National CPS data from 2012-2023 show declines in confirmed child maltreatment, but disparities remained, particularly among Black and female children.
Child maltreatment remains a significant public health concern in the United States.1 A new serial, population-based cross-sectional study examined national trends in confirmed and referred cases of child abuse and neglect from 2012 through 2023 using Child Protective Services (CPS) data from the National Child Abuse and Neglect Data System. The analysis included all confirmed and referred cases among children aged 0 to 17 years and assessed trends by sex, race, and ethnicity.2
The authors noted that “confirmed cases of overall child maltreatment declined,” yet disparities persisted across the study period, especially among Black children and girls.
Across the 12-year period, researchers identified 7,326,987 confirmed cases and 32,980,613 referrals for child maltreatment. Confirmed cases declined over time, with an average annual percent change (AAPC) of −1.53%. Referrals, however, remained unchanged.
Between 2012 and 2018, confirmed cases rose slightly before declining from 2018 to 2023. Trends by subtype showed varied patterns:
The authors observed that “referred cases for maltreatment and its subtypes remained largely unchanged over the study period.”
Significant disparities were identified across racial and ethnic categories. Confirmed child maltreatment rates were consistently lowest among Asian, Native Hawaiian, and Other Pacific Islander children and highest among Black children.
In 2012, Black children had a risk ratio (RR) of 1.84 for overall maltreatment compared with White children. In 2023, the RR remained high at 1.83, indicating persistent disparities. Among American Indian and Alaska Native children, overall maltreatment rates were also elevated at both time points.
The authors highlighted that “disparities persisted across the study period,” with some widening over time for specific groups and maltreatment types.
Racial and ethnic disparities were evident within all subtypes of child maltreatment:
The study emphasized that Black children consistently had “the highest incidence across all maltreatment subtypes.”
Sex-based differences were prominent. Confirmed maltreatment incidence per 10,000 children was 87.51 for girls and 78.46 for boys, indicating higher reported and confirmed maltreatment among female children.
Both boys and girls experienced overall declines in confirmed maltreatment. However, the gap widened for sexual abuse, with the study noting that disparities “were largest and widening over time for sexual abuse.”
For referrals, rates remained stable over time for both sexes.
The authors concluded that despite overall declines in confirmed child maltreatment, persistent disparities necessitate targeted, equity-focused interventions. They emphasized the role of socioeconomic conditions, stating that progress will require addressing “drivers of maltreatment, particularly poverty, and… differential barriers to access to public health benefits programs.”
For clinicians, understanding these trends may inform anticipatory guidance, screening, and cross-sector collaboration to support high-risk families. As the authors noted, the group “with the most room for improvement experienced none,” highlighting ongoing unmet needs in communities disproportionately affected by maltreatment.
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