Op-Ed: Data, Disparities and Recognizing High-Risk Situations for Child Abuse

Photo of teddy bear covering its eyes

According to the United States Department of Health and Human Services (HHS) Child Maltreatment Report, an estimated 3,016,000 children nationally were investigated for abuse in 2021. Of those investigations, 588,229 children were found to be victims of abuse and neglect, equating to a rate of 8.1 victims per 1,000 children. An estimated 1,820 children died from abuse and/or neglect that same year.

We know from data that younger children are more vulnerable and are more likely to be victims, and that girls are more often victims than boys. Children under the age of 1 are victimized more than twice as often as children age 1-2 years, and nearly eight times as often as 17-year-olds. It is estimated that for every incident of abuse or neglect, there are two incidents that have gone unreported.

Additionally, children of color are disproportionately impacted, with higher numbers of allegations as well as substantiated cases, likely related bias, and historical and systemic inequities. According to the HHS report, three races/ethnicities represent the majority of victims: White (42.8%), Hispanic (24.0%), and Black (21.5%). And despite the fact that 50% of U.S. children are white, while Black, non-Hispanic children make up only 14% of the population.

The data is reflective of the same disproportionality among Central Valley counties. According to kidsdata.org, reports of abuse are disproportionately higher among Black and American Indian/Alaskan Native children. Reports of abuse for Black, non-Hispanic children across California as a whole are 98.8 per 1,000. However, among Valley counties, rates are as high as 164.6 per 1,000 children.

We cannot talk about abuse without talking about the critical importance of early intervention and prevention as there are long-term sequelae of child abuse and neglect. Children who are abused or neglected are at increased risk for emotional difficulties and cognitive delay. A longitudinal study published in the journal Child Abuse and Neglect estimated that approximately 80% of young adults who were abused met criteria for at least one psychiatric disorder such as anxiety, depression and suicidality, with significantly impaired function relative to their non-abused counterparts. In addition to the long-term impact on emotional and mental health, the original Kaiser-CDC study on adverse childhood experiences (ACEs) also demonstrated the effect on adult physical health.

It is important to recognize high-risk situations, as well as signs and symptoms of abuse and neglect. Caregiver risk factors include caregiver alcohol or drug abuse, financial problems, housing insecurity, need for public assistance, presence of domestic violence in the home and any caregiver disability including vision/hearing impairment, physical, intellectual, learning and/or emotional disability. The socioeconomic factors place additional stressors on families. Signs of abuse, neglect and maltreatment may include unexplained injuries, excess school absenteeism, being emotionally withdrawn or aggressive, or a caregiver showing little concern for the child. (For a more extensive list of signs and symptoms of child abuse, neglect and emotional maltreatment, visit childwelfare.gov.)

On the bright side, there are protective factors that can help prevent abuse and neglect. Protective factors are those conditions that increase the well-being of children and their families, and serve as buffers when caregivers are under stress. Some of these protective factors include parental knowledge of child development and parenting skills, positive social connections and concrete support for families to help meet their basic needs.

For more information on child abuse prevention, treatment or specialized training, visit valleychildrens.org/abuseprevention or ACESaware.org.


ACEs Aware logo


Valley Children’s is a proud partner of ACEs Aware, who is leading a first-in-the nation effort to screen patients for adverse childhood experiences (ACEs) to help improve and save lives. Find out how to become an ACEs certified provider at acesaware.org.



Okechukwu A, Abraham I. Child Maltreatment and the Ecosystem of Socioeconomic Inequities and Inequalities. JAMA Netw Open. 2022;5(7):e2221516. doi:10.1001/jamanetworkopen.2022.21516

Silverman AB, Reinherz HZ, Giaconia RM. The long-term sequelae of child and adolescent abuse: a longitudinal community study. Child Abuse Negl. 1996;20(8):709-723. doi:10.1016/0145-2134(96)00059-2

https://www.acf.hhs.gov/cb/report/child-maltreatment-2021 Accessed March 17, 2023.

Child Welfare Information Gateway. (2019). What is child abuse and neglect? Recognizing the signs and symptoms. Washington, DC: U.S. Department of Health and Human Services, Children’s Bureau.

Return To Previous Page