The Association between Urbanicity and Child Maltreatment Substantiation In the United States

Background and Purpose: Child maltreatment substantiation is a critical decision point in the child welfare system, influencing service access and long-term system involvement for children and families. In the U.S., national surveillance indicates that 546,159 children were confirmed victims of maltreatment in FY2023, and millions more were the subject of investigations or alternative responses by child protective services agencies. Although substantial geographic variation in child welfare involvement has been documented, it remains unclear whether differences in substantiation across urban and non-urban contexts reflect variation in maltreatment risk or differences in institutional decision-making processes. Prior research suggests that substantiation is a system-dependent outcome shaped by investigative pathways and service availability rather than maltreatment severity alone. The present study examines the association between urbanicity and child maltreatment substantiation among children involved in the U.S. child welfare system, while accounting for key child-level and system-level characteristics.

Method: This study used Wave 1 data from the National Survey of Child and Adolescent Well-Being III (NSCAW III), a nationally representative sample of children involved in child welfare investigations between 2017 and 2021. The analytic sample included 2,099 children with complete data. Urbanicity and child maltreatment substantiation were measured dichotomously (urban vs. non-urban; substantiated vs. non-substantiated). Logistic regression models were estimated to assess the association between urbanicity and substantiation while controlling for child age, sex, race, service receipt (yes/no), and case processing pathway (child protective services vs. alternative response).

Results: Descriptive analyses indicated that substantiation was more prevalent among children residing in urban areas (43.6%) compared to those in non-urban areas (35.1%), and this association was statistically significant at the bivariate level (χ²(1, N = 2,099) = 9.57, p = .002). However, in multivariable logistic regression analyses adjusting for child and system-level characteristics, urbanicity was not independently associated with substantiation status (AOR = 1.00, 95% CI [0.77, 1.30], p > .05). System-level factors emerged as the strongest predictors of substantiation. Children who received services had more than six times higher odds of substantiation compared to those who did not (AOR = 6.36, 95% CI [5.19, 7.79], p < .001), and cases processed through the child protective services investigative pathway had substantially higher odds of substantiation relative to alternative response pathways (AOR = 20.64, 95% CI [4.69, 90.75], p < .001). Child age was also significantly associated with substantiation, with older children exhibiting lower odds relative to infants (adolescents: AOR = 0.37, p < .001).

Conclusion and Implications: Findings suggest that observed urban–rural differences in substantiation are better explained by institutional processes than by geographic context alone. Substantiation appears to function as an indicator of system response and service allocation rather than a direct measure of maltreatment prevalence. These results underscore the importance of interpreting substantiation within its procedural and organizational context and caution against using substantiation rates as proxies for maltreatment risk across communities. Implications for research, practice, and policy include the need for greater attention to how system-level mechanisms shape equitable identification and service access for children and families across place.