Upstream but Uneven: The Mismatch Between Structural Risk and Child Maltreatment Prevention Service Allocation in Texas

State-funded child maltreatment prevention aims to reduce risk, but whether reach aligns with community need is unclear. This county-level cross-sectional study of all 254 Texas counties examined whether Fiscal Year 2023 Prevention and Early Intervention (PEI) service distribution tracked structural risk and substantiated maltreatment. Two outcomes were modeled with negative binomial regression and a log child-population offset: annual family service recipients (home visiting and family support) and average monthly youth service recipients (community-based programs). Structural risk was operationalized through socioeconomic, housing, and violent crime indicators. In fully adjusted models, family service rates were approximately ten times higher in urban than rural counties (incidence rate ratio [IRR] = 10.52, 95% CI [4.74, 23.33]) but unrelated to substantiated maltreatment. This urban–rural gap was absent for youth services, which tracked substantiated maltreatment (IRR = 1.44, 95% CI [1.07, 1.93]). Family prevention reach in Texas tracks geography rather than need, while youth prevention tracks observed maltreatment burden — patterns implicating distinct allocation pathologies in state-administered prevention.