Abstract
INTRODUCTION: In the U.S., child abuse and neglect (CAN) is a significant public health problem. Poverty is a well-known correlate of CAN. OBJECTIVE: Examine racial and ethnic differences in fatal CAN among U.S. children and the intersection of community poverty. PARTICIPANTS AND METHODS: This study integrated National Violent Death Reporting System (NVDRS) data, county poverty data, and population estimates data. We used NVDRS data to examine fatal CAN for children aged 0-17 years for 2003-2022. Fatal CAN was defined as a homicide precipitated by abuse or neglect by a parent or caregiver. Racial and ethnic differences in fatal CAN were examined using pairwise comparisons. Community poverty quartiles for fatal CAN cases were determined using county-level poverty data and population estimate data for 2003-2022. RESULTS: During 2003-2022, NVDRS captured 6182 fatal CAN cases; 57.3% were boys; 79.6% were aged 0-5 years. An argument (21.4%), child's history of abuse (20.1%), and intimate partner violence (IPV; 15.6%) were the three most common precipitators of fatal CAN. IPV as a precipitator was most common among Asian or Pacific Islander (API; 33.0%), Hispanic (16.4%), and White (19.1%) victims than Black victims (10.8%; p < 0.05). More than one in ten (13.9%) fatal CAN deaths co-occurred with the perpetrator's suicide; this occurred most commonly among API victims (38.1%; p < 0.05) than Black (5.8%), multiracial (13.4%), and White (13.9%) victims. A larger proportion of fatal CAN among API victims (14.2%; p < 0.05) was precipitated by a crisis than did fatal CAN of Black (3.3%), multiracial (4.7%), and White (4.5%) victims.During 2003-2022, more than one in three (35.9%) fatal CAN victims resided in communities classified as the most impoverished; 52.7% of AI/AN victims resided in these communities, followed by Black (46.7%), Hispanic (31.3%), multiracial (30.9%), White (28.7%), and API (12.4%) victims. During this same period, 47.8% of API fatal CAN victims resided in communities with the least poverty, followed by White (17.3%), Hispanic (15.3%), multiracial (16.6%), and Black (10.1%) victims. CONCLUSIONS: Fatal CAN is preventable. Employing multiple strategies, at various levels (e.g., individual, familial, community), might aid in preventing nonfatal and fatal CAN.