Income inequality and child maltreatment rates in US counties, 2009–2018

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Background and objective: Studies have confirmed that income inequality is associated with compromised health and well-being. However, much less is known about the effects of county-level income inequality on risk of perpetrating child maltreatment, particularly for distinct types of child maltreatment. By utilizing recent national data over 10 years (2009–2018), our study explored the associations of county-level income inequality (i.e., Gini index and income quantile ratios) with child maltreatment rates, including both overall and specific types of maltreatment rates (i.e., physical, psychological, and sexual abuse and neglect) in the US. Participants and setting: We utilized data from approximately 902 US counties by linking the National Child Abuse and Neglect Data System with the American Community Survey. Methods: Ordinary Least Squares regression models were estimated to examine the relationship between county-level income inequality and child maltreatment rates and the moderating role of poverty rates. Results: Higher scores on county-level Gini index were significantly associated with higher overall child maltreatment rates and neglect, after controlling for county-level characteristics. Income quantile ratios were significantly associated with overall child maltreatment, physical abuse, and neglect. We also found significant interaction effects between income inequality and poverty rates in the associations with physical and psychological abuse rates, suggesting that the effects of inequality were exacerbated by county-level poverty. Conclusions: Given the tremendous increases in inequality in the US over recent decades, this research sheds light on the mechanisms through which inequality impacts parents' caregiving abilities in highly unequal counties.

Original languageEnglish (US)
Article number105328
JournalChild Abuse and Neglect
StatePublished - Aug 2022

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Developmental and Educational Psychology
  • Psychiatry and Mental health


  • Child maltreatment
  • County-level income inequality
  • Maltreatment type
  • Poverty


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