不安全对儿童虐待的影响机制。我们从一般人群中得出的社区层面发现，特别是对基于社区的计划和大规模政策具有重要意义，这些计划和政策旨在对儿童福祉产生人口层面的影响。
