Child maltreatment, also known as child abuse and neglect, is a serious societal problem in the United States in general, and California in particular. Nationally, an estimated 3.3 million referrals, including 6.0 million children under the age of 18, were made to Child Protective Services agencies in 2005. An estimated 3.6 million of these children received investigations or assessment (48.3 children per 1,000) and 899,000 children were found to be victims of child maltreatment for a national rate of 12.1 per 1,000 children. The majority of victims experienced neglect (63%), 17% were physically abused, 9% were sexually abused, and the rest experienced other types of maltreatment (e.g., emotionally or psychologically abused, medically neglected) with some children victims of multiple types of maltreatment. There were an estimated 1,460 child deaths due to abuse or neglect, the most severe and tragic consequence of maltreatment ( http://www.acf.hhs.gov/programs/cb/pubs/cm05/index.htm)

For 2005, California child welfare data show nearly one half million children ages 0-17 (482,000) had at least one child maltreatment referral (51.1 children per 1,000) and over 109,000 of these children had their referrals substantiated (11.4 per 1,000) ( http://cssr.berkeley.edu/CWSCMSReports/referrals/) Nearly 500 children are hospitalized yearly for severe maltreatment and our best estimates are that 130-140 children die each year of child maltreatment in California.

There are multiple systems designed to address different aspects of child maltreatment in California: child welfare, law enforcement and the courts, health care, and community-based organizations. But in terms of population-based surveillance, data from these justice and service systems are incomplete and generate an inconsistent picture of the nature and scope of the problem. Given these complexities, there is no consistent, coordinated surveillance system currently in place to track fatal and non-fatal child maltreatment. The EPIC Branch operates several related projects addressing the development of child maltreatment surveillance and prevention with a public health approach.

1.  Referrals to Department of Social Services Child Protective Services (CPS)
2. Substantiated cases of child maltreatment after CPS investigation
3. Children hospitalized with child maltreatment, and
4. Child deaths due to child abuse or neglect

The EPIC Branch of the Department of Health Services (DHS), in conjunction with the California State Child Death Review Council, is engaged in several surveillance efforts to develop more reliable and valid estimates of child maltreatment in California. The EPIC Branch is currently conducting the following surveillance programs.

Child Maltreatment Prevention and Surveillance Programs

• Fatal Child Abuse and Neglect Surveillance (FCANS) Program
• California Child Abuse and Neglect Reconciliation Audit
• Child Maltreatment Surveillance Cooperative Agreements with the Centers for Disease Control and Prevention (CDC)
  - Part I: Mortality
  - Part II: Morbidity

Additional Information

Please contact Steve Wirtz, PhD, Research Scientist, at steve.wirtz@cdph.ca.gov.