Current literature suggests that food insecurity increases child maltreatment risk. Yet, existing evidence is limited to individual-level associations among low-income, high-risk populations based on local, mostly urban data. This study aims to generalize prior findings to community-level associations in general populations, using national data including all urban-rural areas. We examined, for the first time, if food insecurity rates increase child maltreatment report (CMR) rates at the county level after controlling for potential confounders. We examined both within-community longitudinal changes (i.e., within-effects) and inter-community differences (i.e., between-effects) of food insecurity rates and their associations with CMR rates. We also examined differences by age, sex, race/ethnicity, maltreatment type, and urbanicity. We constructed longitudinal county-level data by linking multiple national databases, including all substantiated and unsubstantiated CMR records, the Map the Meal Gap’s community food insecurity estimates, and Census data. The data covered over 96% of U.S. counties from 2009 to 2018. For analysis, we used within-between random effects models. Regarding between-effects, we found that in inter-community comparisons, higher food insecurity rates were significantly associated with increased CMR rates. This association was consistent by age, sex, maltreatment type, and urbanicity. For within-effects, we found that the association between longitudinal changes of food insecurity rates and CMR rates significantly differed by urbanicity. Specifically, longitudinal increases of food insecurity rates significantly increased CMR rates among large urban counties, but not among small urban and rural counties. Study findings highlight the importance of conducting further research to better understand the mechanisms through which food insecurity impact child maltreatment at both individual and community levels. Our community-level findings from general populations especially have significant implications for community-based programs and large-scale policies to achieve population-level impact on child well-being.

中文翻译：

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社区粮食不安全和虐待儿童报告：2009 年至 2018 年美国国家数据的县级分析

目前的文献表明，粮食不安全会增加虐待儿童的风险。然而，现有证据仅限于基于当地（主要是城市）数据的低收入、高风险人群之间的个体层面关联。本研究旨在利用包括所有城乡地区在内的国家数据，将先前的研究结果推广到普通人群中的社区级协会。我们首次检查了在控制潜在混杂因素后，粮食不安全率是否会增加县级虐待儿童报告 (CMR) 的发生率。我们检查了粮食不安全率的社区内纵向变化（即，内部效应）和社区间差异（即，效应间）及其与 CMR 率的关联。我们还检查了年龄、性别、种族/民族、虐待类型和城市化程度的差异。我们通过链接多个国家数据库构建纵向县级数据，包括所有经过证实和未经证实的 CMR 记录、Map the Meal Gap 的社区粮食不安全估计和人口普查数据。从 2009 年到 2018 年，这些数据覆盖了超过 96% 的美国县。为了分析，我们使用了组间随机效应模型。关于间效应，我们发现在社区间比较中，较高的粮食不安全率与增加的 CMR 率显着相关。这种关联在年龄、性别、虐待类型和城市化方面是一致的。对于内部效应，我们发现粮食不安全率的纵向变化与 CMR 率之间的关联因城市化程度而显着不同。具体来说，粮食不安全率的纵向增加显着增加了大城市县的 CMR 率，但在小城乡县中则没有。研究结果强调了进行进一步研究以更好地了解粮食不安全影响个人和社区层面虐待儿童的机制的重要性。我们从普通人群中获得的社区层面的调查结果对以社区为基础的计划和大规模政策具有重要意义，以实现人口层面对儿童福祉的影响。