JAMA Netw Open. 2025 Dec 1;8(12):e2551677. doi: 10.1001/jamanetworkopen.2025.51677.
ABSTRACT
IMPORTANCE: Approximately 2000 children die each year of child abuse and/or neglect. Foster care is designed as a targeted intervention to reduce harm to children, but its association with child maltreatment mortality is not well understood.
OBJECTIVE: To examine whether foster care entry rates are negatively associated with rates of child mortality due to child abuse and/or neglect.
DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional study assessed associations between child maltreatment mortality rates and foster care entry rates at the state level using administrative data from all US states from January 1, 2010, to December 31, 2023 (N = 700 state-years). Administrative records on all children in state-supervised foster care and all children whose death was attributed by child welfare agencies to child maltreatment were assessed.
EXPOSURES: Number of children entering foster care per 1000 child population.
MAIN OUTCOMES AND MEASURES: Number of child fatalities due to child abuse and/or neglect per 100 000 child population.
RESULTS: The study analyzed 3.4 million records of children in state-supervised foster care from 2010 to 2023 and 24 108 child fatalities that states attributed to child abuse and/or neglect. In 2023, states reported a mean (SD) of 2.62 (1.85) deaths per 100 000 child population and reported a mean (SD) of 3.21 (1.75) entries into foster care per 1000 child population. No evidence was found of a negative association between state-year level foster care entry rates and state-year-level child maltreatment mortality rates (β = 0.17; 95% CI, 0.01-0.34).
CONCLUSIONS AND RELEVANCE: In this cross-sectional study, child maltreatment mortality rates did not appear to decrease with higher foster care entry rates or increase with decreasing foster care entry rates. This evidence suggests that there is not a negative association between child maltreatment mortality rates and foster care entry rates.
PMID:41468015 | DOI:10.1001/jamanetworkopen.2025.51677
