Community characteristics associated with child abuse in Iowa.
OBJECTIVE
Various demographic and community characteristics are associated with child abuse rates in national and urban samples, but similar analyses have not been done within rural areas. This study analyzes the relationships between reported and substantiated rates of child abuse and county demographic, health care resource and social services factors in a predominantly rural state in the US.


METHODS
County-level data from Iowa between 1984-1993 were analyzed for associations between county characteristics and rates of child abuse using univariate correlations and multivariate stagewise regression analysis. Population-adjusted rates of reported and substantiated child abuse were correlated with rates of children in poverty, single-parent families, marriage and divorce, unemployment, high-school dropouts, median family income, elder abuse, birth and death rates, numbers of physicians and other healthcare providers, hospital, social workers, and number of caseworkers in the Department of Human Services.


RESULTS
Rates of single-parent families, divorce and elder abuse were significantly associated with reported and substantiated child abuse in multivariate analysis, while economic and most health care factors were not. Reporting and substantiation rates differed across districts after adjustment for multiple factors including caseworker workload.


CONCLUSIONS
In this rural state, family structure is more significantly associated with child abuse report and substantiation rates than are socioeconomic factors. The level of health care resources in a county does not appear to affect these rates.
Weissman
Alicia M
AM
Department of Family Medicine, College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
Jogerst
Gerald J
GJ
Dawson
Jeffrey D
JD
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000706:statistics & numerical data*; D003153:Community Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D003710:Demography; D004243:Divorce / Q000706:statistics & numerical data; D004552:Elder Abuse / Q000706:statistics & numerical data; D005191:Family Characteristics; D005843:Geography / Q000706:statistics & numerical data; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D017533:Marital Status; D008875:Middle Aged; D012044:Regression Analysis; D012111:Residence Characteristics; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data*; D015406:Single Parent / Q000706:statistics & numerical data; D012949:Social Work, Psychiatric; D000078329:Workforce