Investigators at Mass General Brigham have found that cases of child abuse and neglect in the United States have declined overall over the last decade, but disparities have persisted and in some cases widened. Poverty, which likely underlies much of the observed gaps, was highlighted as a critically important target for intervention. The research is published in JAMA Pediatrics .
"Poverty is a relentless source of stress that permeates families, creating an environment where the struggles for survival may overshadow the nurturing needs of children," said lead author Richard T. Liu, PhD, director of Suicide Research in the Division of Child and Adolescent Psychiatry and of Big Data Studies in the Depression Clinical and Research Program at Massachusetts General Hospital. "Our study highlights that progress is needed in combating drivers of maltreatment, particularly poverty, and in targeting differential barriers in access to public health benefits programs."
For their study, Liu and colleagues tallied confirmed and referred cases of emotional abuse, physical abuse, sexual abuse, and neglect by race, ethnicity, and sex, based on all Child Protective Services cases across the U.S. in 2012–2023. This included 7,326,987 confirmed cases and 32,980,613 referrals.
Overall, confirmed cases of all forms of maltreatment declined, except for sexual abuse, and remained unchanged for referrals. Disparities persisted over time, and incidence was lowest among Asians, Native Hawaiians, and Pacific Islanders (approximately 19 out of every 10,000 children in 2012 compared with 15 in 2023) and generally highest among Black children (approximately 119 of 10,000 children in 2012 to 110 in 2023). Female children experienced more maltreatment, with disparities largest and widening over time for sexual abuse.
"Studies have shown that expansion in Medicaid, SNAP, and other benefits programs are associated with reductions in child maltreatment and related emergency department visits," said Liu. "Strengthening government financial assistance programs can serve as a crucial intervention, addressing underlying challenges of poverty and fostering safer environments for children in need."
Authorship: In addition to Liu, authors include Rachel Y. Levin and Margarid R. Turnamian.
Paper cited: Liu RT et al. "A whole-population study of national trends in child abuse and neglect by sex, race, and ethnicity in the U.S. JAMA Pediatrics DOI: 10.1001/jamapediatrics.2025.4487
