A Multilevel Analysis of Individual and Community Factors Associated With Case Dispositions Following Child Maltreatment Investigations.

Understanding service disposition pathways is critical to provide deeper insight into why certain subgroups of the population are at risk for recurrent Child Protective Services (CPS) involvement and may highlight disparities across groups or geographic areas. Using the Decision-Making Ecology Framework as a lens, the present study examines whether service disposition pathways are influenced by risk assessment, safety concerns, child age, maltreatment type, previous CPS involvement, and/or county-level structural vulnerability. We linked administrative data from New Mexico's Department of Children, Youth and Families (DCYF) to data from the American Community Survey. Multilevel models examining associations between case (N = 12,960) and county (N = 33) characteristics revealed that both case (age, maltreatment type, risk/safety assessments, previous CPS involvement) and county-level factors (transportation and housing) were associated with service disposition. Additionally, we observed considerable variation at the county level in both the provision of services and the relationship between risk assessment and service provision. By linking different factors of the decision-making process in child welfare cases to intervention strategies, the analysis reveals that the perception of risk can vary based on geographical context resulting in different outcomes for families who have similar risks but different county-level vulnerabilities.

Adverse Childhood Experiences, Women Who Are Sex Trafficked, and Social Service Utilization: Implications for Social Work.

The aim of this study was to examine the associations between adverse childhood experiences (ACEs) and the high levels of social service usage by women who are sex trafficked. Fifty (N = 50) women who were sex trafficked were surveyed using purposive and snowball sampling methods. The ACEs score for respondents ranged from 2 to 10 with an average score of 7.4 (SD = 2.3). Emotional and sexual abuse tied at 88 percent as the most frequently cited ACEs among the women in this sample. The prevalence of ACEs was significantly higher in this sample compared with known estimates in similar populations, ranging from 20 percent to 54 percent (p < .001). Considering the well-established link between ACEs and poor health outcomes, these findings point to the need for innovative and targeted social service provisions to women who were formerly sex trafficked that take into consideration the high level of ACEs of the women. Given the sociodemographic diversity of this sample, there is a need for services that are trauma-informed, innovative, and culturally sensitive in a variety of social service settings.

The Spatial Scale and Spread of Child Victimization.

Previous research shows that large, densely populated urban areas have higher rates of child victimization that have persisted over time. However, few investigations have inquired about the processes that produce and sustain hot and cold spots of child victimization. As a result, the mechanisms that produce the observed spatial clustering of child victimization, and hence "why" harms against children tend to cluster in space, remains unknown. Does the likelihood of being a victim of violence in one location depend on a similar event happening in a nearby location within a specified timeframe? Rather, are child victims of violence more likely to reside in suboptimal neighborhood conditions? This paper aims to present an analytical and theoretical framework for distinguishing between these locational (point) processes to determine whether the empirical spatial patterns undergirding child victimization are more reflective of the "spread" via contagion (i.e., dependency) or whether they are produced by neighborhood structural inequality resulting from spatial heterogeneity. To detect spatial dependence, we applied the inhomogeneous K-function to Los Angeles Medical Examiner data on child homicide victim locations while controlling for regional differences in victimization events (i.e., heterogeneity). Our analysis found strong evidence of spatial clustering in child victimization at small spatial scales but inhibition at larger scales. We further found limited support for the spatiotemporal clustering of child victimization indicative of a contagion effect. Overall, our results support the role of neighborhood structural vulnerability in the underlying mechanisms producing patterns of child victimization across Los Angeles County. We conclude by discussing the policy implications for understanding this spatial patterning in geographical context and for developing effective and targeted preventive interventions.

Associations between early child adversity and lifetime suicide attempts among gender diverse individuals: A moderated mediation.

BACKGROUND: This study examines the effect of adverse childhood experiences (ACEs) on lifetime suicide attempts (LSA) across five gender subgroups (i.e., transgender men, transgender women, transgender non-binary, cisgender men and cisgender women). OBJECTIVE: To examine (1) the prevalence of LSA across gender identity subgroups; (2) whether the association between ACEs and LSA is moderated by gender identity subgroup; (3) depressive symptoms, alcohol use disorder, social support, and social well-being as mechanisms linking ACEs with LSA; and (4) the moderating role of gender identity on the four putative mediators. PARTICIPANTS AND SETTINGS: We used nationally representative data from a population-based survey of N = 1368 transgender and cisgender individuals collected between 2016 and 2019. METHODS: Structural equation modeling was used to explore the indirect effect of depressive symptoms on the relation between ACEs and LSA, and the moderating impact of gender identity. RESULTS: LSA was significantly more prevalent among transgender respondents (cisgender man = 5 %; cisgender woman = 9 %; transgender man = 42 %; transgender woman = 33 %; transgender non-binary = 37 %; p < 0.001). Individuals with more ACEs had a greater risk of engaging in LSA regardless of gender identity; however, moderation results showed that the impact of each additional ACE on LSA was stronger for individuals with transgender identities: the likelihood of engaging in LSA was statistically similar for transgender men with no ACEs and cisgender men with all 8 ACEs. Indirect effects of ACEs on LSA via depressive symptoms were also observed, and the mediating effect was moderated by gender identity. CONCLUSIONS: By examining the mechanisms linking childhood adversity to LSA, this study demonstrates that not all ACEs impact gender minority subgroups equally.

Early Child Adversity and Delinquent Behavior in Foster Care Youth: Do Future Expectations and Sexual Identity Moderate the Mediating Role of Posttraumatic Stress?

Purpose: Delinquency in youth is a significant public health concern for individuals who experienced adversity and complex trauma as children. The present study explored the longitudinal associations between adverse child experiences and future engagement in delinquent behavior. Methods: Using a sample of 1,245 foster youth who are aging out of the child welfare system, mediation, moderation, and moderated mediation analysis was used to test the mechanistic role of post-traumatic stress symptoms and the moderating role of sexual identity and positive future expectations on engagement in delinquent behavior. Results: Results showed a positive and significant association between adverse child experiences and engagement in delinquent behavior. Post-traumatic stress symptoms partially mediated the ACEs-delinquency relationship. In addition, sexual minority youth and youth who were less optimistic about the future, but who experienced more ACEs, were at risk for heightened levels of post-traumatic stress. Conclusions: Interventions that promote positive future outlooks may minimize the psychological sequelae of early child adversity and delinquent behavior particularly when tailored to the needs of sexual minority youth.

Gun Violence on Walkable Routes to and from School: Recommendations for Policy and Practice.

Gun-related violence exposure is a significant public health problem for urban youth. Few studies have implemented methods to estimate the spatial influence of activity spaces on gun violence exposure constrained by the physical configuration of walkable street networks. The present research uses computational network and local indicators of spatial autocorrelation methods to explore gun violence exposure along the walkable streets near schools in Compton, California. Findings demonstrated strong evidence that gun violence is clustered at all distances along the pedestrian network and in proximity to Compton Unified School District (K-12) schools, reaching a maximum between 1.2 and 1.8 mi; thereafter the "attractiveness" of schools to gun violence was inhibiting. Almost all schools had at least one shooting within a 5-min walk (i.e., about 400 m); 37.8% of schools had an average shooting distance of less than 400 m; about 250 incidents occurred within 5 min of schools; and about 30 schools had a shooting within a 5-min walking distance. Determining the spatial extent of violence exposure in proximity to key activity spaces for youth, such as schools, has substantial implications for the health and wellbeing of youth living in violence-prone areas. The public health and legal implications of this study are discussed in context.

The neighborhood deprivation gradient and child physical abuse and neglect: A Bayesian spatial model.

BACKGROUND: Child abuse and neglect is a public health priority due to its long-term maladaptive consequences. No study in the USA has assessed the nature and magnitude of the social deprivation effect on substantiated child maltreatment risk. OBJECTIVES: To examine linear and non-linear relationships between area level deprivation and the log-risk of both substantiated physical abuse and neglect while accounting for spatial and heterogeneous random effects. METHODS: Substantiated child maltreatment and population data (2008-2015) were aggregated to neighborhoods in Bernalillo County, New Mexico. The contribution of area level deprivation to the geographical variation in the log-risks of substantiated child physical abuse and neglect was modeled using Bayesian spatial regression. RESULTS: Forty-three percent and 46.4 % of the 153 neighborhoods recorded greater risk for either substantiated physical abuse or neglect compared to the county average. The most deprived 20 % of neighborhoods had 71 % and 72 % more cases of substantiated physical abuse and neglect, respectively, than would be expected if the substantiations were randomly distributed throughout the county. Area level deprivation explained 47 % of the variation in substantiated physical abuse and 51 % of the variation in substantiated neglect after controlling for both spatial autocorrelation and heterogeneity. CONCLUSIONS: Implications from this study can be used to quantify disparities in substantiated child maltreatment attributed to regional differences in social deprivation and to identify priority areas for intervention.

A Network Analysis of the Relationship Between Mental and Physical Health in Unsheltered Homeless Persons in Los Angeles County.

Homelessness is a public health crisis both nationally, in the United States, and internationally. Nevertheless, due to the hidden vulnerabilities of persons who are without shelter, little is known about their experiences during periods of homelessness. The present research adopts a network approach that conceptualizes how the major risk factors of homelessness interact, namely substance abuse problems, poor mental health, disability, and exposure to physical or sexual violence by an intimate partner. Our analysis draws on a large demographic survey of over 5,000 unsheltered homeless persons conducted in 2017 by the Los Angeles Homeless Services Authority. We estimated a network structure for 12 survey items tapping individual risk using the graphical least absolute shrinkage and selection operator algorithm. We then examined network centrality metrics and implemented a community detection algorithm to detect communities in the network. Our results indicated that mental illness and intimate partner violence (IPV) are central measures that connect all other mental and physical health variables together and that post-traumatic stress disorder and IPV are both highly affected by changes in any part of the network and, in turn, affect changes in other parts of the network. A community detection analysis derived four communities characterized by disability, sexual victimization and health, substance use, and mental health issues. Finally, a directed acyclic graph revealed that drug abuse and physical disability were key drivers of the overall system. We conclude with a discussion of the major implications of our findings and suggest how our results might inform programs aimed at homelessness prevention and intervention.

Variability and stability in child maltreatment risk across time and space and its association with neighborhood social & housing vulnerability in New Mexico: A bayesian space-time model.

BACKGROUND: Modeling the spatio-temporal characteristics of substantiated child maltreatment risk has significant implications for child welfare policy. OBJECTIVE: This study quantifies the spatiotemporal risk of child abuse and neglect in New Mexico at the census tract level over 9 years, identifies areas of increased risk, and evaluates the role of multiple measures of social and housing insecurity on substantiated child maltreatment referrals. PARTICIPANTS AND SETTING: Child maltreatment substantiation data across 499 census tracts from 2007 to 2015 were obtained from the New Mexico Department of Public Health. METHODS: Substantiated referral counts were analyzed within census tracts with Bayesian hierarchical space-time models using Laplace approximation. Standardized incidence ratios, spatial risk, and probability exceedances were calculated and mapped. RESULTS: Multiple neighborhood structural factors were associated with an increased risk of substantiated child maltreatment, including the eviction rate (Incidence Density Ratio [IDR] = 1.09 [95 % CrI = 1.01-1.12]), rent burden (IDR = 1.11 [95 % CrI = 1.01-1.13]), urban tracts (IDR = 1.36 [95 % CrI = 1.05-1.77]), food desert tracts (IDR = 1.21 [95 % CrI = 1.04-1.41]), low income tracts (IDR = 1.27 [95 % CrI = 1.09-1.49]), percent of households with no vehicle access ([IDR] = 1.27 [95 % CrI = .247-6.47]), and percent of persons with a disability (IDR = 1.05 [95 % CrI = 1.03-1.06]). The racial/ethnic diversity ratio, however, was associated with lower incidence of child maltreatment allegation risk (IDR = .988 [95 % CrI = .982-.995]). CONCLUSIONS: Population-based child abuse and neglect prevention and intervention efforts should be aided by the characteristics of neighborhoods that demonstrate strong spatial patterns of household and housing vulnerability, particularly in low income, racially segregated neighborhoods.

Examining Spatial Regimes of Child Maltreatment Allegations in a Social Vulnerability Framework.

The present research examines child maltreatment allegations (CMAs) in San Diego County, California, exploring spatial patterns of Child Protective Services involvement and multiple, multidimensional measures of neighborhood social vulnerability. Results showed significant patterns of spatial clustering (i.e., hot and cold spots) of CMAs across the county (Moran's I = .316, p < .001). A geographically weighted regression (GWR) was implemented to examine the relationship between CMAs and social vulnerability at the census-tract level, thereby overcoming the deficiencies of global models. Nonstationarity was detected across four indices of vulnerability (socioeconomic status, race/ethnicity, household composition, and health vulnerability) as well as proximity to on-premise alcohol outlets, percentage of residents in each census tract affected by food deserts, and population density, in some cases showing countervailing effects depending on spatial location. A hierarchical clustering was performed on the GWR coefficients to identify spatial regimes, or clusters, across the county. The results yielded six spatial regimes of social vulnerability differentially related to CMA rates. The present study demonstrates the novelty of GWR in combination with a hierarchical cluster analysis for exploring how local contextual processes influence child maltreatment reporting rates across the county.