RISK AND PROTECTIVE FACTORS

Health professionals must remain alert for risk factors that may increase the likelihood of child abuse and maltreatment. Risk factors may be either characteristics of a caregiver or of a child and may go undetected.

Caregiver Risk Factors

When health professionals observe indicators of possible abuse, they should consider whether the presence of risk factors in a caregiver may signal a need to examine the situation more carefully.

The National Child Abuse and Neglect Data System (NCANDS) cites the following caregiver risk factors:

  • Alcohol abuse that is chronic
  • Domestic violence in which the caregiver is the perpetrator or the victim
  • Drug abuse that is chronic
  • Financial problems that do not allow the family to meet basic needs
  • Inadequate housing or homelessness
  • Public assistance participation
  • Any caregiver disability
    (USDHHS, 2021)

Child Risk Factors

The following characteristics of children were determined to be risk factors:

  • Children younger than 4 years of age
  • Special needs that may increase caregiver burden
  • Physical disability
  • Intellectual disability
  • Mental health issues
  • Chronic physical illnesses
    (CDC, 2021d)

Additional risk factors include:

  • Social isolation
  • Family disorganization, dissolution, and violence, including intimate partner violence
  • Parenting stress, poor parent-child relationships, and negative interactions
  • Community violence
  • Concentrated neighborhood disadvantage (e.g., high poverty and residential instability, high unemployment rates, and high density of alcohol sales outlets)
  • Poor social connections
    (CDC, 2021d)

Another risk factor is race. There is a problem of racial disproportionality and disparity in the child welfare system. Families of color are likely to receive disparate treatment within the system. Higher rates of poverty are strongly related to minority status, but racial bias and discrimination must also be considered. Structural racism, such as the exclusion of African Americans as home buyers, can be linked to child abuse since African American families have been unable to build wealth without owning homes, and are thus often compelled to live in neighborhoods associated with poverty, which is a known risk factor for abuse and neglect (CWIG, 2021).

Risk factors for human trafficking among youth populations include those youth:

  • In the foster care system
  • Who identify as LGBTQI
  • Who are homeless or runaway
  • With disabilities
  • With mental health or substance abuse disorders
  • With a history of sexual abuse
  • With a history of being involved in the welfare system
  • With family dysfunction
  • Who are foreign nationals
  • Who are living on their own
    (AFRJ, 2018)
PARENTAL SUBSTANCE ABUSE AND CHILD ABUSE

Parental substance abuse greatly increases the incidence of child abuse and neglect. A review of research on parental substance abuse and its impact on children showed that:

  • 1 in 5 children in the United States live in homes with parental substance abuse.
  • Parents who are chemically dependent are unable to effectively parent their children.
  • The health and development of children is negatively impacted by parental substance abuse.
  • Children who grow up in homes with prevalent substance abuse are more likely to misuse drugs and alcohol since such norms are established at a young age.
    (Thatcher, 2020)
ACE STUDY

Many children suffer multiple types of abuse, which increases their risk of serious health consequences as adults. The Adverse Childhood Experience (ACE) study, published in 2009, investigated the association between childhood maltreatment and later-life health and well-being.

The findings suggest that certain negative experiences in childhood are major risk factors for illness, poor quality of life, and death later in life. The more adverse childhood experiences that were experienced by an individual, the greater the risk of developing:

  • Substance abuse
  • Chronic health problems
  • Mental illness
    (CDC, 2021b)

Protective Factors Against Adverse Childhood Experiences

Individual, family, and community protective factors safeguard children from experiencing adverse effects such as abuse and neglect. There is scientific evidence to indicate that a supportive family environment and social networks have a protective effect against adverse childhood experiences.

Individual and family protective factors include:

  • Nurturing relationships in the family
  • Stable family relationships where children are safe, cared for, and supported
  • Children having positive peer relationships
  • Children being successful in school and education being valued by the family
  • Children having relationships with caring adults outside the family
  • Families able to provide shelter, food, clothing, and healthcare for children
  • Caregivers having college degrees or higher education
  • Caregivers being consistently employed
  • Families having a good social support network
  • Caregivers monitoring children and enforcing rules
  • Adults resolving conflict in a nonviolent manner
  • Families participating in fun activities together

Community protective factors include:

  • Access to financial assistance in the community
  • Access to medical and mental health services
  • Access to housing that is safe and stable
  • Access to good-quality childcare
  • Access to good-quality preschool
  • Access to good-quality afterschool programming
  • Access to work opportunities with policies that are supportive to families
  • Strong partnerships in the community between businesses, healthcare, government, and other institutions
  • Residents feeling connected and involved with one another
  • Violence not being tolerated
    (CDC, 2021c)