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.