Wilson Rebecca F, Yue Xin, Thomas Karen E, Kota Krishna Kiran, Betz Carter J
Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Injury Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Child Prot Pract. 2025 Apr;4:100108. doi: 10.1016/j.chipro.2025.100108.
In the U.S., child abuse and neglect (CAN) is a significant public health problem. Poverty is a well-known correlate of CAN.
Examine racial and ethnic differences in fatal CAN among U.S. children and the intersection of community poverty.
This study integrated National Violent Death Reporting System (NVDRS) data, county poverty data, and population estimates data. We used NVDRS data to examine fatal CAN for children aged 0-17 years for 2003-2022. Fatal CAN was defined as a homicide precipitated by abuse or neglect by a parent or caregiver. Racial and ethnic differences in fatal CAN were examined using pairwise comparisons. Community poverty quartiles for fatal CAN cases were determined using county-level poverty data and population estimate data for 2003-2022.
During 2003-2022, NVDRS captured 6182 fatal CAN cases; 57.3% were boys; 79.6% were aged 0-5 years. An argument (21.4%), child's history of abuse (20.1%), and intimate partner violence (IPV; 15.6%) were the three most common precipitators of fatal CAN. IPV as a precipitator was most common among Asian or Pacific Islander (API; 33.0%), Hispanic (16.4%), and White (19.1%) victims than Black victims (10.8%; p < 0.05). More than one in ten (13.9%) fatal CAN deaths co-occurred with the perpetrator's suicide; this occurred most commonly among API victims (38.1%; p < 0.05) than Black (5.8%), multiracial (13.4%), and White (13.9%) victims. A larger proportion of fatal CAN among API victims (14.2%; p < 0.05) was precipitated by a crisis than did fatal CAN of Black (3.3%), multiracial (4.7%), and White (4.5%) victims.During 2003-2022, more than one in three (35.9%) fatal CAN victims resided in communities classified as the most impoverished; 52.7% of AI/AN victims resided in these communities, followed by Black (46.7%), Hispanic (31.3%), multiracial (30.9%), White (28.7%), and API (12.4%) victims. During this same period, 47.8% of API fatal CAN victims resided in communities with the least poverty, followed by White (17.3%), Hispanic (15.3%), multiracial (16.6%), and Black (10.1%) victims.
Fatal CAN is preventable. Employing multiple strategies, at various levels (e.g., individual, familial, community), might aid in preventing nonfatal and fatal CAN.
在美国，虐待和忽视儿童（CAN）是一个重大的公共卫生问题。贫困是CAN的一个众所周知的相关因素。
研究美国儿童致命性CAN中的种族和民族差异以及社区贫困的交叉情况。
本研究整合了国家暴力死亡报告系统（NVDRS）数据、县贫困数据和人口估计数据。我们使用NVDRS数据研究2003 - 2022年0至17岁儿童的致命性CAN。致命性CAN被定义为由父母或照顾者的虐待或忽视引发的他杀。使用成对比较来研究致命性CAN中的种族和民族差异。使用2003 - 2022年的县级贫困数据和人口估计数据确定致命性CAN病例的社区贫困四分位数。
在2003 - 2022年期间，NVDRS记录了6182例致命性CAN病例；57.3%为男孩；79.6%年龄在0至5岁。争吵（21.4%）、儿童的虐待史（20.1%）和亲密伴侣暴力（IPV；15.6%）是致命性CAN的三个最常见诱因。作为诱因的IPV在亚裔或太平洋岛民（API）、西班牙裔和白人受害者中比黑人受害者中更为常见（API为33.0%，西班牙裔为16.4%，白人为19.1%，黑人为10.8%；p < 0.05）。超过十分之一（13.9%）的致命性CAN死亡与犯罪者自杀同时发生；这在API受害者中最为常见（38.1%；p < 0.05），高于黑人（5.8%）、多种族（13.4%）和白人（13.9%）受害者。与黑人（3.3%）、多种族（4.7%）和白人（4.5%）受害者的致命性CAN相比，API受害者中更大比例（14.2%；p < 0.05）的致命性CAN是由危机引发的。在2003 - 2022年期间超过三分之一（35.9%）的致命性CAN受害者居住在被归类为最贫困的社区；52.7%的美国印第安人/阿拉斯加原住民（AI/AN）受害者居住在这些社区，其次是黑人（46.7%）、西班牙裔（31.3%）、多种族（30.9%）、白人（28.7%）和API（12.4%）受害者。在同一时期，47.8%的API致命性CAN受害者居住在贫困程度最低的社区，其次是白人（17.3%）、西班牙裔（15.3%）、多种族（16.6%）和黑人（10.1%）受害者。
致命性CAN是可预防的。在各个层面（如个人、家庭、社区）采用多种策略可能有助于预防非致命性和致命性CAN。
