Community home visiting services and child maltreatment report rates, Illinois zip codes, 2011-2018

Background: Research is sparse on the community-level impacts of home visiting programs on child maltreatment. Objective: To examine community-level associations between state-funded home visiting programs (i.e., IDHS-HV), federal-funded home visiting programs (i.e., MIECHV), and child maltreatment report (CMR) rates, overall and within subgroups of age, sex, and maltreatment type. Participants and setting: 3824 zip code-years during 2011-2018 in Illinois for IDHS-HV/CMR associations and 1896 zip code-years during 2015-2018 for MIECHV/CMR associations. Methods: We measured county-level IDHS-HV rates (per 1000 children aged 0-5) since data were only available at that level. MIECHV rates (per 1000 children aged 0-5), CMR rates (per 1000 children), and all controls were measured at the zip code level. We used spatial linear models to handle spatial autocorrelation. Results: Adjusted for controls, longitudinal increases of IDHS-HV rates were significantly associated with decreased overall CMR rates (coefficient: 0.28; 95 % CI: 0.45, 0.11), age 0-5 CMR rates ( 0.52; 0.82, 0.22), age 6-11 CMR rates ( 0.31; 0.55, 0.06), male CMR rates ( 0.25; 0.45, 0.05), female CMR rates ( 0.29; 0.49, 0.08), and neglect report rates ( 0.13; 0.24, 0.02). In contrast, longitudinal increases of MIECHV rates were significantly associated with increased CMR rates within several subgroups. Conclusions: Our findings suggest that increasing state-funded home visiting services in communities may have benefits in lowering their CMR rates. Given the very low MIECHV service rates and the federal policy that requires MIECHV to target at-risk communities, the significant positive MIECHV/CMR associations we found might indicate MIECHV programs are typically in higher risk communities.