Comparison of trends in CPS reports of child maltreatment and child maltreatment-related mortality across time, place and race/ethnicity.

Child maltreatment is a persistent public health problem in the United States. Child Protective Services (CPS) data are the de facto data source for child maltreatment surveillance, despite these data's established limitations. Maltreatment-related mortality could be a complementary source of child maltreatment surveillance data. We calculated trends over time, and patterns across state and by race/ethnicity, comparing child maltreatment report rates to child maltreatment-related mortality rates, between 2005 and 2020. These two measures of maltreatment show different time trends and patterns by state and race/ethnicity. Time trends in maltreatment-related mortality decreased slightly across the study period for all racial/ethnic groups, while maltreatment report rates increased, particularly for Non-Hispanic Black children. Reports and mortality data revealed very different pictures of which states had the highest and lowest maltreatment rates, overall and by race/ethnicity. Only 14 states had report and mortality rates in the same tertile, with less alignment when stratified by race/ethnicity. Patterns in child maltreatment report rates and death rates do not align. Future work should consider additional sources of data to improve maltreatment surveillance. These findings highlight the need to identify a valid and consistent approach to capture patterns of maltreatment in the United States.