Child maltreatment investigations are more common than is generally recognized when viewed across the lifespan. Building on other recent work, our data suggest a critical need for increased preventative and treatment resources in the area of child maltreatment.

This article reports rates of recidivism among initially substantiated and initially unsubstantiated child maltreatment events to determine if substantiation status is associated with higher risk of recidivism. This is an important question given recent concerns that unsubstantiated cases may have as high or almost as high a risk of recidivism as do substantiated cases. The data are analyzed at both the victim level and the case level, divided by type of maltreatment, and followed for 4.5 years. The data used are administrative and combine a series of state databases with census data. Analyses are performed at the bivariate and multivariate (Cox proportional hazards model) levels. The main finding is that unsubstantiated cases are at high risk for recidivism, in many cases as high a risk as substantiated cases. Implications for practice, policy, and research are presented with a focus on the importance of providing preventative services to unsubstantiated cases.

Although our findings do not preclude the possibility of racial bias, these findings suggest that racial bias in reporting and in the child welfare system are not large-scale drivers of racial disproportionality. Our data suggest that reduction of black/white racial disproportionality in the child welfare system can best be achieved by a public health approach to reducing underlying risk factors that affect black families.

Child maltreatment chronicity as measured by official reports is a robust indicator of future negative outcomes across a range of systems, but this relationship may desist for certain adult outcomes once childhood adverse events are controlled. Although primary and secondary prevention remain important approaches, this study suggests that enhanced tertiary prevention may pay high dividends across a range of medical and behavioral domains.

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