The Prevalence of Confirmed Maltreatment Among US Children, 2004 to 2011

IMPORTANCE: Child maltreatment is a risk factor for poor health throughout the life course. Existing estimates of the proportion of the US population maltreated during childhood are based on retrospective self-reports. Records of officially confirmed maltreatment have been used to produce annual rather than cumulative counts of maltreated individuals. OBJECTIVE: To estimate the proportion of US children with a report of maltreatment (abuse or neglect) that was indicated or substantiated by Child Protective Services (referred to as confirmed maltreatment) by 18 years of age. DESIGN, SETTING, AND PARTICIPANTS: The National Child Abuse and Neglect Data System (NCANDS) Child File includes information on all US children with a confirmed report of maltreatment, totaling 5,689,900 children (2004-2011). We developed synthetic cohort life tables to estimate the cumulative prevalence of confirmed childhood maltreatment by 18 years of age. MAIN OUTCOMES AND MEASURES: The cumulative prevalence of confirmed child maltreatment by race/ethnicity, sex, and year. RESULTS: At 2011 rates, 12.5% (95% CI, 12.5%-12.6%) of US children will experience a confirmed case of maltreatment by 18 years of age. Girls have a higher cumulative prevalence (13.0% 95% CI, 12.9%-13.0%) than boys (12.0% 12.0%-12.1%). Black (20.9% 95% CI, 20.8%-21.1%), Native American (14.5% 14.2%-14.9%), and Hispanic (13.0% 12.9%-13.1%) children have higher prevalences than white (10.7% 10.6%-10.8%) or Asian/Pacific Islander (3.8% 3.7%-3.8%) children. The risk for maltreatment is highest in the first few years of life; 2.1% (95% CI, 2.1%-2.1%) of children have confirmed maltreatment by 1 year of age, and 5.8% (5.8%-5.9%), by 5 years of age. Estimates from 2011 were consistent with those from 2004 through 2010. CONCLUSIONS AND RELEVANCE: Annual rates of confirmed child maltreatment dramatically understate the cumulative number of children confirmed to be maltreated during childhood. Our findings indicate that maltreatment will be confirmed for 1 in 8 US children by 18 years of age, far greater than the 1 in 100 children whose maltreatment is confirmed annually. For black children, the cumulative prevalence is 1 in 5; for Native American children, 1 in 7.